Vasectomy & Complications
Vasectomy is a surgical procedure performed on males in which the vas deferens--the tubes which transport sperm during ejaculation--are severed and sealed, resulting in permanent sterilization. Approximately 500,000 men undergo the procedure in the United States each year. It is a common means of contraception for men or couples who no longer wish to have children, and in most cases can be reversed. The surgery itself is a simple process conducted under local anesthetic, and the risk of serious complications is extremely low.
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Short-Term Complications
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A number of general complications are associated with vasectomy surgery. Pain, swelling, bruising and small amounts of blood present in the ejaculate are all normal symptoms to experience post-surgery. Most of these symptoms will subside after a short time, however if they persist medical advice should be sought. More serious risks include: allergic reaction to anesthesia; post-surgery infection; internal bleeding, or allergic reaction to sutures.
Psychological Effects
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Men may experience a range of emotions following a vasectomy. Most are associated with the loss of their ability to reproduce, feelings of emasculation, degradation, or a period of mourning which usually passes after a brief time. A small percentage will experience more severe depression and anger. Couples can experience difficulties adjusting, which can manifest in impotence, premature ejaculation or other sexual dysfunction. Such symptoms are generally a result of psychological causes and not surgical complications.
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Sperm Granuloma
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In a small number of cases, sperm can leak internally from the surgical site into the surrounding tissue. Sperm is highly antigenic to the rest of the body and prompts an immune response, where the body creates pockets of firm tissue around the escaped sperm to protect itself. This phenomenon occurs in a relatively high number of cases, however a large number go unnoticed by the patient as the body resolves them naturally. If the granulomas become painful or inflamed, steroid treatment is commonly prescribed.
Epididymis Inflammation
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Post-vasectomy, the testes continue to produce and store sperm. The excess sperm is usually metabolized by the body, however in a small number of cases a build-up can a occur in the epididymis, the part of the testes where sperm is stored. This can result in increased pressure, swelling, tenderness, and a noticeable increase in size of the epididymis. The majority of cases will subside with the use of anti-inflammatory or antibiotic treatments, however persistent cases may be remedied by surgical removal of the epididymis and associated tissue.
Chronic Testicular Pain
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A small percentage of men suffer from long term pain, also known as Post Vasectomy Pain Syndrome (PVPS). The term PVPS is used to categorize any condition where pain goes unresolved for more than three months post-surgery. This can occur due to a range of causes, from excess scar tissue, pinched nerves, psychosomatic disorders and congestive epididymitis. Another cause can be chronic orchialgia, which occurs when the unused dead sperm collect in the testes, causing a dull ache.
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