Ask the Doctor

From Darrin:-
Ever since I had my vasectomy there has been a small lump about the size of a large pea right where the cut was made. Originally on both sides, but one has disappeared. What would this be, and should it be there? I had the op 3 years ago.

The good news is that any “lump” on the scrotal skin that has stayed the same or decreased in size over a three year period is unlikely to be dangerous to your health. Unfortunately, I don’t have a picture to better characterize this “lump”. Some of the possibilities of a lump in the skin over the previous vasectomy sites include keloids and hypertrophic scars. Both of these are an overgrowth of scar tissue that some people are predisposed to developing. This is particularly seen in more pigmented individuals and these individuals are likely to develop similar keloids or hypertrophic scars at other surgical sites or sites of injury on the body.

This can also represent a suture granuloma. This happens when the body does not completely absorb the suture if one was used for closing the surgical sites. Instead the body “walls” off the suture because the body recognizes it as a foreign object. Patients can also develop inclusion cysts at the surgical site. These are small pockets of skin that were incorporated into the the healing wound.

Finally, this can also be an ingrown hair follicle. Most men undergo scrotal shaving prior to a vasectomy and ingrown hairs can be a problem when they grow back. The fact that one of the “lumps” has disappeared spontaneously, albeit after a prolonged period of time, suggests that this process is benign and likely related to one of the above mentioned conditions.