Vasectomy bruising-A concern?

A common question after a vasectomy and as well microscopic vasectomy reversals is “What is the significance of skin bruising around the vasectomy site?” More importantly to the patient inquiring about this is, “Is anything wrong or does anything need to be done?”

The medical term is ecchymosis. This skin discoloring is only “skin deep.” This is an important distinction as this is common and resolves usually over a few days. The tissue plane anatomy also explains why this bruising extends up the inguinal area on occasion. Again, this not a major concern if it is “skin deep” only.

Deeper tissue bruising or an area of swelling such as hematoma is a bit more complicated, but even this is treated expectantly and resolves with time. (I prefer that the patient did not have this common issue subsequent to a vasectomy. I take measures to prevent a hematoma but they occur occasionally. This is why the importance of being of your feet for approximately 48 hours after the procedure is emphasized.)

So, when patients call or are seen after a scrotal procedure for this complaint, I am relieved on examination to find that the discoloration involves the skin and no underlying fullness consistent with a hematoma. A hematoma is an isolated consolidation of blood/fluid related to the procedure that takes longer to be absorbed in time by the body.

In either case, nothing is recommended surgically. Neither finding affects the effectiveness of the vasectomy.

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