Complications

There is no evidence that vasectomy results in an increased risk of cardiovascular disease, prostatic or testicular cancer, erectile failure or autoimmune disease. There is no evidence linking osteoporosis development and previous vasectomy.

• early complications following vasectomy occur in 1-6% of men
  • early complications include haematoma, wound infection, cyst-like sperm granulomas (see notes), epididymitis-orchitis and congestive (non-infective) epididymitis (2)
    • the most common side effects are wound haematoma and staphylococcal wound infection
    • most men will develop wound haematoma to a degree, but large problematical haematoma formation is rare (2). Development of postoperative haematoma may be limited by adequate scrotal support and by the avoidance of physical exercise for up to 3-4 days following the procedure
• late complications following vasectomy
  • chronic testicular pain has been found to be the most common late complication and men should be informed of this possibility
  • significant chronic orchalgia may occur in up to 15% of men after vasectomy (3)

Notes:

• sperm granuloma
  • granulomas (cyst-like) may occur at 60% of vasectomy sites and are usually asymptomatic and relieve intraluminal pressure
  • consists of a mass of degenerating spermatozoa surrounded by macrophages
  • there is distension of the epididymal duct and the associated pressure effect may occasionally result in pain (in about 3-5% of cases)
  • a sperm granuloma is a site of sperm phagocytosis and of presentation of spermatozoal autoantigens to the immune system - sperm granuloma may be for the anti-sperm antibody production (seen in up to 60% of patients after vasectomy) (2)

Reference:

1. Br J Urol 1997; 79: 599-601.
2. Brechin S, Bigrigg A. Male and Female Sterilisation. Curr. Obst. & Gynae. 2006;16(1):39-46.
3. Awsare NS et al. Complications of vasectomy. Ann R Coll Surg Engl. 2005 Nov;87(6):406-10