Vasectomy is a surgical method that offers permanent contraception by preventing the release of sperm from your body. This involves blocking the tubes known as vas deferens, responsible for transporting sperm.

Despite being a routine procedure that thousands of men undergo annually, vasectomy continues to instil fear in many individuals due to its main side effect, Chronic scrotal pain.

Chronic scrotal pain can be highly discouraging, primarily because it is a challenging condition to manage after the procedure.

But how common it is?

A recent UK study, which analyzed the results of over 90,000 vasectomies conducted over 15 years, found that the likelihood of complications resulting from the procedure is significantly lower than anticipated.

Every year, around 11,000 vasectomy surgeries are conducted in the United Kingdom, the vast majority of which are performed in primary care settings by specialized general practitioners.

In the US, 50 million men—or roughly 5% of all married males of reproductive age—have had vasectomy procedures. Every year in the United States, more than 500,000 men choose to undergo vasectomies.

Dr. Gareth James, leading the Association of Surgeons of Primary Care, collected data on 94,082 vasectomies between 2006 and 2021. Most of the data was gathered through patient questionnaires, with one completed on the day of the operation and the second sent to patients four months later. Approximately 80% (roughly 77,000) of patients responded to the initial questionnaire, and just under 40% (36,500) of patients filled out the second one.

The review of vasectomy outcomes was headed by Mr. Julian Peacock, a Senior Registrar at Gloucestershire Hospitals NHS Foundation Trust, along with Mr. John Henderson, a Consultant Urological Surgeon. They analyzed a substantial dataset that had never been independently assessed, allowing them to revise the standard complication rates, some of which were based on figures dating back to the 1980s.

For instance, chronic scrotal pain is a significant complication associated with vasectomies, with the British Association of Urological Surgeons (BAUS) patient information leaflet quoting that it affects ‘up to 5% of all patients.’ However, upon analyzing recent data, the team discovered that the actual rate was as low as 0.12% of patients.

According to Mr. Peacock, “The chances of chronic scrotal pain could be very off-putting, especially as it’s a difficult condition to manage. So we hope that this more up-to-date rate gives a better picture of the small chance of this happening.”

In addition to chronic scrotal pain, the rates of post-operative infection and haematoma, which is the formation of blood clots in the scrotal tissue, were also reviewed. The BAUS statistics report the infection rates as 2-10% of patients, but the updated data indicates that it is closer to 1.3%.

Similarly, the updated information suggests that the haematoma rates could be as low as 1.4%, which is lower than the 2-10% quoted in the BAUS statistics.

The study analyzed vasectomy failure rates for 70,947 patients. The early failure rate, defined as finding motile sperm at 3 months, was slightly higher than previously quoted, occurring in 360 patients or 0.5%, compared to the 0.4% figure reported by BAUS. Late failure, which happens when the severed ends of the vas deferens rejoin, was found in just 10 patients, or 0.014%, compared to BAUS’s figure of 0.05%.

Mr. Peacock stated that “Vasectomy is a very reliable and safe contraception method. These figures might encourage more men to undergo the procedure, so we hope our research will be incorporated in the guidelines that provide information for pre-vasectomy counselling and leaflets.“

According to Dr. Marij Dinkelman-Smit, an Assistant Professor of Urology at Erasmus University Medical Centre in Rotterdam, Netherlands, and a member of the EAU’s section of Andrological Urology, “although other countries’ standard information may be more up-to-date, nevertheless it is very useful for us as urologists to see large datasets of patient perspectives on this frequent procedure. As specialists, we mainly see the problems that arise from vasectomies, so it’s relevant for us to fill in the complete picture.”