Possible Causes of Post Vasectomy Pain Syndrome (PVPS)

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Post Vasectomy Pain Syndrome (PVPS)
Vasectomy Pain, Swelling & Possible Complications
Complications Following No-Scalpel Vasectomy Procedure

• A non-meticulous “rough” surgery where significant amounts of tissue and nerves have been disrupted and/ or tied that have caused lingering irritation of the nerves. While this may be one of the more frequent causes of post vasectomy pain syndrome of post vasectomy pain syndrome one can imagine that it would be less common in the patients of experienced vasectomists.
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• A sperm granuloma could develop post vasectomy that becomes inflamed and aggravates the surrounding nerve endings. The sperm granuloma is a build up of extravisated sperm at the end of the cut vas tube end. The reason why a sperm granuloma may develop is not well understood.
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• Inflammation and swelling of the surrounding nerves called neuroma could develop. This could cause intermittent or constant pain.
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• A congestive state in the epididymis from back pressure to the epididymis and testes from performing a closed-ended vasectomy. Some authors believe that by blocking both the upper and lower cut ends of the vas tube the normal passage of sperm from the penis and away from the epididymis and testes causes a build up of pressure and ensuing pain. Studies have shown that this situation can be prevented to a large degree by performing an open-ended vasectomy. This is one in which the lower end or testicular end of the cut vas is left open thereby allowing the sperm to drain out of the tube preventing a build up of pressure.
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• A vasectomy carried out too close to the epididymis can cause chronic pain and inflammation at the epididymis.
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• Some speculate that post vasectomy pain could be mediated by an immune reaction. It is known that antibodies to sperm are produce by the body after vasectomy. It is possible that these antibodies can react with testicular epididymal and or scrotal tissue to cause an inflammatory reaction.
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• An undiagnosed depression that is totally unrelated to the vasectomy. In these cases the vasectomy and the perceptions of continued pain become a somatization reaction i.e a physical expression of psychological pain.
  Depression can also be caused by post vasectomy pain syndrome. The depression can keep the pain perceptions ongoing even once the original cause of the pain is long gone.
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• Shorter term causes of post vasectomy pain include infection and post operative inflammation which should resolve easily with the appropriate medications and not linger long enough to fall into the category of becoming a syndrome.
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• While there is no evidence that vasectomy causes prostatitis, new cases of prostatitis have been infrequently described post vasectomy. So prostatitis should be ruled out by digital exam and possibly scope.
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• If none of these presents itself, then time is another factor.
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