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Physical exertion.There is a noticeable enlargement of the epididymides in vasectomized men.[13][14] Sperm sometimes leak from the vas deferens of vasectomized men, forming lesions in the scrotum known as sperm granulomas. Some sperm granulomas can be painful.[15][16] The presence of a sperm granuloma at the vasectomy site prevents epididymal pressure build-up, perforation, and the formation of an epididymal sperm granuloma. It thus lessens the likelihood of epididymal discomfort.[17]One study using ultrasound found that the epididymides of patients with post-vasectomy pain syndrome were enlarged and full of cystic growths.[18]Treatment depends on the proximate cause. In one study, it was reported that 9 of 13 men who underwent vasectomy reversal in an attempt to relieve post-vasectomy pain syndrome became pain-free, though the followup was only one month in some cases.[2] Another study found that 24 of 32 men had relief after vasectomy reversal.[19]Nerve entrapment is treated with surgery to free the nerve from the scar tissue, or to cut the nerve.[20] One study reported that denervation of the spermatic cord provided complete relief at the first follow-up visit in 13 of 17 cases, and that the other four patients reported improvement.[12] As nerves may regrow, long-term studies are needed.One study found that epididymectomy provided relief for 50% of patients with post-vasectomy pain syndrome.[21]Orchiectomy is recommended usually only after other surgeries have failed.[21]^ a b Potts JM (2008). "Post Vasectomy Pain Syndrome". Genitourinary Pain and Inflammation. Current Clinical Urology. Humana Press. pp. 201–209. doi:10.1007/978-1-60327-126-4_13. ISBN 978-1-58829-816-4.^ a b c Nangia AK, Myles JL, Thomas AJ Jr (2000). "Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation". J. Urol. 164 (6): 1939–42. doi:10.1016/S0022-5347(05)66923-6. PMID 11061886.^ Christiansen C, Sandlow J (2003). "Testicular Pain Following Vasectomy: A Review of Postvasectomy Pain Syndrome". Journal of Andrology. 24 (3): 293–8. doi:10.1002/j.1939-4640.2003.tb02675.x. PMID 12721203.^ Manikandan R, Srirangam SJ, Pearson E, Collins GN (2004). "Early and late morbidity after vasectomy: a comparison of chronic scrotal pain at 1 and 10 years". BJU International. 93 (4): 93, 571–574. doi:10.1111/j.1464-410X.2003.04663.x. PMID 15008732. S2CID 44286821.^ Awsare NS, Krishnan J, Boustead GB, Hanbury DC, McNicholas TA (2005). "Complications of vasectomy". Ann R Coll Surg Engl. 87 (6): 87: 406–410. doi:10.1308/003588405X71054 (inactive 1 November 2024). PMC 1964127. PMID 16263006.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)^ "Vasectomy Guideline - American Urological Association". www.auanet.org. Retrieved 2022-04-30.^ Leslie, Thomas A.; Illing, Rowland O.; Cranston, David W.; Guillebaud, John (December 2007). "The incidence of chronic scrotal pain after vasectomy: a prospective audit". BJU International. 100 (6): 1330–1333. doi:10.1111/j.1464-410X.2007.07128.x. ISSN 1464-410X. PMID 17850378. S2CID 23328539.^ Choe, J. M.; Kirkemo, A. K. (April 1996). "Questionnaire-based outcomes study of nononcological post-vasectomy complications". The Journal of Urology. 155 (4): 1284–1286. doi:10.1016/S0022-5347(01)66244-X. ISSN 0022-5347. PMID 8632554.^ McMahon,

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