Chris’ experience: Post-vasectomy hematoma

I had a no-scalpel vasectomy in the fall of 2008. At the initial appointment, the doctor told me I had a varicocele on my left side, but that it was common and I could still have the procedure. A week or so later, the procedure was quick (10-15 mins) and virtually painless. The doctor and his nurse seemed very familiar with it. As advised by them, I lay in bed for the rest of the day and the following day, iced the area, and took it easy for the next week. I had no bruising at all–no discoloration of the scrotum–and the puncture wounds seemed to close up quickly. I didn’t feel a need to take the Vicodin he had prescribed or any other pain killers.

During the first week or so, I had some minor discomfort, especially on the left side. It felt like my underwear was pinching. I kept wanting to rearrange it and it was difficult, at times, to get comfortable. Still, I could move around more or less normally (if a little gingerly) and felt like I was making good progress. Towards the end of the week, I noticed what felt like a small hard button at the top end of the left vas i.e. on the section of the severed vas connected to the abdomen, not the section connected to the testicle. I checked on the right side and thought I felt the same thing there. It was tender to the touch.

On day 11, the discomfort suddenly increased. It came on, I think, after walking my daughter approx 1/2 a mile to school (which I had done the previous few days without a problem) and was enough to make me feel faint. The pain was just on my left side. I lay down and iced the left side of my scrotum, which actually made it more uncomfortable because it made everything feel tighter; it was less uncomfortable when my scrotum was not so cold and bunched up. I now have a swelling roughly the size of my testicle against the abdomen/base of the penis at the top of the left side of the scrotum. It is hard to touch and very tender. It feels like it is the vas itself, only all swollen up. It is quite painful for me to walk around or even just change position and I’ve spent the last couple of days in bed. There’s still no bruising/discoloration on the scrotum.

From what I’ve read on your site and elsewhere, it seems likely that this is a hematoma. Perhaps the existing varicocele made bleeding more likely and those weak veins hemorrhaged. Does that make sense?
I wrote the above on 10/26/08 but wanted to update the story because it might be helpful for people looking for similar stories to their own.

So, the update is that I went to the doctor the next day and he confirmed that it was a hematoma. He said it was within the spermatacord, which had created a tamponade. That’s why it felt so hard, the cord was totally inflated with blood. He told me to take warm baths daily and prescribed an anti-inflammatory (Celebrex, 200mg daily). I kept up the baths for a week or so and took the medicine for about 2 weeks. This was less time than prescribed because I developed a rash and my family practitioner thought it could possibly be caused by Celebrex. My father-in-law, who is a physician, was surprised I’d been prescribed Celebrex at all, as he seemed to think it was linked to a higher incidence of heart attacks; he’s a psychiatrist, so not exactly an expert, and I never checked whether this was correct.

The pain was already less acute the day I saw the doctor and continued to decrease fairly rapidly. Within a couple of weeks, the swelling had gone down considerably and ceased to be uncomfortable; now it has all but disappeared. I’m very relieved because some people talked of 3-6 month recovery periods, with on-going discomfort after that. I wonder if my swelling was limited and my recovery shorter because the hematoma was contained within the spermatacord. My only concern is that the vas may have reconnected itself on that side (I read somewhere that this was possible after a hematoma) because, unlike on the other side, I cannot feel an obvious gap. However, it’s hard to tell whether this is true (or whether the swelling has completely gone down) because of the varicocele on that side, which makes the cord feel thicker and lumpier.

Your website was a real help to me, and I hope my account might be reassuring to people having similar problems – I’m only sorry I didn’t take any photos! Overall, I’m very glad I had the vasectomy, despite the pain for those few days and the discomfort for a week or two longer than I expected.

Submitted by Chris