Vasectomy Health Article

Morbidity and mortality rates

Complications occur in approximately 5% of vasectomies. The rates of incidence of some of the more common complications are:

• mild bleeding into the scrotum: one in 400
• major bleeding into the scrotum: one in 1000
• infection: one in 100
• epididymitis: one in 100
• sperm granuloma: one in 500
• persistent pain: one in 1,000

Fournier gangrene is a very rare but possible complication of vasectomy in which the lining of tissue underneath the skin of the scrotum becomes infected (a condition called fasciitis). Fournier gangrene progresses very rapidly and is treated with aggressive antibiotic therapy and surgery to remove necrotic (dead) tissue. Despite treatment, a mortality rate of 45% has been reported for this condition.

Alternatives

There are numerous options available to couples who are interested in preventing pregnancy. The most common methods are female sterilization, oral contraceptives, and the male condom. Female sterilization has a success rate of 99.5%; oral contraceptives, 95–99.5%; and the male condom, 86–97%.

BOOKS

"Family Planning: Sterilization." Section 18, Chapter 246 in The Merck Manual of Diagnosis and Therapy, edited by Mark H. Beers, MD, and Robert Berkow, MD. Whitehouse Station, NJ: Merck Research Laboratories, 1999.

PERIODICALS

Hartanto, Victor, Eric Chenven, David DiPiazza, et al. "Fournier Gangrene Following Vasectomy." Infections in Urology 14, no.3 (2001): 80-82.

ORGANIZATIONS

Alan Guttmacher Institute. 1120 Connecticut Ave., NW, Suite 460, Washington, DC 20036. (202) 296-4012. <www.agiusa.org>.

Planned Parenthood Federation of America. 810 Seventh Ave., New York, NY 10019. (212) 541-7800. <www.plannedparenthood.org>.

OTHER

The Alan Guttmacher Institute. "Contraceptive Use." 1999 [cited February 28, 2003]. <http://www.agi-usa.org/pubs/fb_contr_use.html>.

"Facts About Birth Control." Planned Parenthood Federation of America. January 2001 [cited February 28, 2003]. <http://www.plannedparenthood.org/bc/bcfacts1.html>.

"Facts About Vasectomy Safety." National Institute of Child Health and Human Development. September 3, 2002 [cited February 28, 2003]. <www.nichd.nih.gov/publications/pubs/vasect.htm>.

"Vasectomy: Questions and Answers." EngenderHealth. 2000 [cited February 28, 2003]. <www.engenderhealth.org/wh/fp/cvas2.html>.

VasectomyMedical.com. February 4, 2003 [cited February 28, 2003]. <http://www.vasectomymedical.com>.

Donald G. Barstow, RN Stephanie Dionne Sherk

WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?

Vasectomy is a minor procedure that can be performed in a clinic or doctor's office on an outpatient basis. The procedure is generally performed by a urologist, who is a medical doctor who has completed specialized training in the diagnosis and treatment of diseases of the urinary tract and genital organs.

QUESTIONS TO ASK THE DOCTOR

• How often do you perform vasectomies?
• What is your rate of complications?
• How long will the procedure take?
• What will the procedure cost? Will my insurance cover the cost?
• Do you perform vasectomy reversal? What is your success rate?