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Had vasectomy. Have testicle pain, swelling and mass on testicle. Suspected epididymitis, prescribed antibiotic. Cause?

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Practicing since : 2005
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Two years ago I had a vasectomy. This week I had some aching in my right testicle. Three days later it started to swell and I detected a raisin-sized mass towards the bottom and right side of the testicle. I went to the doctor today and he said he thought it was a case of epididymitis. He prescribed some anti-biotics for a few weeks and told me to check back with the urologist who performed the surgery at the end of the drug regimen. He didn't think the mass was cancerous due to its location. The mass is what has me worried. What is it? I have read of sperm granulomas and spermatoceles, but from what I understand, these are typically located at the top of the testicle. Both ends of the vas deferens were cauterized during the procedure if that makes any difference. The pain and swelling happened two months ago after having sex for a few days in a row with my wife. The same thing happened again in this scenario. I appreciate any answers you may be able to provide.
Posted Tue, 8 Oct 2013 in Men's Health
Answered by Dr. Manuel C See IV 32 minutes later
Brief Answer:
I believe it is a sperm granuloma.

Detailed Answer:
Sperm granuloma are caused by sperm leaking from a vas deferens into the tissue around it and forming a small lump. The sperm that leaked will cause an inflammatory reaction which causes the pain and swelling in the area. The location of the spermatocoele can be at the top or bottom of the testis anywhere along the tract of the vas deferens.

Usually it will resolve with pain medications and warm compress on the area. In severe cases where in the pain and granuloma is causing severe alteration in quality of life and if it interferes with your daily activity then surgery may be an option to remove the granuloma. Surgery can be done under local anesthesia as an out patient procedure but this is usually a last resort.

The doctor is right in saying that mass in that area is usually benign (non-cancer) 99% of the time. I would suggest a testicular ultrasound just to be sure if the mass you are feeling is in the testicle or outside the testicle (in the vas segment).

I hope i was able to answer your questions and concerns clearly. Thank you very much.

Yours Truly,

Manuel C See IV, M.D. DPBU
Above answer was peer-reviewed by
Follow-up: Had vasectomy. Have testicle pain, swelling and mass on testicle. Suspected epididymitis, prescribed antibiotic. Cause? 23 hours later
Should I wait to finish the antibiotics as instructed or should I see my urologist sooner to get the ultrasound scheduled?
Answered by Dr. Manuel C See IV 19 minutes later
Brief Answer:
Finish the antibiotic then see your Urologist.

Detailed Answer:
Good Day and Thank you for the follow-up question.

I would advise to finish the antibiotic coverage then see your Urologist. That way we can see what will happen after the antibiotic duration, number 2. The Urologist would also would want you to finish the antibiotics first to rule out an infectious process then if it doesn't resolve then get the ultrasound and we'll see what is inside the scrotum.

Thank you again and have a good day.
Above answer was peer-reviewed by
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