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Post operative testicular pain

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    I had my vasectomy on March 16, and the weekend-after recovery seemed to go fine. In fact, aside from a small amount of chafing and redness around one of the incisions, I experienced no discomfort at all. So on the Saturday of the following weekend, 8 days after the procedure, I had sex just to make sure everything was going to work OK, and it felt fine.

    However, the day after that was when I began to experience testicular pain, which I have now had constantly for a week. This alarms me because I experienced no pain of this kind at all for the entire week immediately following the procedure, and now it’s constant.

    It’s very uncomfortable to refrain from any physical exercise or sexual activity, but I am concerned that this dull ache in my testicles might continue for a prolonged period, and I am afraid to do anything that might aggravate the condition.

    What guidance can you offer me as to what to expect, and as to managing this condition so it does not get worse?

    Dr. Edward Karpman

    Pain in the testicle after a vasectomy can be caused by some type of trauma to the testicle or epididymis. The testicle and epididymis undergo a state of transition after a vasectomy where these structures must accommodate sperm that can no longer be released. During sexual intercourse, the testicle or epididymis could have been injured.

    Initial treatment for any type of pain should be conservative and focus on relieving any inflammatory component that might be causing the pain. Over-the-counter anti-inflammatories are usually recommended for a period of 2-4 weeks. Warm soaks in a bath tub for 20 minutes a day also help relieve any discomfort associated with inflammation. Finally, a scrotal support or tight underwear help relieve any pressure related to the pull of gravity on the testicles.

    Bacterial infections of the testicles are highly unlikely after a vasectomy since these spread from the urinary system backwards, up the vas deferens into the epididymis and testicle. This pathway is no longer available for bacterial transmission after vasectomy, if the procedure was successful. Vasectomy does not prevent other pathologic processes such as testicular torsion from occurring. People susceptible to this condition can develop acute onset of pain that is excruciating. This is an urological emergency that requires immediate attention from a physician.

    Any pain pain that persists for longer than a week or two after conservative treatment requires evaluation by a physician. However, most of the pain that men experience after a vasectomy is temporary and relieved with conservative measures.

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