Vasectomy is a safe and straightforward medical procedure where complications and side effects are rare. However, like any procedure, there is an element of risk, and it’s important to be aware of potential side effects, which include:
- Bleeding: There is a 1-2 percent risk of developing a haematoma (blood clot) within the scrotum following a vasectomy. Most of these are small and the body will reabsorb them over 2-4 weeks. Very rarely patients can develop a larger haematoma requiring hospital admission and drainage. It is common for patients to have some bruising in the skin following a vasectomy which normally resolves over a week or so.
- Infection: There is a 1-2 percent risk of developing an infection following a vasectomy. Most of these will respond to oral antibiotics. Very rarely patients will require admission to hospital for management (which may include intravenous antibiotics and drainage of an abscess).
- Orchalgia: Patients can develop pain in the scrotum or up into the abdomen following a vasectomy which may be related to disruption of nerves in the membranes surrounding the vas deferens. In most cases this will resolve on its own accord by 6 months. Rarely mild discomfort will persist. Around 1 in 1000 patients will experience more severe pain that persists and may need to consider further surgery or medication to try to resolve this. In rare cases, patients experiencing orchalgia may also perceive changes in their semen, sex drive, climax sensation and erections.
- Congestion: Patients can develop a tender build-up of sperm upstream from the vasectomy site. In most cases this will settle with simple anti-inflammatory medications. Around 1 in 1000 patients will have continued discomfort severe enough to require surgical intervention
- Sperm Granuloma: Patients can develop a pea sized lump on the end of a vas deferens at the vasectomy site. These can be tender and discomfort will normally respond to simple anti-inflammatory medications. Around 1 in 1500 may require surgical intervention to remove the tender lump.
It is important for patients to be aware that treatment for ongoing pain following vasectomy (whether it be related to or orchalgia, congestion or sperm granuloma) may not always be successful. As such, despite meticulous vasectomy technique, there is a very small risk that patients can experience ongoing pain, sufficient to impact on their quality of life, and that is resistant to all treatment.
Recanalisation – there is approximately a 1 in 2500 risk of vas deferens tubes rejoining following a vasectomy. If this happens early the semen test never becomes sperm free. If this happens late (months or years after the semen test has tested clear of sperm) it can result in an unplanned pregnancy. Vasectomy still remains the most effective form of contraception available (including tubal ligation).