Painful lump in scrotum after vasectomy: Causes, Diagnoosis, Symptoms

Vasectomy is a surgical procedure that involves the cutting and tying of the vas deferens. Vas deferens is the tube through which sperm travels towards the urethra. After a vasectomy, men are unable to impregnate a woman.

Recovery from vasectomy is usually not with complications. Sometimes, a lump in the scrotum after a vasectomy can occur. The lump can be totally harmless or, possibly, for some reasons harmful. It is advisable that you check with your doctor if you are to notice such a lump.

In some cases, such a lump could be a sign of malignancy. This doesn’t however mean that vasectomy causes cancer. This article discusses hard or painful lumps in the scrotum after vasectomy: Causes, Diagnosis, Symptoms and treatment.

Causes of lump in scrotum after vasectomy

Vasectomy is done through the scrotal skin. A doctor makes an incision and cuts the vas deferens. In some procedures, the vas deferens can be clipped, tied or cauterized. The main aim is to prevent sperm from being ejaculated. Below are the possible causes of a lump in the scrotum after vasectomy:


Also referred to as scrotal hematoma, it develops when blood collects in the scrotum. This is mainly caused by continued bleeding after vasectomy. It may also be caused by an injury or trauma sustained during the operation. Once outside blood vessels, blood usually clots to form a hard, immovable lump.

Scrotal hematoma after vasectomy is considered generally harmless. The clotted blood gets absorbed slowly back into the body. However, the lump may cause a bit of pain and swelling. Hematoma lumps last for 1-2 months.

Sperm granulomas

Vasectomy doesn’t take away the ability of the testicles to produce sperm. In some cases, sperm may leak at the points where the vas deferens has been cut. The sperm will then collect and form a mass under the skin. With time, a bump will develop. Lumps formed in this manner are not painful.

Sperm granulomas are the leading causes of lumps after vasectomy. The problem is that the condition rarely shows any symptoms in most cases.

Other causes

Some men experience pain and inflammation in the vesicles after vasectomy. This is known as post-vasectomy pain syndrome. This condition has not been found to have a direct association with vasectomy however.

Other forms of testicular lumps may occur with or without vasectomy. A patient may correlate the two in some cases. It is therefore important that you have a lump in your testicles checked by a doctor. Chances are that it could be a benign tumor or a malignant one.

Symptoms of lump in scrotum after vasectomy

A painful lump in the scrotum after a vasectomy is a common symptom of hematoma. The pain occurs not long after the procedure. It can continue for 1-2 months until the blood clot has resolved. About 6% of men undergoing vasectomy will develop a hematoma.

Sperm granulomas can go for a long time without any symptoms. Eventually, a bump will be felt under the skin. The bump is usually without any pain or swelling. This condition has been noted to occur in 6-50% of all vasectomy procedures.

If you experience chronic pain after the vasectomy, you probably are dealing with post-vasectomy pain syndrome. This can be caused by accumulation or leaking of sperm. it could also occur due to some form of injury sustained to the testicles.

Pain and swelling in the testicles are the most common symptoms after vasectomy. The symptoms should go away in the normal period it takes a normal wound to heal. If that does not happen, seek medical attention from your doctor.

Diagnosis and treatment for lump in scrotum after vasectomy

Diagnosis can be done by observing the symptoms and performing physical examination. An X-ray can be considered to confirm the diagnosis.

Hematoma after a vasectomy doesn’t require treatment. It resolves on its own with time. If it is to cause a lot of pain or discomfort, it can be surgically removed. Some painkillers may also help.

Sperm granulomas require surgical correction. If left untreated, the lump will probably keep enlarging indefinitely.

Post-vasectomy pain syndrome can be corrected with pain medications or nerve blockers. In some cases, a vasectomy reversal is the only option that can effectively address the condition.

In some cases, anti-inflammatory medications can be administered. These are however generally used for most types of inflammations such as painful lump on top of foot, cystic lumps, lumps due to allergic reactions and so on. Antibiotics are rarely used when treating lumps after vasectomy. They are more useful for lumps on skin such as sore lump behind ear or infected cysts.

Lump in scrotum after vasectomy and signs of cancer

Getting a vasectomy will not cause cancer. It will also not increase the chances of developing the disease. The problem is that a lump in the scrotum or the testicles can be taken for a side effect of vasectomy even when it is not. It for such reasons that men are advised to get screened once they notice a lump in the testicles or on the scrotum. Below are the common signs of a lump caused by cancer cells:

  • hard, fixed and immovable
  • mostly with irregular borders
  • painless in the initial stages
  • swollen lymph nodes; such as lump behind earlobe or in groin area
  • occurrence of lumps elsewhere in the body, including hard lump in breast in men
  • voice hoarseness
  • sudden weight loss
  • sores that take long to heal
  • bloody discharge in urine
  • pain in the belly
  • can occur on or inside the testicles

Not all cancer lumps will exhibit all these characteristics. In fact, a cancer lump can be painful and smooth. All of them will however keep gaining mass indefinitely.

Note that both testicles are not equally sized. It is normal to have one of your testicles slightly bigger than the other. It is also common to have either of them hanging lower than the other. During self-examination, you will notice lump-like structures on and at the back of each testicle. They are known as epididymis and are normal in a healthy testicle.

Self-care measures for a lump in scrotum after vasectomy

Some self-care measures can help avoid or speed recovery from a lump in scrotum after vasectomy. They include:

Avoid wearing tight underclothes. You can consider a jock strap to keep the testicles from hanging loosely. This will avoid extended damage to these areas. To avoid the element of surprise, consider learning more on topics such as small lumps on the eyelid, signs of testicular cancer lumps, types of lumps on the skin and so on.

Take a break from work or activities that will require you to strain too much. Physical activities may increase the chances of damaging the healing regions of the testicles.

If you are to notice some pain or inflammation on the area that has been operated on, try cold compressing with ice. It will ease pain, reduce inflammation and soothe reddened skin.

Avoid blood thinning medications during the recovery process. Such medications may increase chances of bleeding. Examples of blood thinners include; ibuprofen, aspirin and ketoprofen. PDE5 inhibitors such as sildenafil (Viagra) and tadalafil (Cialis) are also types of blood thinners.

Be sure to talk with your doctor on after-care measures after your vasectomy. While mistakes can occur during the operation itself, how you conduct yourself after may contribute to formation of lumps associated with vasectomy.