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In about 2% of cases, bleeding inside the scrotum can cause a painful swelling known as a hematoma. In these cases, the scrotum swells up shortly after vasectomy. The doctor should be called immediately. Risk for hematoma is less in no–scalpel vasectomy.
Infections occur in about 4% of men after standard vasectomy. The risk for infection is reduced with no–scalpel vasectomy. The incision site may become infected, causing a redness and swelling around the incision. Antibiotics, antimicrobial creams or ointments, or both, along with hot baths several times a day will usually clear the infection in a few days.
After vasectomy, sperm often leaks from the vasectomy site or from a rupture in the epididymis, the tightly coiled, thin tube that connects the testicle to the vas deferens. Sperm has very strong antigenic qualities, that is, the immune system views sperm as foreign agents and attacks them. Sperm leakage provokes an inflammatory reaction. The body forms pockets to trap the sperm in scar tissue and inflammatory cells. Firm balls of tissue about one–half inch in diameter then form, these are known as sperm granulomas. They occur in about 60% of vasectomy patients. In about 3% to 5% of cases, sperm granulomas obstructing the already blocked ends of the vas deferens can generate pressure build–up in the epididymis, causing a rupture from the pressure of the fluid. If the epididymis ruptures, the testicles can become enlarged and painful. A damaged epididymis can be repaired, but if the patient later wishes a reversal of the vasectomy, disruption of this tiny tube makes success much less likely.
In about one percent of all vasectomies, the epididymis becomes so congested with dead sperm and fluid that the patient feels a dull ache in his testicles. This condition, called chronic orchialgia, usually disappears within six months.
Epididymitis occurs when an inflammation at the site of the vasectomy causes swelling of the epididymis. This condition occurs within the first year and can be treated with heat and anti–inflammatory medications. It usually clears up within a week.