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Complications of vasectomy Awsare NS; Krishnan J; Boustead GB; Hanbury DC; McNicholas TAAnn R Coll Surg Engl 2005[Nov]; 87 (6): 406-10INTRODUCTION: Vasectomy is a common method of sterilisation. However, it is less popular than tubal ligation world-wide. It is also a frequent cause of litigation relating to its complications. This article reviews the early and late risks associated with the procedure. PATIENTS AND METHODS: Data collection was done using the internet to search Medline for obtaining evidence-based medicine reviews. Cross-references were obtained from key articles. Websites of government bodies and medical associations were searched for guidelines relating to vasectomy. DISCUSSION: Early complications include haematoma, wound and genito-urinary infections, and traumatic fistulae. Vasectomy failure occurs in 0-2% of patients. Late recanalisation causes failure in 0.2% of vasectomies. Significant chronic orchalgia may occur in up to 15% of men after vasectomy, and may require epididyectomy or vasectomy reversal. Antisperm antibodies develop in a significant proportion of men post-vasectomy, but do not increase the risk of immune-complex or atherosclerotic heart disease. Similarly, vasectomy does not enhance risk of testicular or prostate cancer. Vasectomy has a lower mortality as compared to tubal occlusion, but is still significantly high in non-industrialised countries because of infections. CONCLUSIONS: Vasectomy, though safe and relatively simple, requires a high level of expertise to minimise complications. Adequate pre-operative counselling is essential to increase patient acceptability of this method of permanent contraception.|Cardiovascular Diseases/etiology[MESH]|Fistula/etiology[MESH]|Hematoma/etiology[MESH]|Humans[MESH]|Immune System Diseases/etiology[MESH]|Infections/etiology[MESH]|Male[MESH]|Pain, Postoperative/etiology[MESH]|Treatment Failure[MESH]|Urogenital Neoplasms/etiology[MESH]|Vasectomy/*adverse effects/mortality[MESH] |
