Epididymectomy is an effective treatment for scrotal pain after vasectomy.

OBJECTIVE To investigate the efficacy of epididymectomy in patients with significant scrotal pain after vasectomy. PATIENT AND METHODS Sixteen patients were identified retrospectively to have undergone epididymectomy for pain after vasectomy; 19 epididymectomies were performed (three bilateral and 13 unilateral). Details from the preoperative investigations, histological examination and follow-up of symptoms were analysed and correlated. Outcomes were initially assessed at the routine outpatient clinic review 3 months after surgery and the long-term outcomes were assessed by a telephone interview 3-8 years after epididymectomy (mean 5.5 years). RESULTS Of the 16 patients, 14 had excellent initial symptomatic benefit from epididymectomy. At 3-8 years afterward, nine of 10 patients interviewed had a sustained improvement of their scrotal pain. The following were indicators of a poor outcome: atypical symptoms including testicular or groin pain; erectile dysfunction and normal appearance of the epididymis on ultrasonography. Patients with bilateral scrotal pain can have a good outcome after epididymectomy. CONCLUSION Epididymectomy in well-selected patients is a reliable and effective treatment for pain after vasectomy.