General Complications
Although they are very rare, any operation can have major consequences which have to be considered including anaesthetic risks, heart attack, stroke, clots in the legs and even death. In my experience, I have not seen any of these associated with this procedure.
Permanency
Vasectomy is performed as a permanent form of contraception. In some men it can be successfully reversed, but there are no guarantees. If you have a vasectomy you should intend this to be a permanent form of contraception.
Spontaneous Re-canalisation
It is possible in a small percentage of men for the vas to re-join, leading to return of fertility and failure of the procedure. Although it is not possible to predict in whom this will happen, it is more likely within the first year. Unfortunately no form of contraception comes with a 100% guarantee and therefore if your wife/partner misses a period, you must consider the possibility of pregnancy even though you have had a vasectomy.
Latency
A vasectomy does not work immediately. After you have had the vasectomy it takes time to wash out sperm stored in the seminal vesicles and during this time you are fertile. You can not assume you are sterile until you return a sperm which show sterility, i.e. no sperm. You must continue your present form of contraception until this result is achieved. Until you return a negative sperm counts after the procedure you must consider yourself fertile! Unfortunately it is impossible to predict accurately when this will occur and occasionally more than 2 sperm tests are necessary before being given the all clear. The first sperm count should be performed after a minimum of 2 months and a minimum of 10 ejaculations.
Bleeding and Infection
Wound infection can occur with any procedure. To reduce the risk of infection the scrotum will be shaved at the time of the procedure. Bruising of the area is not uncommon and rarely a collection of blood may require drainage. To decrease the risk of bleeding complications, Aspirin and arthritis medication should be stopped for one week before the operation.
Pain
It is common to have some pain the scrotum typical of any operation but this usually settles within 1-2 weeks and should respond to simple pain relieving medication e.g. Paracetamol. Occasionally pain can persist for various reasons including chronic inflammation in the wound.Occasionally men notice painful ejaculation or pain in the testicle. Pain in the testicle can sometimes become chronic and longstanding although this is extremely uncommon. This is initially treated wit antibiotics and anti inflammatory medication but if it persists there are surgical options to treat it.
Sprem Granuloma
This is a lump at the site of the vasectomy that is an inflammatory reaction to the leakage of sperm. It may very rarely cause pain and tenderness at the vasectomy site and it can be related to re-canalisation. It may be necessary to remove the lump surgically if it is causing complications.
Long Term Associations
Vasectomy has been reported to have an association with increased risk of heart disease, testicular cancer, and most recently prostate cancer. None of these associations has been proven and an equal number of reports have shown no association.
Antibody Production
Some men make antibodies to sperm cells after their vasectomy. This is one cause of persistent infertility after vasectomy reversal, as the sperm may not function effectively even though the tubes may be re-joined. They have no relevance unless considering reversal.
Sexual Function
There should be no physical change to erections or sexual function. There would be a theoretical decrease of about 10% of ejaculate volume but this is not noticeable. Psychological factors may change sexual function after this surgery.
