Vasectomy Risks and Complications
Vasectomy is a safe, simple and effective birth control
method.
What are the general risks?
Any surgical procedure carries some risk, but vasectomy
is considered to be low-risk, and complications are uncommon. It is important
to note that vasectomy should be considered a permanent form of birth
control, and it does not protect against sexually transmitted diseases
or AIDS.
Discuss any concerns and risks associated with vasectomy
with your physician. The following is a list of most, but not all, of
the risk issues to consider.
Allergic Reaction Rarely, some men may experience
itching and hives, as an allergic reaction to local anesthetic.
Antibodies Sperm which are no longer released
through ejaculation and absorbed by the body may attract antibodies produced
following vasectomy.
Bleeding Generally painless bleeding may occur following
vasectomy and collect under the skin, so that the penis and scrotum appear bruised
and/or swollen. The scrotum skin is very thin, which may make bruising appear
worse than it actually is and is a normal reaction after vasectomy.
Chronic Orchialagia Rarely; the patient may experience
a dull ache in the testicles following vasectomy that is thought to be caused
if the epididymis becomes congested with dead sperm and fluid. If this condition
occurs, it usually disappears within six months.
Congestion A common name for chronic orchialgia
(see above).
Epididymitis This uncommon condition occurs
when the larger tube behind the testicle, connected to the vas, becomes
inflamed and swollen. The application of heat and the use of anti-inflammatory
medication usually clear this up within a week.
Failure Pregnancy may result if a man fails
to abstain from sex or use alternative forms of birth control during the
waiting period, until the testing for live sperm is completed. There is
also one chance in 10 thousand that the cut vas will spontaneously rejoin.
Hematoma Bleeding inside the scrotum rarely may
cause painful swelling immediately following a vasectomy. The result is known
as a hematoma, and while seldom serious, it should be reported to a physician.
Immune Reactions Following vasectomy, the immune
system may recognize the absorbed sperm cells as foreign proteins and produce
antibodies in response. While many men may experience this immune reaction,
current evidence indicates that this reaction generally is not harmful. Immune
reactions can also contribute to the development of clogging of arteries, which
in turn could lead to heart attacks. However, there is no evidence of an increased
risk of atherosclerosis because of a vasectomy.
According to the National Institutes of Health, research that examined this
issue found no evidence that vasectomized men were more likely than others to
develop heart disease or any other immune illness. (NIH
Publication Number 96-4094, April 1996)
Infection If blood collects under the skin
following vasectomy, it can become infected. Infection of the incision
site, or deeper tissue, occurs in less than 5 percent of all cases. Such
infections usually respond favorably to antibiotic treatment, antimicrobial
creams and hot baths, usually within a week.
Postoperative Pain Some degree of scrotal pain or
ache is normal following a vasectomy. The use of acetaminophen (Tylenol), with
or without codeine frequently is recommended over aspirin, which can cause bleeding.
Painful discomfort normally disappears within a day or two, while a slight ache
may remain longer.
Prostate Cancer Studies looking at the association
of prostate cancer with vasectomy have demonstrated conflicting results in the
past. To answer this question, a major study involving over 2000 men was performed
and reported in the Journal American Medical Association (JAMA
2002; 287:3110-3115). The conclusion was clearly that there is no
increased risk of prostate cancer with vasectomy (NIH
News Release).
Sexual Difficulties It is usually reported
that men who undergo vasectomy and their partners express greater enjoyment
and spontaneity of sex. However, occasionally a man may experience sexual
problems after vasectomy, but these almost always have an emotional basis.
Counseling usually alleviates the problem.
Sperm Granulomas Very rarely, sperm
leakage from the testicular cut end of the vas may cause a small and usually
painless lump. This lump does not pose a danger and frequently resolves
over time.
In Summary:
- Although a simple, safe and common surgical procedure,
any surgical procedure includes some risk.
- A vasectomy is considered to be low risk, and
complications usually are uncommon.
- Some pain and discomfort may be expected, but
this normally decreases and disappears within days, given routine post operative
care.
- It’s important to review possible risks
and complications with your physician.
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