Vasectomy and Vasovasostomy (Reversal Surgery)

Description

Alternative Names

Complications

Vasectomy is a low-risk procedure and the complications, which occur in about 10% of patients, are usually easy to control. One study of no-scalpel vasectomy, for example, reported only seven complications out of 4,255 procedures and they were mostly minor. Pain or soreness typically lingers for a few days after the procedure, but this is normal and usually does not require a return visit to the doctor.No deaths resulting from vasectomy have been reported in the United States.

Postoperative Care

Nearly all men recover completely in a few days. The following are some guidelines after the operation to help recovery:

• An hour or two after the procedure the effects of the local anesthetic wear off, and most patients then experience a dull ache in the testicles and groin. The doctor may prescribe a painkiller for the first few days, continuing with mild over-the-counter pain relievers if discomfort persists. Acetaminophen (Tylenol) with or without codeine is the primary choice for postoperative pain. Aspirin, ibuprofen (Advil, Medipren, Motrin, Nuprin), naproxen (Aleve), or other so-called NSAIDs can cause bleeding and should be avoided.
• The patient should stay in bed on his back for at least one day and apply ice packs for 8 hours. The doctor may suggest that the patient wear an athletic supporter.
• Some oozing of blood onto the gauze pads is normal during the first day or two after the operation.
• The patient should not perform any heavy physical labor for at least two days. Sports and heavy lifting may be resumed two to three weeks after surgery.
• A semen analysis is done about six to twelve weeks after the surgery to ensure that no live sperm remain in the semen. The semen is usually collected at home in a small jar and delivered to the doctor's office, where it is examined under a microscope. A second semen analysis is sometimes performed again about four months after the vasectomy, although many experts now believe that a second sample is unnecessary unless sperm found the first time were motile (still able to move). Of note: The British Andrology Society recommends taking the initial sample after four months and when the patient has ejaculated at least 24 times.

Postoperative Pain

All men experience some pain in the scrotum (the sac that contains the testes) after the operation. This pain generally disappears within two days, although the patient may feel sore for a few more days. In rare cases, pain can be persistent, which is known as post-vasectomy pain syndrome. The cause of this is unclear.

Itching and Hives

A few men may have an allergic reaction to the local anesthesia and develop itching and hives.

Bleeding

Frequently, blood may seep under the skin, so that the scrotum and penis appear to be bruised. If there is no dangerous swelling, this painless problem usually disappears without treatment within a week or two. If the patient bleeds excessively in the days after the operation and requires more than two or three gauze changes per day, he should call his doctor.

Hematoma

In between 2% and 5% of cases, bleeding inside the scrotum can cause a painful swelling known as a hematoma. In these cases, the scrotum swells up shortly after vasectomy. The doctor should be called immediately.

Infection

Infections occur in between 4% to 9% of men after vasectomy. The incision site may become infected, causing redness and swelling around the incision. Antibiotics, antimicrobial creams or ointments, or both, along with hot baths several times a day will usually clear the infection in a few days. There have been a few cases of infections in the lining of the heart (endocarditis) and severe gangrene of the scrotum, but they are extremely rare.