Anyone else on profile for vasectomy complications?

pain syndrome is distinct from postprocedure pain; however, there is some controversy regarding its definition and therefore prevalence [54]. Historically, rates for post-vasectomy pain syndrome have been reported as very low (<1 percent). However, surveys have found that the incidence of "troublesome" post-vasectomy pain is reported by approximately 15 percent of men, with pain severe enough to impact quality of life in 2 percent; survey respondents, however, may not have been representative of all post-vasectomy men [55-58].

The cause of most post-vasectomy pain syndromes is chronic congestive epididymitis [55]. Testicular fluid and sperm production remain constant following vasectomy. The majority of this fluid accumulates in the epididymis, which then swells. While asymptomatic in most men, some will develop a chronic dull ache in the testes, which is made worse by ejaculation. Other causes or contributors to pain syndromes include the formation of sperm granuloma, or nerve entrapment at the vasectomy site.

First-line therapy for post-vasectomy pain is the administration of nonsteroidal anti-inflammatory medications and warm baths. If unsuccessful, local nerve blocks or steroid injections may be performed by a pain specialist. If the post-vasectomy patient's discomfort is localized to a tender, palpable granuloma, this may be excised, followed by fulguration of the leaking end of the vas [59].

Refractory cases may require surgery, including either vasectomy reversal (vasovasostomy) or complete epididymectomy. Vasovasostomy successfully relieves pain in up to 70 to 82 percent of well-selected patients.