Vasectomy Risks

There is some pain during and after vasectomy but the pain is no where near as bad as most patients imagine it will be.

During the vasectomy, there is some minor discomfort associated with the local anesthetic air jet injector. Most patients describe it similar to the sensation of getting lightly tapped on the skin with a small rubber band.

There is very little pain associated with the actual vasectomy procedure.

The local anesthetic does wear off within after the vasectomy. Most patients can easily control this discomfort with over the counter anti-inflammatory medications.

Most patients rate their pain a 2 on a scale of 1 to 10 the day after their vasectomy procedure. 

Some patients can have episodic pain within the first several months after their vasectomy procedure. Usually firm fitting underwear and over the counter anti-inflammatory medications can easily treat this discomfort.

It is rare for a vasectomy patient to need narcotic medications to treat their pain.

Regret is a real risk after vasectomy. 

The most common reasons for regret are the desire to have another child after divorce and remarriage, unexpected loss of child, or a change of heart. 

The chance of regret after vasectomy in the United States has been estimated to be 17 out of every 100 patients (17%).

Vasectomy reversal is not a direct risk of vasectomy, but vasectomy reversal is a consequence of vasectomy if you have vasectomy regret. Vasectomy should be considered permanent because there are no guarantees reversal will be successful. Most people are aware, to some small extent, vasectomy can be reversed. 

Anyone considering vasectomy should be aware of important concepts regarding vasectomy reversal. Vasectomy can be reversed. If vasectomy is reversed:

• Within the first five years the chance of successful reversal is approximately 90%. 
• After 15 years the chance of successful reversal is approximately 50% to 60%.

Unfortunately, health insurance will never pay for reversal of vasectomy. Patients will have to pay out of pocket for reversal. There are no guarantees vasectomy reversal will work.

Inflammatory reactions can occur after vasectomy in the epididymis or in the vas deferens. This is usually temporary.

Often this can be on one-side but can sometimes involve both sides. The symptoms are mild swelling and discomfort. Often this occurs three (3) to ten (10) days after a vasectomy and will resolve over 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%). Over the counter anti-inflammatory medication, firm fitting underwear, and hot baths at night will greatly help with the discomfort. The inflammation should resolve within two weeks.

The vasectomy site on either side of the scrotum could develop a painful nodule. 

It is common to form a non-painful nodule at the vasectomy site. 

Approximately 1 out of every 4 patients will normally form a nodule at either vasectomy site. These nodules are usually small and not painful. They are essentially the divided ends of the vas deferens and can easily be felt through the scrotal skin in patients who have relaxed scrotums. These are essentially ‘normal’ vasectomy site nodules. Technically these nodules are not a complication of vasectomy.

Painful nodules are not common after vasectomy. Painful nodules can either be sperm granulomas (collection of sperm) or neuromas (scar tissue with nerves). 

Painful nodules that persist for more than twelve months after vasectomy are not common and may be evidence of either a symptomatic sperm granuloma or neuroma. The chance of 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 edges of the scrotal skin opening, and resolves within several hours. Non painful bruising is very common after vasectomy.

The most serious form of bleeding is internal scrotal bleeding that can cause blood to accumulate and cause a scrotal hematoma. A hematoma is a collection of blood that forms a solid blood clot. Scrotal hematomas after vasectomy only occur within the first 24 to 48 hours after having a vasectomy procedure.

Although a hematoma is uncomfortable, most hematomas will slowly be absorbed by they body and resolve slowly over time. A second procedure is not usually required to treat a scrotal hematoma.

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

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

Infection occurs 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 vasectomy infections will present within the first 14 days of a vasectomy procedure.

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

No procedure is 100% effective. Vasectomy failure is possible but not likely with a His Choice Vasectomy. 

A vasectomy can fail because the vas deferens may be difficult to find and divide or the vas deferens can reconnect after division. 

Difficult to find vas deferens are more likely to occur in patients who have had previous scrotal surgery. Surgery for undescended testicle is the most common reason for having a more complicated vasectomy procedure. 

Reconnection of the vas deferens can occur early (weeks to months) after a vasectomy or later after a vasectomy (months to years).

The most common reason for vasectomy failure is not using an appropriate backup method within the first three (3) months of the vasectomy procedure.

The chance of any vasectomy failing is estimated to occur in 3 out of every 1000 patients (0.3%).

 His Choice Vasectomy has a very low risk of failure. 

As a result of using cautery to divide the vas deferens, cautery to the inside of the upper portion of the vas deferens, and separation of the divided ends of the vas deferens with healthy tissue interposed between the two divided ends, the chance of having a failure of a His Choice Vasectomy is 3 to 5 patients out of every 10,000 patients… or 0.05%.

A His Choice Vasectomy is one of the most effective forms of vasectomy with one of the lowest chances of vasectomy failure.

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

Chronic scrotal pain can occur after any surgery to the male reproductive system (testicles, prostate, penis, etc), urinary system (kidneys, ureters, bladder), or surgery to the anterior abdominal wall (i.e. hernia surgery) or posterior abdominal wall (i.e. spine surgery).

It is common to have minor aches and pains the first several weeks after vasectomy. In the vast majority of cases these aches and pains will completely resolve by six (6) months.

Chronic scrotal pain is defined as scrotal pain that lasts for six (6) months or more 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 lasts for more than six (6) months or more after their vasectomy. Many of these patients report the discomfort as enough to notice but not bothersome enough to significantly impact their life or require them 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 medical or surgical treatment. 

The chance of developing severe 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%).

The blood supply to each testicle is redundant and numerous. Theoretically, if a significant portion of the blood flow to the testicle has been interrupted then the testicle could suffer enough damage to become atrophic (smaller). In severe cases this could result in complete loss of function to the effected testicle.

Although impaired testicular blood flow is a possible risk of vasectomy, it is a rare complication and is estimated to happen in about 1 out of every 10,000 vasectomy procedures or <0.01%.

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

The patient would likely have a pre-existing vascular insufficiency from a previous vascular insult (previous hernia surgery, pelvic surgery, diabetes, heavy cigarette smoking, or other medical conditions which can cause vascular disease) that would exacerbate the vasectomy insult to the testicle.

Although impaired testicular blood flow is possible, most men can seek vasectomy with the reassurance this is an extremely rare complication.

Allergy or adverse reaction to an anesthetic or medication can occur with any of the medications used or taken by a patient during or after a vasectomy procedure. This is an uncommon risk with vasectomy.

Emotional reactions 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.

Overall it is estimated that less than 10% 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, will resolve with time, and will not require any additional treatments.

The main benefit of vasectomy is a highly reliable permanent birth control that effectively prevents pregnancy.

This benefit can easily be obtained with a simple procedure that can be performed in less than 15 minutes in a doctor’s office using local anesthesia. Vasectomy allows control over your reproduction. Vasectomy allows you not to be reliant upon another person’s compliance with birth control.

Vasectomy also provides benefits to the female partner because it allows them to avoid the risks associated with female sterilization (tubal ligation). Although male and female sterilization are effective and safe, the complications associated with female sterilization are often far more serious than complications from vasectomy.

Female sterilization is an intra-abdominal procedure performed under general anesthesia in a hospital operating room. Anesthesia risk and risk of injury to internal abdominal organs can occur with female sterilization procedures. Failure of female sterilization can result in unintended pregnancy. Pregnancies after female sterilization failure can be serious and life-threatening ectopic (tubal) pregnancies.