Generally, if whilst you are a patient in the Park Hospital a significant swelling is noticed, this could be a postoperative haematoma requiring surgical drainage. This presents within 12 hours of having surgery and would have been diagnosed whilst as an inpatient. It is due to arterial bleeding. Mr Harriss has only had this experience in post-op micro-surgical vasectomy reversal patients 3 times in over 2000 cases.
In our experience there are two types of lumps after vasectomy reversal that patients become concerned about in the postoperative period, either a “third testicle” approximately two to three centimetres in size occurring in the midline underneath the wound between the testes or a lump above the testis in the spermatic cord.
“My lump feels like a third testicle”
This is due to a collection of blood or exudate in the space between the Dartos muscle and the skin underneath the wound. It is called a Seroma which is an accumulation of fluid in the tissue that can occur after surgery. The fluid, called serum, leaks out of nearby blood and lymphatic vessels (we are not talking about the vas deferens here). Cells are typically present in the fluid, which is normally clear.
This lump will either decrease in size naturally and quite suddenly or resolve over two to three months. Occasionally Mr Harriss has needed to aspirate a seroma if it persists beyond three months. Normally, we advise that you attend your GP to check that the lump is not caused by anything else, for reassurance. If at 3 months, the lump is still present and has not reduced in any size, then Mr Harriss will be happy to examine you in clinic when you attend for your three month postoperative semen analysis at CARE in Nottingham.
“My lump feels like a pea in the spermatic cord”
Patients often feel lumps in the spermatic cord above the testicle related to the rejoin site or to suture material used to ligate internal veins within the spermatic cord. Providing that there is no excessive pain then this is unlikely to be an infection or sperm granuloma and patients should be reassured that most lumps after vasectomy reversal resolve within three months but again Mr Harriss would be happy to see you in clinic for an examination at the three months semen analysis.