There are many options available to us and a vasectomy seemed a reasonable, reliable choice.
Before learning more about the procedure, I assumed vasectomies carried a low incidence of side effects with little overall risk.
MY husband and I didn’t know much about vasectomies, just what your average person would know I guess. And in my experience, most men will not take sufficient effort and time to research the topic of vasectomies. However, this particular procedure influences a delicate function and sensitive area which should be regarded with additional respect, so I took it upon myself to learn on behalf of my husband.
After extensive reading, in my opinion, statistics and information that levels up to nearly 1 in 20 (5%) and higher of chronic conditions/disorders possible – this is too high a risk percentage for me to ask of my husband to carry out when there are other methods available.
Of course, I fully support every couple to make their own choice in such a private matter.
My goal in sharing this information is to create a greater awareness for men (and their partners) about the risks of vasectomy surgery, particularly such longer term pain-related side effects that may not be disclosed properly when prompted by a medical professional.
A Quick Once-Over on the Procedure
The surgical procedure for male sterilization (permanent male birth control) is known as a vasectomy. (Click here to review an interesting read about the history of vasectomies)
The procedure is considered a minor operation under local anesthesia which usually takes 20 to 30 minutes to carry out and involves cutting the tubes that carry the sperm (vas deferens) and sealing them off with sutures or surgical clips. This prevents sperm from mixing with the semen that is ejaculated from the penis.
…and for those of you wondering, an egg cannot be fertilized when there are no sperm in the semen.
After a short recovery at the doctor's office (usually an hour or less), the patient is free to go home and rest (bag of peas, please?).
Recovery usually takes a few days; however, patients are advised to avoid strenuous exercise for a week.
There is normally a two-month wait after the surgery when the semen is tested to confirm a negative sperm result.[*][*][*]
The cost of a vasectomy can range from $800 to $1000 in the US. In the event you change your mind, it will cost you even more – approximately around $6,000-$15,000.[*]
The Short of It
Short term post procedure complications
Allergic reaction to the anaesthesia used during procedure[*]
A few men will develop itching & hives due to an allergic reaction to anaesthesia[*]
All men experience some form of pain in the scrotum, it usually disappears within 2 days, but the scrotum will still be sore for a few more.
Bruising & swelling[*]
This is normal. The bruising and swelling doesn't always happen immediately - it often happens after a few days but in most cases has mostly disappeared after two weeks.
Frequently blood may seep under the skin, so that penis and scrotum appear bruised. If there is no dangerous swelling, this problem usually disappears without treatment within a week or two.
Pooling of blood within the tissue of the scrotum occurs in up to 29 percent of all vasectomy patients. It usually starts within the first week after the procedure, and can cause a painful swelling.
Chronic Pain Conditions Following Vasectomy
Post-vasectomy pain syndrome
Post-vasectomy pain syndrome (PVPS) is a chronic and sometimes debilitating condition that can develop immediately or several years after vasectomy.[*]
The incidence of PVPS can range approximately from 10-15% (that’s at least 1 out of every 10 vasectomies).[*][*][*][*]
Considering the high incidence of such a chronic condition, recent recommendations instruct doctors to warn patients there is a risk of long term pain following vasectomy procedures.[*]
The treatment for PVPS (and the other of chronic/persistent pain conditions following a vasectomy) can include conservative treatments (ex. avoidance of sexual activity and anti-inflammatory medications) or surgical methods (ex. removal of the epididymis and vasectomy reversal).
Other Chronic Pain Conditions Following Vasectomy
Persistent pain after the vasectomy procedure has been evaluated in Urological literature as early as the late 1970’s. Here are several studies examining characteristics of chronic genital pain after vasectomy:
patient’s genital pain complaints included epididymal pain, pain on ejaculation and pain during intercourse.
patients complained of testicular pain as a dull ache that increased with sexual arousal, intercourse or ejaculation. A retrospective study of post-vasectomy patients found 33% had chronic testicular discomfort and 15% considered the pain troublesome. The pain was described by some as a dull ache and others as a sharp severe pain. The sharp pain was testicular and could increase in frequency after intercourse.
5% of the patients complained of pain associated with intercourse.
4% of 488 men had pain with intercourse. Other patients with post-vasectomy pain have required epididymectomy for relief of pain.
9 out of 10 patients reported constant pain in either the testes or epididymides. Four of ten had pain with activity, and three had pain during intercourse.
Uncertainty of Cancer Association
Prostate Cancer Concern
The link with prostate cancer and vasectomy procedures is inconclusive.
With several studies confirming an increased risk, it is medically advised that when a man considers a vasectomy, the uncertain association between cancer risk and the procedure should be a routine part of informed consent.[*][*][*][*]
In 1993, a team of Harvard epidemiologists presented data from two large studies in the Journal of the American Medical Association (JAMA). One of the two studies was retrospective, while the other was prospective and followed new patients. Both studies found vasectomy to be associated with a moderately elevated relative risk of prostate cancer that increased with time after the procedure. After more than 20 years, a vasectomized man appeared to be twice as likely to develop prostate cancer as a nonvasectomized man of the same age.[*]
A definitive conclusion has not yet been made regarding cancer risk and vasectomy, as many studies provide no association with cancer and vasectomy. It is noted however, that the vasectomy procedure with other potential risk factors (such as race, family history, and dietary habits) may link vasectomy as an associated factor (but not causally linked) to the development of prostate cancer as a primary carcinogen.[*]
The studies that have been completed over the last 20 years are inconclusive, yet the medical community agrees that further research is essential.[*][*][*][*]
While infection after a vasectomy is fairly common, a small number of men do run into trouble after the operation (one study illustrated a 32.9% overall infection rate after vasectomy).[*][*][*]
The most common infection following vasectomy is of the incision site. Infections of the urinary tract and epididymis are also typical. Rarer types of infections can include Fournier's gangrene and endocarditis (an inflammation of your heart's inner lining).[*]
Any infection, particularly with the growing occurrence of bacteria that have become resistant to antibiotics, should be treated seriously.
Here is Karen’s story regarding infection after a routine vasectomy procedure on her husband: How a vasectomy operation killed my husband.
Where have all the cowboys gone?
Sperm backup, re-absorption and immune response
When a vasectomy is performed sperm are still produced, however, there is no longer an exit strategy. This results in several peculiar responses from the body:
If the re-absorption of backed up sperm fails or is inadequate, the epididymides become enlarged, inflamed and can be quite painful. Epididymitis is one of the more common post-vasectomy complications, occurring in approximately 1 out of every 15 vasectomies. Heat and anti-inflammatory medications (alone or combined with antibiotics) are used to treat this condition. This particular side effect can lead to chronic post-vasectomy pain and can affect a man’s ability to participate in physical activities on a long-term basis.[*][*][*][*]
Typically, immune cells will not come in contact with sperm, however, in the event of vasectomy certain barriers are breached an immune response will be mounted.
Membranes in the epididymis increase in size to break down and absorb matured sperm which triggers the immune system to produce more macrophages and the large majority of men (up to 75%) will develop anti-sperm antibodies.[*][*]
Concern has encouraged researchers into learning more about anti-sperm antibodies and the effects on the body because immune reactions against parts of one's own body can cause disease.[*]
Current knowledge has not yet yielded large concern at this time, nevertheless rheumatoid arthritis, tumor growth, atherosclerosis (clogging of arteries), and multiple sclerosis are just some of the illnesses suspected or known to be caused by immune reactions of this type.[*][*][*]
When sperm leaks out into the scrotum via the cut/damaged vas defrans (the tube that is severed to keep the sperm from entered the semen), another immune response occurs. The sperm is surrounded by a protective mass (granuloma) which is commonly felt as swelling and radiating pain in the groin which can last up to year.[*]
Granulomas occur in approximately 40% of vasectomies, nearly 1 out of every 5 men that has a vasectomy will experience pain that last more than 3 months (described as interfering with daily activities).[*][*][*]
Before choosing a vasectomy, a couple should seriously consider the many alternative methods of contraception – particularly when there is risk is chronic pain.
I hope this information helps with creating more awareness of risk that may not be discussed openly/willingly from your medical professional.