Vasectomies
In the United States, about 50 million men have had a vasectomy and more than 500,000 men are electing to have one every year. (1) This rate has increased by 26% between 2014 and 2021 and while the reasons for the surgery may vary, one factor is the ease at which vasectomies are now conducted, with the option for an office-based minimally invasive procedure that is quick to perform and can be done under local anesthesia.(2)
Common complications related to Vasectomies:
While the frequency of risks of complications are low, the most common ones and their incidence rates are: (1,3)
-Sperm granulomas: 40%, this may be a hard and sometimes painful lump typically the size of a pea, from sperm leakage from the cut vas deferens. It may occur 2-3 weeks after surgery at site of the vasectomy or in the epididymis or testicle.
-Hematoma: 4-22%, this is a collection of blood pooling outside of a vessel, usually looking like a bad bruise, and typically appears shortly after surgery.
-Post-vasectomy pain syndrome (PVPS): 1-14% , usually light pain but may impact QOL or require conservative management or further surgery, classified as chronic if lasts 3 months or greater. PVPS is constant or on-off scrotal discomfort with unclear causes as to the exact root of the pain.
-Infection: 0.2-1.5%, this is usually mild and typically limited to the incision site.
4 movement tips for what to do after a vasectomy and WHY:
While following your doctor’s instructions post-surgically, know that your recovery timeline might differ than someone else before you feel ready to resume more vigorous activities. Typical men should be to everyday non-vigorous activities within a few days (1). Unless experiencing any complications, here are some movements to start with after any swelling has gone down and compression is no longer needed. Please be sure to listen to your body and discontinue if increased pain, as you may need to wait for further healing.
Quadruped rocks with breath work: testicular distraction via gravity which is a good way to mobilize the nerves to the scrotum and provide gentle mobilization of painful granulomas and the spermatic cord. The possible addition of a gentle pull to increase sensory input of traction to any thickened areas of granuloma may also help alleviate pain while using breath work to down-regulate the nervous system.
Adductor foam rolling: working into tension through the local region via self-myofascial release, manipulating tight areas in the adductor muscles and surrounding connective tissues, as well as helping to reduce local inflammation and increase blood flow to the muscles.
Hip hinge: working to restore ability of the neural tissue regionally to tolerate movements that lengthen through the groin area and a gluteal stretch that can be graded to reduce protective muscle activity and elicit gentle stretching through the surrounding tissues.
Half kneeling lunge rocks with overhead stretch (nerve glide to help mobilize neural tissue across the front of hip and groin and adjacent structures to help restore their ability to tolerate normal compression, friction and tensile forces associated with life’s activities.
Signs of when to see a pelvic PT post-surgery:
If your surgical site has healed but you are experiencing continued pain that worsens with sitting for prolonged periods, clothing pressure, sexual or recreational activities, you may benefit from seeing a pelvic floor PT. If you have any history of back, hip, lower abdomen, or pelvic pain prior to surgery your nervous system may already be sensitized and more vulnerable to post-surgical pain symptoms or you may have developed increased tension through your pelvic floor in response to the discomfort.
Always consult with your urologist if there is any redness, swelling, bleeding or any signs of infection or difficulty urinating. If appropriate a course of antibiotics or NSAIDs may be used prior to or in conjunction with PT to help reduce any inflammation and improve comfort.
Sources:
https://my.clevelandclinic.org/health/treatments/4423-vasectomy
https://www.usnews.com/news/health-news/articles/2023-08-31/more-american-men-now-opting-for-vasectomy
Yang, F., Li, J., Dong, L., Tan, K., Huang, X., Zhang, P., Liu, X., Chang, D., & Yu, X. (2021). Review of Vasectomy Complications and Safety Concerns. The world journal of men's health, 39(3), 406–418. https://doi.org/10.5534/wjmh.200073
