What side effects and complications can occur with vasectomy?

Since it is only a minor procedure, there are usually very few side effects and complications. The wounds of the testicles can cause pain, but this usually goes away by itself after a few days. In rare cases, wound healing disorders such as post-bleeding, wound infections and bruising (haematomas) in the testicular area may occur.

The inflammation can also spread to the epididymis. In addition, inflammation of the vas deferens can also occur. A very rare consequence of the procedure is chronic pain in the testicular area.

They can become worse during sexual activity and represent a considerable restriction of sexual and everyday life. This pain can be caused by nodular accumulations of sperm (sperm granulomas). They can be caused by the fact that immediately after the procedure, sperm production is not yet reduced and the sperm cannot be broken down by the body sufficiently quickly.

This leads to a dilatation of the epididymis, which can be felt as a pea-sized hardening in the testicles. In rare cases, this also results in a recanalization of the spermatic ducts, i.e. an unintentional connection of the two ends that were previously severed, which can result in renewed male fertility. Recanalization occurs in up to 1% of cases and is detected by functional sperm in the seminal fluid a few months after the procedure.

In these cases, a new procedure is necessary to achieve the man’s infertility.The procedure can also cause psychological problems for the man due to infertility. This is especially the case if the procedure was not carefully thought through and the man was not aware of the consequences. In addition, in rare cases, damage to various nerves may occur during the operation, which may result in disturbance of various functions or sensations.

In order to avoid further complications, men who already have problems in the area of the testicles, groin or lumbar spine before the operation should inform their treating physician in advance. The most serious complication is the loss of the testicle. Very rarely the testicle has to be removed if vessels have been injured or if an epididymitis can no longer be treated with other methods.

Furthermore, in rare cases vasectomy cannot lead to infertility if the spermatic duct has not been cut or the two cut ends grow together again. The vasectomy is usually performed with the help of a local anesthetic, which is completely sufficient. However, the injections with which the local anesthetic is given may be unpleasant.

During the procedure, some men feel a slight pulling sensation. After the procedure, there is usually pain in the wound for about two days. This can be treated with painkillers, e.g. ibuprofen.

The incision is very small, about one centimeter, and the skin of the testicles is relatively insensitive, so that no strong pain is to be expected. Sometimes the pain can last longer, but often it only occurs with certain movements and should disappear after two weeks. Usually sexual activity can be resumed after seven days.

Whether and what kind of pain you can expect after a vasectomy, you can find out in our article: Pain after a vasectomyEpididymitis occurs with a frequency of 0.5-5% after a vasectomy. With the non-scalpel method it is a little less frequent than with conservative vasectomy. The epididymitis is very painful and must be treated by a doctor in any case.

In the course of an epididymitis there is a swelling, overheating and redness of the scrotum. Usually the inflammation is accompanied by high fever. For treatment, a few days of bed rest should be observed.

Furthermore, painkillers can be taken. In some cases an antibiotic is necessary. Men who have already had one or more epididymitis before a vasectomy should discuss this with their doctor before a vasectomy.

In most cases, a long-term outcome cannot be expected after a vasectomy. Occasionally, however, post-vasectomy syndrome may occur. Figures on the frequency of this syndrome vary greatly.

The syndrome is defined as chronic pain in the groin, testicles or epididymis without any inflammation. The pain is associated with vasectomy. There are various approaches to explain this chronic pain, but a clear cause has not yet been found.

Psychological aspects are also discussed as a factor. The intensity of the pain ranges from occasional pulling to impairing chronic pain. Although there are studies that claim that there is a slightly increased risk of prostate cancer, there are also studies that did not find an increased risk. Scientifically, an increased risk cannot be explained. An increased risk for testicular cancer or other tumor diseases could not be proven in studies.