Vasectomy: Risks, Complications, and Side Effects

From Vasectomy.com’s Website

All surgeries carry some risk, but complications from vasectomy tend to be rare, minor, and seldom require intensive medical treatment. Below, find some of the most common risks and side effects for a vasectomy.

If you have concerns or want more information about the possible risks, complications, and long-term effects of a vasectomy, talk to your doctor.

Vasectomy risk factors

Allergic Reaction – Rarely, some men may experience itching and hives, as the result of an allergic reaction to the local anesthetic.

Antibodies – After a vasectomy, sperm produced in the testicles are absorbed by the body. This process may cause the immune system to produce antibodies to the sperm. These “anti-sperm antibodies” are mostly harmless, but they can affect the success of a later vasectomy reversal. (They have not, however, been linked to other immune-related diseases. For more information, see “Is there a link between vasectomy and disease?“)

Bruising – Bruising may occur on the skin of the scrotum or the penis. This is a normal side effect of a vasectomy, and the bruises should be gone after about two weeks.

Chronic Scrotal Pain – Fifteen to 19 percent of men who have had a vasectomy experience pain that lasts more than three months and interferes with daily activities. This type of pain, however, can also have causes unrelated to the vasectomy—such as inflammation of the epididymis, trauma, or twisting of the testicle (torsion).

Epididymitis – One of the more common post-vasectomy complications, occurring in up to 6 percent of vasectomies, epididymitis is caused by inflammation and swelling of the epididymal tube. Heat and anti-inflammatory medications (alone or combined with antibiotics) can usually clear it up within a week.

Hematoma – Pooling of blood within the tissue occurs in up to 29 percent of all vasectomy patients. It usually starts within the first week after the procedure, and can cause pain or swelling. While it is rarely serious, you should report any bleeding to your doctor.

Infection – Infections occur in about 3.5 percent of vasectomy patients. These are usually minor and respond favorably to antibiotic treatment, antimicrobial creams, and hot baths. More serious infections are rare.

Postoperative Pain – Short-term pain after a vasectomy is normal and usually resolves within a day or two, although a slight ache can remain for a while longer. Surgeons usually recommend acetaminophen (e.g. Tylenol) with or without codeine for the first 48 hours, since aspirin and ibuprofen (such as Advil or Motrin) can cause bleeding.

Sexual Difficulties – A vasectomy should not affect your sex drive, or your ability to have erections or ejaculate. If you experience sexual difficulties after a vasectomy, contact your doctor. They may be a sign of either emotional or physical issues, including heart disease.

Sperm Granulomas – These small, usually painless lumps occur when sperm leak out of the vas and cause an inflammatory reaction. The resulting cluster of immune cells does not pose a danger and usually resolves over time. Granulomas do cause pain in a small number of men, typically about two to three weeks after the vasectomy.

References

Adams CE, Wald M. Risks and complications of vasectomy. Urol Clin North Am. 2009; 36(3):331-6.

Davis BE, Noble MJ, Weigel JW, Foret JD, Mebust WK. Analysis and management of chronic testicular pain. J Urol. 1990; 143(5):936-9.

Kendrick JS, Gonzales B, Huber DH, Grubb GS, Rubin GL. Complications of vasectomies in the United States. J Fam Pract. 1987 Sep;25(3):245-8.

Schwingl PJ, Guess HA. Safety and effectiveness of vasectomy. Fertil Steril. 2000 May;73(5):923-36.

Using the form below you can leave your number 24/7 and we’ll call with an appointment or you can ask a question and Dr. McHugh will answer it. 

Most common question from the male having a vasectomy? Hint: it is not “when can I have sex?”

a-vasectom-y

The answer: “Does a vasectomy cause prostate cancer?”

Vasectomy Not Associated With Prostate Cancer

Urology – February 28, 2009 – Vol. 25 – No. 04

There is no association between prostate cancer and age at vasectomy or years since vasectomy.

Article Reviewed: Vasectomy and the Risk of Prostate Cancer. Holt SK, Salinas CA, Stanford JL: J Urol; 2008;180 (December): 2565-2568.

Background: The majority of the literature now has shown no association between vasectomy and prostate cancer. The effect of vasectomy on men with a family history of prostate cancer or on those who underwent a vasectomy at a young age or had an extended period of time since the procedure has been poorly studied due to small sample sizes and short study follow-up.

Objective: To assess the risk of prostate cancer in men by age and length of time to exposure from vasectomy to disease.

Design: Population-based, prostate cancer case-controlled study.

Participants: 1327 men aged 35 to 74 years residing in King County, Washington, with a diagnosis of prostate cancer.

Methods: Cases of prostate cancer were identified from the SEER database for this population. Structured in-person interviews were conducted. Eligible controls were identified by random digit telephone dialing. Analysis based on prostate cancer Gleason score and stage was performed. Analysis was also performed based on demographics, age, prostate cancer screening history (within the last 5 years), family history of prostate cancer, and vasectomy parameters.

Results: 1327 men were eligible for study from the SEER database; 1001 completed the personal questionnaire. In total, 1340 controls were identified, of which 942 were interviewed. The control population showed that men who had undergone vasectomy were older, white, married, non-smokers with higher income and education, and had undergone PSA screening. Of men with prostate cancer and controls, 36% had undergone a vasectomy. Mean number of years since vasectomy in cases and controls was 21.1 years. No significant association was seen between prostate cancer and vasectomy status, age at vasectomy, years since vasectomy, or year of vasectomy. There was no evidence of risk estimates across vasectomy parameters. Risk did not change if men with prostate cancer within 2 years of vasectomy and controls with no PSA screening within 5 years (n=136) were excluded.

Conclusions:

No association was found between prostate cancer and vasectomy, even in men who had a vasectomy performed at a young age or had an extended period of time since vasectomy.

Reviewer’s Comments: This paper is a well-conducted, large case-control study that answers the concern about possible limitations of previous work that reported the lack of association between prostate cancer and vasectomy. This criticism often indicated inadequate follow-up since vasectomy to make this claim. In this study, average time since vasectomy in cases of prostate cancer and controls was 21 years. Multiple variables were looked at including vasectomy in the face of prostate cancer family history and screening. This large study should end the criticism on previous work that did not answer the question of prostate cancer and time from vasectomy. (Reviewer–Ajay K. Nangia, MBBS).

Vasectomy associated with Prostate Cancer?

vasectomy-fact-sheet

Vasectomy Not Associated With Prostate Cancer

Urology – February 28, 2009 – Vol. 25 – No. 04

There is no association between prostate cancer and age at vasectomy or years since vasectomy.

Article Reviewed: Vasectomy and the Risk of Prostate Cancer. Holt SK, Salinas CA, Stanford JL: J Urol; 2008;180 (December): 2565-2568.

Background: The majority of the literature now has shown no association between vasectomy and prostate cancer. The effect of vasectomy on men with a family history of prostate cancer or on those who underwent a vasectomy at a young age or had an extended period of time since the procedure has been poorly studied due to small sample sizes and short study follow-up.

Objective: To assess the risk of prostate cancer in men by age and length of time to exposure from vasectomy to disease.

Design: Population-based, prostate cancer case-controlled study.

Participants: 1327 men aged 35 to 74 years residing in King County, Washington, with a diagnosis of prostate cancer.

Methods: Cases of prostate cancer were identified from the SEER database for this population. Structured in-person interviews were conducted. Eligible controls were identified by random digit telephone dialing. Analysis based on prostate cancer Gleason score and stage was performed. Analysis was also performed based on demographics, age, prostate cancer screening history (within the last 5 years), family history of prostate cancer, and vasectomy parameters.

Results: 1327 men were eligible for study from the SEER database; 1001 completed the personal questionnaire. In total, 1340 controls were identified, of which 942 were interviewed. The control population showed that men who had undergone vasectomy were older, white, married, non-smokers with higher income and education, and had undergone PSA screening. Of men with prostate cancer and controls, 36% had undergone a vasectomy. Mean number of years since vasectomy in cases and controls was 21.1 years. No significant association was seen between prostate cancer and vasectomy status, age at vasectomy, years since vasectomy, or year of vasectomy. There was no evidence of risk estimates across vasectomy parameters. Risk did not change if men with prostate cancer within 2 years of vasectomy and controls with no PSA screening within 5 years (n=136) were excluded.

Conclusions:

No association was found between prostate cancer and vasectomy, even in men who had a vasectomy performed at a young age or had an extended period of time since vasectomy.

Reviewer’s Comments: This paper is a well-conducted, large case-control study that answers the concern about possible limitations of previous work that reported the lack of association between prostate cancer and vasectomy. This criticism often indicated inadequate follow-up since vasectomy to make this claim. In this study, average time since vasectomy in cases of prostate cancer and controls was 21 years. Multiple variables were looked at including vasectomy in the face of prostate cancer family history and screening. This large study should end the criticism on previous work that did not answer the question of prostate cancer and time from vasectomy. (Reviewer–Ajay K. Nangia, MBBS).