COMPLICATIONS

 
 
The primary complications associated with vasectomy include; hematoma, infection, sperm granuloma and pain. The most serious complications resulting from vasectomy, although rare, are generally involve damage caused to the blood vessels or nerves that run through the vasal sheath. 
Of the more common serious complications that can occur following vasectomy, chronic pain, sometimes called; Post-Vasectomy Pain Syndrome, is typically the most bothersome. Pain of some type is experienced by from 12% to 52% of men post-vasectomy[1] However, serious chronic pain, the type that drives men to seek additional treatment occurs only 2.2% to 15% of the time[2][3][4]
There continues to be much controversy as to the primary causes of chronic pain following vasectomy. One of the reasons for the lack of consensus on the subject may be because chronic post-vasectomy testicular pain may be caused by a variety of circumstances. Among the theories proposed are; epididymal congestion (excessive pressure created in the epididymus as a result of creating a closed system), epididymal blowout (rupture of the epididymis due to excessive pressure), nerve impingement (related to ligation or pressure from sperm granulomas), damage to tissues including; vas deferens, nerves or blood vessels due to instruments, infection and/or edema (swelling).
Other complications such as infection, hematoma can be resolved either on their own or with minor medical intervention. Sperm granulomas are generally not serious but can occasionally require further surgical intervention.
Chronic pain is generally managed by either discovering and correcting some issue that is irritating the nerves (such as a granuloma or a misplaced suture or clip) or coverting a closed-end vasectomy to an open end vasectomy or performing a vasectomy reversal (vasovasostomy).

[1]Royal College of Obstetricians and Gynaecologists. Male and Female Sterilisation.
National Evidence-based Guideline No. 4. London: RCOG Press, 2004.
[2]McMahon AJ, Buckley J, Taylor A, Lloyd SN, Deane RF, Kirk D. Chronic testicular
pain following vasectomy. Br J Urol 1992; 69: 188–91.
[3] Choe JM, Kirkemo AK. Questionnaire-based outcomes study of nononcological
post-vasectomy complications. J Urol 1996; 155: 1284–6.
[4]Manikandan R, Srirangam SJ, Pearson E, Collins GN. Early and late morbidity
after vasectomy: a comparison of chronic scrotal pain at 1 and 10 years. BJU
Int 2004; 93: 571–4.
 
 

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