Post-Vasectomy Pain: Discomfort During Intercourse

Since the sterilization, I have been experiencing abdominal discomfort during intercourse?

Last December, I underwent a vasectomy.
The incision on the right side healed well and the stitches fell out on their own, but the left side healed slowly.
During a follow-up visit, I showed the doctor the left incision, and he said that the inside had healed, but the stitches had not been absorbed and had not fallen out.
I lay on the operating table and couldn't see how the doctor handled it, but I felt that he was pulling and cutting.
It was very painful, and I wasn't sure if it was related to the vasectomy, but this issue arose after the procedure; I did not have this problem before the vasectomy.

I can feel a small, hard, round object, about the size of a grain of rice, located near the base of the penis, which I can trace from a tube on the left testicle.
Since I am hesitant to press too hard, I can only feel that it is a hard object.
When I touch or slightly squeeze it, I experience a slight feeling of pressure in my abdomen, and during sexual activity, the feeling of pressure and pain becomes very pronounced.
This pain does not occur every moment during sex; I cannot determine exactly when it arises, but it may be when I accidentally bump against this hard object.
In my daily life, I do not experience this pain; it almost exclusively occurs during sexual activity.

What could this hard object be? Here is the image: https://imgur.com/ZXHjgeL

Mr. Zhang, 20~29 year old female. Ask Date: 2020/02/26

Dr. Li Xinyi reply Urology

The area of ligation may develop a hard lump due to the sutures and surgical cauterization.
Most people will experience this, and a larger lump may indicate that the inflammation was more severe at the time.
However, generally speaking, this is not a cause for concern, and some individuals may see gradual improvement over time.
It can take up to six months for fibrotic tissue to resolve.
Additionally, some people may feel a sense of fullness during intercourse after the procedure, but it is less common to experience pain.
If pain occurs, it may indicate that localized inflammation has not completely resolved.
It is advisable to have a doctor examine the area before considering medication.

Reply Date: 2020/02/26

More Info

Post-vasectomy pain, especially discomfort during intercourse, can be a concerning issue for many men. It’s important to understand that while vasectomy is a common and generally safe procedure for male sterilization, some patients may experience complications or discomfort during the recovery phase.
From your description, it seems that you have a hard, pea-sized lump near the base of your penis, which is causing discomfort during sexual activity. This lump could potentially be a few different things. One possibility is that it is a granuloma, which is a small area of inflammation that can occur after surgery. Granulomas can form when the body reacts to the surgical sutures or tissue changes, and they may feel firm to the touch. Another possibility is that it could be a remnant of the vas deferens or a small cyst that has formed in the area.
The discomfort you’re experiencing during intercourse could be related to this lump, especially if it is being compressed or manipulated during sexual activity. The sensation of pressure or pain in the abdomen when you touch the lump may indicate that it is indeed affecting nearby structures or nerves.
It’s also worth noting that post-vasectomy pain syndrome (PVPS) is a recognized condition that can occur in some men after the procedure. This syndrome can manifest as chronic pain in the scrotum, testicles, or pelvic area, and it can sometimes be exacerbated during sexual activity.
To address your concerns, here are several steps you can take:
1. Consult Your Urologist: It’s crucial to follow up with your urologist regarding the lump and the pain you’re experiencing. They may want to perform a physical examination and possibly imaging studies (like an ultrasound) to better understand what the lump is and whether it requires treatment.

2. Pain Management: If the pain is significant, your doctor may recommend pain management strategies. Over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate discomfort. In some cases, prescription medications may be necessary.

3. Avoid Aggravating Activities: Until you have a clearer understanding of what the lump is, it may be wise to avoid activities that exacerbate the pain, including certain sexual positions or vigorous physical activities.

4. Consider Physical Therapy: If the pain persists, pelvic floor physical therapy may be beneficial. A specialized therapist can help address any muscular or nerve-related issues that may be contributing to your discomfort.

5. Surgical Options: If the lump is determined to be problematic and causing significant pain, your urologist may discuss surgical options to remove it or address any underlying issues.

6. Monitor Symptoms: Keep track of your symptoms, including when the pain occurs, its intensity, and any other associated symptoms. This information can be valuable for your healthcare provider in determining the best course of action.

In summary, while post-vasectomy pain can be distressing, it is essential to communicate openly with your healthcare provider about your symptoms. They can help determine the cause of the lump and the discomfort during intercourse, and together you can develop a plan to manage your pain effectively. Remember, you are not alone in this experience, and many men face similar challenges after a vasectomy.

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