Risks and Possible Complications

Potential Side Effects of a Vasectomy

Regardless of what method of contraception you and your partner choose they all have side effects, from the contraceptive pill to the coil. Even a pregnancy has risks especially as we get older. A vasectomy has no hormonal side effects and it is the most effective method of contraception available.

While a vasectomy takes 10-15 minutes to do it is still a surgical procedure so the risks below are important to note.

1. Bleeding may occur, although it is much less likely with a no-scalpel technique. Both large and small hematomas (blood collections) are rare, they only occur in approximately 1 in 1000 cases. It is more common that bruising will occur superficially in your scrotal skin but this is painless, and resolves by itself.

2. Infection is also a rare complication and will respond to antibiotics quickly if it does occur.

3. Sperm granuloma is a pea-sized (sometimes tender) lump on the vas tube at the vasectomy site. It is very common and does not cause problems very often. It’s presence serves to help keep pressure off the testicle so it may actually be a good thing and if a reversal was ever necessary it makes the reversal more likely to succeed.

4. Congestion due to build-up of sperm and white blood cells upstream from or at the vasectomy site, can occur anytime after vasectomy, but usually goes away with use of an anti-inflammatory drug such as ibuprofen. This is the most common side effect we would see, 1-2% of men experience epididymitis (inflammation at the back of the testicle) at some stage after a vasectomy. We perform an open ended vasectomy (the lower end is left open) and this will decrease any chance of congestion or pressure.

5. PVP or Post-Vasectomy Pain is defined as pain that is persisting for a period of months or longer, and is interfering with life.  It is a range of symptoms, from random/intermittent low grade symptoms that may not be treated or even reported to more significant symptoms that are interfering with life and require treatment.  In our experience the incidence of pain after a vasectomy ranges, depending on symptoms and time, from 2 in 100 to 1 in 1000. We don’t see or treat 2% of patients as most symptoms resolve with time and simple analgesia. The number of men that have post-vasectomy pain that will consider having interventions such as vasectomy reversals or pain management procedures is significantly less than 1%.

6. Failure/Recanalization is the development of a channel for sperm flow between the two cut ends of the vas. If this happens during the healing process (early failure) we see live sperm in the semen sample and the vasectomy needs to be repeated. This is approx. 1 in 1000, but it is picked up on semen testing after your vasectomy and the vasectomy would need to be repeated.

If recanalization happens after the semen sample and the vasectomy is said to be effective this is late failure and an unplanned pregnancy could result. The long term failure rate of a vasectomy is approximately 1 in 2000.

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