Vasectomy: What you need to know

A vasectomy is a method of permanent sterilization preventing pregnancy by stopping the entry of sperm into the semen. The procedure involves cutting or blocking deferens vas— the two tubes which carry sperm from the testicles to the urethra.

It is a very effective form of male contraceptive, but not accurate at 100 per cent. Around 1–2 out of every 1,000 women still become pregnant in the year following the vasectomy of their partner.

Though the operation is free, there may be some people afterwards experiencing pain and other problems.

In this article, we look in more detail at a vasectomy which includes common side effects, risks and complications, recovery, and when to see a doctor.

Short-term side effects

It's recommended to abstain from sex after a vasectomy for at least a week.
It’s recommended to abstain from sex after a vasectomy for at least a week.

Below is a list of some common vasectomy side effects.

1. Pain

A person can experience tenderness, pain, or pressure in the scrotum or pelvic area immediately after a vasectomy.

A person will abstain from sex until the discomfort is gone, which is usually around a week later.

2. Infection

Most patients at the site of surgical procedure develop an infection. The infection will lead to severe pain and swelling.

To treat the symptoms of a bacterial infection, doctors may prescribe antibiotics.

3. Bleeding

Excessive bleeding can increase pain during or after surgery and may require further treatment.

4. Pregnancy

The semen usually takes about 3 months to be sperm-free.

As a result, a woman can still become pregnant immediately after she has a vasectomy with her partner.

5. Swelling

Swelling and scrotum pain are common. The scrotum may look swollen or discolourated in some cases.

Long-term consequences and risks

The majority of the long-term effects of a vasectomy are positive. For example, some people report improvements in their sex life which may be due in part to decreased anxiety about getting a partner pregnant unintentionally.

There are potential risks after the procedure, however, including the ones below.

1. Recanalization

Recanalization occurs when the vas deferens return to form a new connection, allowing the vasectomy to reverse itself.

The sperm may then re-enter the semen, which means the person is fertile again.

2. Failed vasectomy

A vasectomy can fail occasionally. A person may need to repeat the surgery in this case or find another alternative for birth control.

3. Regret and confusion

Many people may regret having a vasectomy, and may feel unsure as to whether they may still want children, especially if they start a new relationship.

Vasectomies are typically reversible but the likelihood of success depends, among other things, on the form of vasectomy and the skill of the reversal surgeon.

4. Cancer

The probability that a person may get cancer after a vasectomy is very small.

A 2019 report that tracked over 38 years of over 2.1 million Danish men found a small but statistically significant rise in prostate cancer among people with vasectomies.

Researchers do not know why this risk exists, or whether the risk is clarified by another independent factor.

5. Decreased sexual function

Many people worry that a vasectomy may result in reduced or less pleasurable orgasms.

However, vasectomy has no effect on sexual function unless a person has an injury during the procedure or develops a syndrome of postvasectomy pain.

Complications

Following a vasectomy, some people experience serious complications but these are rare.

We list some possible complications below.

1. Infection and bleeding

Infection and bleeding following the procedure are generally treatable although they may be serious or even fatal in rare cases.

A severe untreated infection or an infection resistant to antibiotics may spread to other areas of the body.

Similarly, severe bleeding can involve a transfusion of blood, or even endanger the life of a person.

A chirurgist may accidentally damage the testicular artery during the procedure. Such injury can cause bleeding or damage to the testicles, as well as discomfort in the short or long term.

2. Postvasectomy pain syndrome

Postvasectomy pain syndrome is a more common complication which causes a person to have long-term pain in the scrotum. The region may be sore or very sensitive.

Postvasectomy syndrome can affect orgasm and sexual function.

Although the pain may be lessened by some medications, no specific treatment is fully effective, and some people live with long-term testicular pain.

1–2 per cent of people who have a vasectomy experience chronic pain according to the recommendations of the American Urological Association.

3. Damage to nerves and sexual function

Uncomplicated vasectomies have no effect on impotence. However, both groin nerve damage and postvasectomy pain can have an effect on sexual function.

Recovery

Most people take about a week to recover from a vasectomy.

The following self-care tips may help with pain:

  • wearing snug fitting underwear, such as briefs, as this can reduce movement and irritation
  • applying a cloth covered ice pack to the affected area to reduce pain and swelling
  • taking pain relievers, such as acetaminophen or ibuprofen
  • avoiding having sex in the days following the procedure

If after a week sex is still painful a person should wait until the pain is that.

Recovery can take longer when surgical complications are present, such as infection or bleeding.

A person will follow the advice of his or her doctor for recovery.

If a doctor prescribes antibiotics, a person should make sure that even if their symptoms improve, they complete the full course of treatment.

What to expect after the procedure

After the procedure a person can feel groggy if it occurred under general anesthesia. A driving will be dangerous so they should make alternative plans to get home.

There will be no grogginess if the medical team uses a local anesthetic instead. The initial numbing injection, however, may hurt or sting, and a person may feel pain and swelling over several hours, which will get worse. The discomfort generally lasts from a few days to a week.

Many people find the pain is handled easily by home therapies.

There is still a risk of pregnancy until a doctor determines that the semen does not contain any sperms. Until then people who wish to avoid pregnancy should use birth control.

A few months after the procedure, a doctor will check the presence of sperm in the person’s semen. This test is the best way of validating the vasectomy success.

When to see a doctor

A person should contact a doctor if they have:

  • a fever above 100°F
  • sudden swelling of the scrotum, which becomes very tender
  • pus coming out of the wound
  • unbearable pain that does not respond to medication
  • pain that lasts longer than a week
  • excessive bleeding
  • pain that comes back after weeks or months

Summary

Many people who have a vasectomy return to work within a few days and have no serious complications, including their normal activities.

A vasectomy is generally very safe, and is much easier for females than permanent sterilization procedures.

A person considering a vasectomy should speak with their doctor about the risks, though. We may specifically question if their health history makes them more susceptible to any specific complications.

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