Although most men experience minor complications immediately after a vasectomy, chronic complications are not common.
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Short-term complications
A majority of men experience some adverse effects immediately post-surgery, most commonly bruising, inflammation, and pain in the affected area. Occasionally, an infection may occur and some men may also notice blood in their semen the first few times they ejaculate following the procedure.
However, these effects are not usually long-lasting and subside within about a week. To manage the pain for the short-term, cold packs may be applied to the area and analgesic medications such as paracetamol and ibuprofen may also offer a benefit. Tight-fitting underwear can help to restrict movement and subsequent pain of the penis.
Post-vasectomy pain syndrome (PVPS)
PVPS is a syndrome involving chronic pain following a vasectomy, which may present immediately or delayed up to several years later. Most men do not suffer from ongoing pain but some studies have reported 3-10% of patients noting some issues.
The characteristics of PVPS pain can vary between cases from constant pain to intermittent pain that intensifies during certain activities, such as sexual intercourse or extensive physical exertion. The pain may affect one or both testicles and may be described as a dull ache or sharp and intense pain.
Primary progressive aphasia
Some scientific research has suggested a link between primary progressive aphasia, which is a form of dementia, and vasectomy. Patients who had had a vasectomy in the past were found to be twice as likely, with a risk of 40% in comparison to 16%, of developing this form of dementia as compared to the control group.
However, this link requires further research before it is regarded as true, as there have been no further studies to support this claim at this point in time.
Hematoma
In rare cases, a hematoma may develop inside the scrotum after a vasectomy. This is a collection of blood that forms a clot in the tissue surrounding a ruptured blood vessel. It is usually small in size but may grow to be very large in some men to fill the scrotum entirely and make the area become swollen and painful.
While the majority of cases of hematoma are minor and do not cause major issues, the quality of life is reduced significantly for some men as a result and may require surgical removal of the clot.
Sperm granulomas
Occasionally the vas deferens that has been clamped and cut during the vasectomy surgery may leak some sperm. It is possible for this sperm to then collect and form granulomas in the surrounding tissue, although this is rare.
These hard lumps may not cause any symptoms but they have the potential to become swollen and cause significant local pain. Depending on the severity of the condition, sperm granulomas may be managed with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or may need to be surgically removed.
Fertility
A vasectomy is considered to be a permanent form of contraception and men do not need to use an alternative method of contraception. However, very rarely the vas deferens may reconnect over time and lead to the presence of sperm in semen and, consequently, the ability to conceive a child.
Taking a sperm test to confirm sperm count is zero can help to confirm the efficacy of the vasectomy as a contraceptive method, but most men do not routinely require this.
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