Occasionally a vasectomy patient may develop a painful nodule at the site where the vas deferens was divided. Most often this is on one side but can involve both vas deferens.
This is estimated to occur in about 1 to 2 out of every 100 patients or 1.5%.
Nodules after vasectomy: Normal or abnormal?
Initially after a vasectomy the vas deferens division sites will be tender from normal, reactive inflammation. The sites were the vas deferens were divided and exposed to thermal coagulation will go through a normal reactive healing process. The vasectomy sites on each vas deferens will be tender for the first seven (7) to fourteen (14) days.
As sperm exits the bottom vas deferens, which is intentionally left open, they will collect at the very end of the opened vas deferens. These areas will form small sperm granulomas about the size of a pea and these nodules will be tender initially. This tenderness will gradually resolve.
These vasectomy site nodules are often higher on the vas deferens than most patients realize and they can very often be felt near the base of the penis. It is common for these nodules to be present after vasectomy and to be tender for up to six (6) months.
If tenderness persists for more than six (6) months then these nodules could represent symptomatic granulomas or neuromas (abnormal collection of healing nerves). Sometimes patients will notice they are more tender with erections or ejaculation.
Occasionally anti-inflammatory medication or injections of anesthetic may improve the discomfort. Often a second vasectomy procedure with nodule excision may need to be performed to remove these painful nodules. If a second procedure is performed the nodules may reform but most often they will not.