What are the potential complications of a vasectomy?

From the Guidelines

Vasectomy complications can include short-term issues like pain, swelling, and infection, as well as long-term issues such as post-vasectomy pain syndrome and chronic scrotal pain, which occur in about 1-2% of men, as reported in the 2012 AUA guideline 1.

Potential Complications

Potential complications of a vasectomy include:

• Short-term complications: pain, swelling, bruising, and infection at the surgical site
• Long-term complications: post-vasectomy pain syndrome, chronic scrotal pain, and sperm granulomas
• Rare complications: bleeding inside the scrotum (hematoma), recanalization, and anti-sperm antibodies

Minimizing Complications

To minimize complications, men should:

• Follow post-operative care instructions carefully
• Refrain from ejaculation for approximately one week after vasectomy, as recommended in the 2012 AUA guideline 1
• Use proper rest, ice application, and over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours as needed) for discomfort

Important Considerations

It's essential to note that:

• Vasectomy doesn't protect against sexually transmitted infections
• The risk of pregnancy after vasectomy is approximately 1 in 2,000 for men who have post-vasectomy azoospermia or PVSA showing rare non-motile sperm (RNMS), as reported in the 2012 AUA guideline 1
• Repeat vasectomy is necessary in about 1% of vasectomies, provided that a technique for vas occlusion known to have a low occlusive failure rate has been used, as stated in the 2012 AUA guideline 1

From the Research

Potential Complications of Vasectomy

The potential complications of vasectomy can be categorized into short-term and long-term complications.

• Short-term complications include:
  • Infection 2, 3, 4, 5, 6
  • Hematoma 2, 3, 4, 5, 6
  • Pain 2, 3, 4, 5
  • Epididymitis 4, 5, 6
  • Sperm granuloma 3, 4, 5, 6
• Long-term complications include:
  • Chronic pain syndrome 3
  • Sterilization failure 3, 5
  • Antisperm antibody formation 6
  • Psychogenic impotence 6

Incidence of Complications

The incidence of complications from vasectomy is relatively low, with most studies reporting less than 5% of cases experiencing any complications 4.

• Infection occurs in approximately 3.8% of cases 5
• Hematoma occurs in approximately 0.33% of cases 5
• Epididymitis occurs in approximately 1.9% of cases 5
• Sperm granuloma occurs in approximately 1.3% of cases 5
• Failure rates are less than 1% 4, 5

Comparison to Other Contraceptive Methods

Vasectomy has been shown to have fewer serious complications and a comparable failure rate to tubal ligation 6.

• Vasectomy is 30 times less likely to fail and 20 times less likely to have postoperative complications than tubal ligation 2