10 Risks You Should Know About Before Getting a Vasectomy

A vasectomy is a permanent form of birth control. About 10% of families in the U.S. choose vasectomy as their birth control. It requires minor surgery, usually in the office of a urologist or family physician. It’s safe, effective, and affordable. But there are some potential side effects you should consider first. 

Is a vasectomy a safe procedure?

Vasectomies are safe procedures. Most complications are mild or uncommon. And the complications that do occur are usually easy to treat. You can help minimize the risk of problems by following your surgeon’s instructions after a vasectomy.

Risks associated with vasectomies

There are a number of possible short-term and long-term complications after a vasectomy. The degree of risk varies depending on the experience of your surgeon and the type of procedure you have. 

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A no-scalpel vasectomy (NSV) has a lower rate of complications than a traditional vasectomy. Not all vasectomy providers do NSV procedures, so make sure to ask your surgeon which procedure they will be doing.

Here are 10 of the most common complications of a vasectomy.

1. Hematoma

This can happen when the tiny blood vessels bleed into the scrotum. The surgeon will make sure to stop all visible bleeding, but sometimes there can be bleeding after the surgery. 

Fortunately, there are some steps you can take to prevent this complication. The general recommendation is to avoid any strenuous activity for at least 5 days after a vasectomy. 

2. Swelling

As with any surgery, some degree of swelling is expected after a vasectomy. This is the body’s natural attempt at healing after the trauma of the procedure. Support garments and ice packs can help to reduce hematoma formation.

3. Infection 

Infections happen in only about 2% of vasectomies. You can help decrease the risk of infection by keeping the incision site clean and dry. If redness, swelling, pain, fever or discharge occur, be sure to let your surgeon know right away.

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4. Sperm granulomas 

Granulomas are small lumps that can form in the scrotum after a vasectomy. They happen when sperm leaks from a cut end of the vas deferens tube (the tube that carries sperm from the testes). Sperm granulomas are very common and happen in about 40% of people after a vasectomy. 

They aren’t painful in most cases. But a surgeon can remove the granuloma if it’s large or painful. It is important to have any lumps in the scrotum examined to make sure they’re not a more serious condition.

5. Short-term postoperative pain 

Short-term postoperative pain can be due to local lymph node swelling, scrotal pain, or pain with ejaculation. This is usually mild and treated with over-the-counter (OTC) medications like acetaminophen (Tylenol) or ibuprofen (Advil). Ice and a supportive undergarment can also be useful.

6. Discoloration of the scrotum

Scrotum discoloration (change of color) is a common complication after vasectomy. This is usually due to bruising and bleeding from the procedure. It’s not typically serious or harmful. In most cases, it goes away in a few days.

7. Failure

The failure rate for a vasectomy is lower than 1%. You’ll need a semen analysis after the procedure to be sure there’s no sperm mixing with the semen. 

In rare cases, the tubes that were cut can form a new pathway over time. This can cause sperm to be ejaculated, which can lead to a pregnancy. If your partner shows any signs of pregnancy after your vasectomy, you should still encourage them to take a pregnancy test.

8. Epididymitis

The testicles still make sperm, even after a surgeon cuts the vas deferens. The body usually reabsorbs the sperm, but sometimes the sperm builds up. This can cause epididymitis, a type of inflammation. 

Epididymitis occurs in about 1% of people after a vasectomy. Although an infection can cause epididymitis, this is rarely the case after a vasectomy. Treatment usually consists of heat packs and supportive underwear.

9. Vasovenous fistula

This is a very rare complication of a vasectomy. A vasovenous fistula occurs when inflammation causes an opening between the vas deferens and the small blood vessels. 

The main symptoms are blood in the urine and pain. Surgery is needed to close the hole and correct a vasovenous fistula.

10. Long-term postoperative pain

Post-vasectomy pain syndrome (PVPS) is the most common late-stage complication of vasectomy. This is typically pain in the scrotum that occurs over 6 six months after surgery and lasts for at least 3 months. In most cases there’s no cause that can be found. But experts believe it may be due to the formation of scar tissue.

How long does it take to recover from a vasectomy?

Recovery from a vasectomy is usually pretty quick. Most people go home the same day. If you don’t do heavy lifting at work, you may be able to resume working the next day. Overall, most people are back to their normal activities within 2 weeks.

You’ll need to avoid submerging the incision in water for about 5 days. It’s OK to shower, but you should avoid swimming and hot tubs. Your surgeon will recommend ice packs and a supportive undergarment for 3 to 4 days after surgery. This will help control any pain. If needed, you can also use OTC pain relievers. 

A vasectomy will not affect your ability to have sex. You’ll still be able to have an erection, achieve orgasm, and ejaculate semen, if you could before. And you can engage in sexual activity as soon as you feel up to it. For most people, this is about 1 week after the surgery. 

Remember to use another form of birth control until you have a negative semen analysis and your surgeon says your semen is clear of sperm.

When to see a provider about vasectomy side effects 

Most people have mild discomfort and bruising after a vasectomy. That’s to be expected. But there are a few reasons you need to follow up with your healthcare provider. 

Your surgeon will give you written instructions about when to call for help. Here are some general signs of complications to watch for:

• Bleeding: It’s normal to have mild, blood-tinged drainage for 1 to 2 days. See your healthcare provider if there’s more bleeding than what they told you to expect.

• Severe pain: If the pain is severe and you can’t control it with ice and the recommended pain relievers, let your provider know.

• Fever: This may be a sign of infection. Contact your healthcare provider right away if you have a fever.

• Blood in the urine (hematuria): This is a very rare complication associated with a vasovenous fistula. If you see blood in your urine, let your surgeon know. 

• Severe swelling: Your surgeon will tell you how much swelling is normal. A jockstrap and ice should help reduce swelling.

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Written by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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