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Swollen testicle one year post vasectomy

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    My husband got a vasectomy 8 years ago. A year after the surgery I noticed that his right testicle is a lot larger than the left. Is this something to be alarmed about? He has had a check up since, and nothing abnormal was found.

    Dr. Edward Karpman

    A swollen testicle immediately after a vasectomy can be associated with normal post-procedure swelling or can represent a collection of blood in the scrotum called a hematoma. A sperm granuloma can also occur after a vasectomy, especially when the testicular end of the vas deferens is left open or un-tied. Sperm granulomas can be felt as a swelling in the scrotum and can occur on one or both sides. These are benign collections of fluid/sperm from the open end of the vas deferens which usually do not cause any problems.

    However, when the swelling occurs as far out from the vasectomy as described (one year), we can’t overlook the fact that another problem might be occurring in scrotum, unrelated to the vasectomy. I would be most concerned about a testicular tumor, which requires IMMEDIATE urologic evaluation and treatment. Testicular tumors occur most frequently in the 15-45 year old age group and are not related to the vasectomy. The swelling can also represent a benign process such as a fluid collection around the testicle (hydrocele) or emanating from the epididymis (spermatocele). The latter two conditions might be bothersome, but are not life-threatening. A troublesome hydrocele or spermatocele can be easily corrected by a surgical procedure.

    As you can see, scrotal swelling may represent many different pathologic processes. Whether or not this swelling is related to your vasectomy can only be determined after a careful physical examination by your physician. If there is any doubt as to the nature of the swelling, a scrotal ultrasound is always helpful in differentiating between the causes.

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