Vasectomy Risks

Regret is a very real risk after a vasectomy procedure.

The most common reasons for regret are divorce and remarriage, unexpected death of a child, or a just a pure change of heart. Divorce and remarriage is the most common reason for reversal, especially when the new partner does not have a child.

The chance of regret after vasectomy is estimated to be 17 out of every 100 patients (17%).

If you regret your vasectomy procedure then you will seriously consider vasectomy reversal surgery or in-vitro fertilization (IVF). This treatments are expensive, never covered by health insurance, and are not guaranteed to work.

Vasectomy reversal is not a direct risk of vasectomy, but is a possible consequence of vasectomy should you regret your vasectomy and wish to have more children.

Vasectomy should be considered permanent because there are no guarantees vasectomy reversal surgery will be successful. Most people are aware, to some extent, vasectomy can be reversed.

Vasectomy reversal is not guaranteed and is very expensive. You will have to pay out of pocket for vasectomy reversal because health insurance will never pay for you to have your vasectomy reversed.

Inflammatory reactions can occur after vasectomy in the epididymis or vas deferens.

Often this is one-sided but can involve both sides. The symptoms are mild swelling and discomfort that often occurs three (3) to ten (10) days after a vasectomy and resolves with time.

An inflammatory reaction can also be delayed and occur weeks to months after a vasectomy. The risk of an inflammatory reaction is about 5 out of every 100 patients (5%).

Inflammatory reactions are your body’s normal response to healing. Typically patients have mild scrotal discomfort. The inflammation is due to either the vasectomy procedure itself or exposure to sperm.

Typically the pain from inflammation can be easily managed with over the counter anti-inflammatory medications, wearing tight under wear, and hot baths. This usually resolves within two weeks.

The vasectomy site on either side of the scrotum could develop a painful nodule. These painful nodules can either be sperm granulomas (collection of sperm) or neuromas (scar tissue with nerves).

Small nodules, even small granulomas, the size of a pea at each vasectomy site are common and do not require treatment. It is estimated that 25% of patients will form a small nodule at either one of both vasectomy sites.

Nodule formation at the vasectomy site(s) are common. Painful nodule formation that last for more than six (6) months is not common and may be evidence of either a symptomatic sperm granuloma or neuroma.

The chance of having a painful nodule formation after vasectomy is estimated to occur in 1 or 2 out of every 100 patients (1.5%).

Bleeding can occur during or after a vasectomy procedure. Most bleeding after vasectomy is minimal, from the scrotal skin edges, and resolves within several hours of the vasectomy procedure. The most serious form of bleeding is a scrotal hematoma. A scrotal hematoma is when blood accumulates in the scrotum.

• An arterial scrotal hematoma will develop quickly within the first 6 to 12 hours of the procedure. The scrotum will be large, tense, and painful.
• A venous scrotal hematoma usually occurs within 12 to 24 hours. With a venous hematoma the scrotum is not as large and not as painful as an arterial hematoma.

The risk of hematoma formation after vasectomy is less than 1 out of every 1000 patients (0.1%).

Most scrotal hematomas do not need additional treatment. The body will slowly dissolve the hematoma over a 4 to 20 week time frame after vasectomy. The larger the hematoma the longer it takes for the body to absorb the blood. In rare cases, a hematoma may require a surgical drainage in the operating room.

The main reason we request patients to limit their activity after vasectomy is to prevent the occurrence of a scrotal hematoma.

Infection is a risk with any surgical procedure but infection is a very rare complication of vasectomy.

Infection can occur because bacteria are introduced into the scrotum during the vasectomy procedure or bacteria can gain access to the scrotal space after the procedure but before the scrotal incision has completely healed. Most infections after vasectomy will present within the first fourteen (14) days of a vasectomy procedure.

The risk of infection after vasectomy is approximately 1 out of every 1000 patients (0.1%).

On some rare occasions, we may observe a prostate infection after vasectomy. This happens less than 1% of patients. It is debatable if this is coincidental or due to bacteria being introduced inadvertently in the tubes at the time of a vasectomy.

If a prostate infection occurs after vasectomy it is usually obvious 10 to 30 days after the vasectomy procedure.

Vasectomy can fail because the vas deferens on either side may be difficult to find and divide or they can reconnect.

Reconnection of the vas deferens can occur early (weeks to months) after a vasectomy or later after a vasectomy (months to years). Most reconnections happen within the first 3 months. This is the main reason we request a single after vasectomy semen sample be done three months after the vasectomy procedure.

The most common reason for early vasectomy failure is not using an appropriate backup method within the first three (3) months of the vasectomy procedure. This is less of a method failure and more of a failure to follow directions!

The chance of a vasectomy failing early is estimated to occur in 3 out of every 1000 patients (0.3%). If you have a His Choice vasectomy and once you successfully pass the 3 month after vasectomy semen sample test, the chance of a late failure is 0.05% … or up to 5 out of every 10,000 patients!

Chronic scrotal pain can occur after vasectomy. Chronic scrotal pain is uncommon and poorly studied.

Chronic scrotal pain can occur after any surgery to the abdomen, back, groin, or scrotum.

It is common to have minor aches and pains the first several weeks after vasectomy. In most patients these normal aches and pains will completely resolved by one (1) to three (3) months.

Chronic scrotal pain is defined as scrotal pain that last for more than six (6) months after a surgical procedure and can range from minor to severe.

Minor chronic scrotal pain is often reported by patients as discomfort that did not exist before vasectomy and last for more than six (6) months after their vasectomy.

Many of these patients report the discomfort is enough to notice but not bothersome enough to seek medical treatment.

Severe chronic scrotal pain is pain lasting more than six (6) months after a vasectomy procedure and is reported as being severe enough to impact quality of life and requires additional treatment. The chance of developing chronic pain after vasectomy is estimated to be less than 9 out of every 1000 patients (<0.9%).

Impaired testicular blood flow to either testicle could occur as a result of the vasectomy procedure.

Despite numerous blood vessels supplying each testicle, a vasectomy procedure could impair blood flow to either testicle and this could cause atrophy (size reduction) of a testicle or, if severe enough, result in loss of the testicle. This is estimated to occur in 1 out of every 10,000 patients (<0.01%).

Impaired blood flow, testicular atrophy, and loss of a testicle are extremely rare complications.

A significant insult to the testicular blood flow would most likely require a rare, unusual and severe vasectomy complication in a patient with pre-existing vascular compromise.

If this complication occurs it is usually in a patient who has had prior scrotal surgery or severe medical illnesses. The patient who experiences this rare complication would have had a previous vascular insult (previous hernia surgery, pelvic surgery, diabetes or other medical conditions which can cause vascular disease) that would exponentially exacerbate the vasectomy insult to the testicle.

Although impaired testicular blood flow is possible, most men can seek vasectomy with the reassurance this is a very unlikely complication.

Allergic reactions to medications or the local anesthesia can occur. Although allergic reactions are possible with any procedure or medication, it is extremely rare to have an allergic reaction during or after a vasectomy procedure.

Emotional reactions that could interfere with normal sexual function and inter-personal relationships are possible after vasectomy. Reactions severe enough to impact sexual function after vasectomy are uncommon.

Most patients will not have emotional reactions after vasectomy. Those rare patient who do experience these changes often suffer from depression, anxiety, or have challenging life circumstances they are dealing with. Often the vasectomy is a coincidental occurrence.

Overall it is estimated that less than 5% of men will have a vasectomy complication. Most of these complications (tenderness and discomfort) are minimal and will quickly resolve.

Some complications are severe and may require additional treatment. Although severe complications can occur they occur very infrequently. Most vasectomy complications are mild and will resolve with time.

The main benefit of vasectomy is highly reliable permanent birth control and prevention of unintended pregnancy.

These benefits can easily be obtained with a simple surgical procedure in less than 15 minutes within a doctor’s office under local anesthesia. Vasectomy allows patients control over their reproduction and allows them not to be reliant upon their partners compliance with birth control.

Vasectomy also provides benefits for the patient’s partner as a very effective form of birth control that allows them to avoid the risks associated with fallopian tubal ligation. Although vasectomy and fallopian tubal ligation are equally effective and safe, the complications associated with tubal ligation sterilization procedures are more serious.

Tubal ligation surgery is an intra-abdominal procedure performed under general anesthesia. Anesthesia risk and risk of injury to internal abdominal organs can occur with tubal ligation procedures. Failure of tubal ligation can result in unintended pregnancy. Pregnancies from tubal ligation failure can be serious and life-threatening ectopic (tubal) pregnancies.