How common is chronic pain after vasectomy?

  • Canadian Urology Association give the chronic pain outcomes for vasectomy at between 1–14% (Link)
  • American Urological Association says chronic pain serious enough to impact quality of life occurs after 1–2%of vasectomies. (Link)
  • British Association of Urological Surgeons, patient advice reports troublesome chronic testicular pain which can be severe enough to affect day-to-day activities in 5–14% of vasectomy patients. (Link)
  • UK National Health Service says long-term testicular pain affects around 10% of men after vasectomy. (Link)
  • 11th edition of Campbell Walsh Urology (2015) cites 10% incidence of chronic scrotal pain caused by vasectomy. (Link)
  • European Association of Urology (2012) cites 1–14% incidence of chronic scrotal pain caused by vasectomy, usually mild but sometimes requiring pain management or surgery (Link)
  • Royal College of Surgeons of England says significant chronic orchalgia may occur in up to 15% of men after vasectomy, and may require epididymectomy or vasectomy reversal. (Link)
  • Journal of Andrology cites large studies that find Post Vasectomy Pain Syndrome 2–6% of the time (Link)
  • UpToDate says “surveys have found that the incidence of “troublesome” post-vasectomy pain is reported by approximately 15% of men, with pain severe enough to affect quality of life in 2%. However, survey respondents may not have been representative of all men who have had a vasectomy.” (Link)
  • European Association of Urology says “Post-vasectomy scrotal pain syndrome is a scrotal pain syndrome that follows vasectomy. Post-vasectomy scrotal pain syndrome is often associated with negative cognitive, behavioural, sexual or emotional consequences, as well as with symptoms suggestive of lower urinary tract and sexual dysfunction. Post-vasectomy pain may be as frequent as 1% following vasectomy, possibly more frequent.” (Link)
  • American Family Physician says “Recent studies estimate the incidence of severe postvasectomy pain syndrome to be between 1% and 6%” (Link)
  • International Journal of Environmental Research and Public Health published a meta-analysis in March 2020 to determine the incidence of PVPS, which examined 559 peer-reviewed studies and concluded that “Post-vasectomy pain syndrome occurred in 5% of subjects” (Link) The authors determined that “the overall incidence of post-vasectomy pain is greater than previously reported.”
  • Very Common = Greater than 10%
  • Common = 1% to 10%
  • Uncommon = 0.1% to 1%
  • Rare = 0.01% to 0.1%
  • Very Rare = Less than 0.01%
  • Know about Post Vasectomy Pain Syndrome
  • Understand the impact it would have on your life
  • Understand that it may be permanent
  • Know that the risk is at least 1%
  • Explicitly accept the risk
  • Before vasectomy, sperm is kept separated from the immune system. After vasectomy, the immune system typically creates antibodies that cause it to seek out and kill sperm. In other words, men commonly become allergic to their own sperm, and a chronic auto-immune response can cause inflammation, making the area feel swollen and raw on the inside.
  • After vasectomy, the testes continue producing sperm, but since the sperm cannot escape, they can create pressure inside the epididymis and vas deferens. In fact, the pressure can get high enough to rupture these tissues, releasing the sperm and allowing it to form a bubble in the scrotum called a granuloma. Anyone who has experienced epididymitis will immediately recognize the nagging ache of a swollen epididymis. If you haven’t had this experience, you can compare it to the painful pressure an ear infection can cause.
  • Nerves severed during the procedure sometimes heal poorly and interact with scar tissue and auto-immune inflammation, irritating the nerves and causing pain called neuralgia, which in PVPS is usually described as a burning sensation that is hard to localize but centered in the groin.
  • The vas deferens is not just a passive tube — it is lined with muscles that contract during ejaculation to move sperm along. Vasectomy disrupts the function of these muscles.
  • The groin is a very complex region of the body, constantly under mechanical stress whether you are sitting, standing or walking. Multiple organ systems work in close proximity, so that problems in one system can spill over to cause problems in other systems. Nerves that enter the inguinal canal can refer pain to the inner thigh, stomach and lower back — disrupting the normal functioning of muscles in those areas. For a point of comparison, surgery to repair an inguinal hernia results in chronic pain even more frequently than vasectomy. 16% of the time based on this study. Another study puts chronic pain at 28% post hernia surgery, with 11% saying it interfered with work or leisure activity. Chronic pain is not unique to groin surgery — it is a common complication of many kinds of surgery, which is why you should avoid surgery unless you need it!
  • Women who hope their partner will have a vasectomy: “Don’t tell my husband about that, I’ll never get him to go.”
  • Men deciding whether or not to get a vasectomy: “I stayed away from the horror stories. Didn’t want to freak myself out.”
  • Men who are experiencing PVPS: “I need to focus on the positive.”
  • Men considering whether to warn another man who is getting a vasectomy: What happened to me was a one-in-a-million freak accident, and not relevant to his decision.

Other long-term complications of vasectomy

Vasectomy is correlated with an increased rate of prostate cancer. Scientists argue about why this is the case. For a long time, the consensus view has been that vasectomy does not cause prostate cancer. However, recent studies strongly suggest that a little more than 1% of vasectomies result in prostate cancer.

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