Sperm Granuloma: Should You Be Concerned?

The road to recovery after a vasectomy is typically short and straightforward (requiring not much other than rest and the occasional semen test), but one factor to be aware of is the potential development of a sperm granuloma. Here, we’ll walk you through what a sperm granuloma is, why it may form, the symptoms, treatment options, and more. 

Understanding the Anatomy 

There are many different organs within the male reproductive system. Each organ serves a different purpose, and they all function in tandem to allow for reproduction. The most important organs to be aware of when researching a sperm granuloma are:

• The Testes: where the body creates sperm
• The Epididymis: where sperm matures and develops the ability to swim
• The Vas Deferens: the “tubes” that connect the epididymis to the urethra 
• The Urethra: where sperm travels to exit the body 

What Is a Sperm Granuloma?

A sperm granuloma is a tiny, hard lump that can form in or around the epididymis or vas deferens. The granuloma or “lump” itself is made up of numerous sperm cells. Sperm granulomas are relatively uncommon within the general population but are much more likely to occur after certain medical procedures or traumas. 

What Can Cause a Sperm Granuloma?

Some factors that can lead to a sperm granuloma are much more common than others. 

A Vasectomy

The most likely cause of a sperm granuloma is a vasectomy. The doctor will cut or close the vas deferens during a vasectomy procedure. This cut in the vas deferens will prevent the flow of sperm stored in the epididymis from reaching the urethra and exiting the body. 

In some instances after getting a vasectomy, sperm can leak out of the vas deferens and cause a granuloma. According to one study, sperm granulomas impact 20-50% of vasectomy recipients. 

Another Surgery

Surgeries that involve the vas deferens, epididymis, and other male sex organs can also result in a sperm granuloma forming. Procedures like a vasectomy reversal, epididymectomy, and orchiectomy can cause a granuloma.

Trauma

Trauma to the testicular region, such as a sports injury or a forceful hit/kick can lead to the formation of a granuloma. Injuries like these can cause internal damage or tearing of the vas deferens, which would allow for a build-up of sperm to occur. 

Infection

In rare cases that typically involve younger men, sperm granulomas can be caused by an infection. While infections inside the scrotum are considered uncommon, the possibility does exist. 

Know the Symptoms 

The more informed you are on the symptoms of a sperm granuloma, the easier they are to detect. Consider talking to your healthcare provider about the possibility of a sperm granuloma if you notice the following issues in the scrotum: 

• Hard, Small Lump(s) 
• Pain/Discomfort 
• Swelling 
• Redness

How To Treat a Sperm Granuloma

In most cases, sperm granulomas are harmless and will naturally resolve within a few months without medical intervention. However, they sometimes need to be treated with medicine or be surgically removed. Always discuss any pain or abnormal symptoms with your physician.

Observation

If the sperm granuloma is small and not causing pain, your doctor may recommend that you wait and see if it goes away on its own. A doctor’s course of treatment normally depends on the granuloma’s size, location, severity and/or the severity of any residual symptoms. 

Medication

In scenarios where the sperm granuloma is larger or causing pain, the doctor may prescribe medication designed to treat the granuloma or to treat the swelling, pain, and redness. 

Surgery

Sperm granuloma removal surgery involves the doctor making a small incision in the scrotum and extracting the lump. It is a relatively simple procedure and can be performed in an outpatient setting. 

Surgery is often the last resort, as the procedure can cause additional discomfort and swelling in the short term. Most doctors will only deem it necessary for granulomas that are either abnormally large and/or painful.