A vasectomy is a procedure that cuts and seals the tubes that transmit sperm to a man’s ejaculate. As a result, a man shouldn’t be able to get a woman pregnant. It’s generally used as a form of birth control.

A vasectomy is typically performed in a doctor’s office. While it’s a safe and commonly performed procedure, there are potential complications that can occur. You doctor should review these possible complications with you before performing the procedure.

The American Urological Association (AUA) estimates 175,000 to 500,000 men have a vasectomy in the United States each year. While the risks for complications are very small, it’s possible to experience longer-term side effects.

Pain and discomfort

Some men may report chronic scrotal pain following vasectomy. This pain can range from dull and aching to sharp. The AUA estimates about 1 to 2 percent of men experience chronic scrotal pain after the procedure. They rarely require further surgery to correct the pain.

Delayed surgical failure

After a vasectomy, a man should have negative or nonmotile sperm in their semen sample.

In rare cases, the vas deferens that were cut can grow back together over time. As a result, a man can experience a delayed vasectomy failure and have viable sperm in his semen sample again.

Recent research estimates this occurs in 0.05 to 1 percent of all men who undergo vasectomies.

Epididymitis

The epididymis is a duct located behind the testicles. It allows sperm to flow to the vas deferens. When a man has a vasectomy, sperm can still flow from the epididymis to the vas deferens, but becomes backed up because the vas deferens has been cut. In some men, this can cause inflammation of the gland, or epididymitis.

Symptoms associated with the condition include pain and swelling. Epididymitis following vasectomy occurs in an estimated 1 to 3 percent of all men after a vasectomy.

Vasovenous fistula

A vasovenous fistula is a very rare complication of vasectomy. This condition occurs when multiple blood vessels adhere to the vas deferens that then become injured when a man has a vasectomy. This can result in the pooling of blood that leads to the development of a fistula, or abnormal connection between the vas deferens and nearby blood vessels.

Symptoms of a vasovenous fistula may include blood in urine or ejaculate. While this complication is very rare, seek immediate medical attention if you have these symptoms.

Sperm granuloma

A sperm granuloma is a lump of sperm that can cause small bumps or cysts that range from 1 millimeter to 1 centimeter in size. A person can experience multiple lesions. They don’t usually cause any symptoms. However, some men may have pain at the granuloma areas.

Experts estimate 15 to 40 percent of men undergoing vasectomy experience a sperm granuloma. In some instances, a man may have to have the granuloma surgically removed.

Sometimes you may experience side effects within hours to days after having a vasectomy. These side effects don’t often extend beyond the recovery period. However, if you’re uncertain if a complication is expected, then talk to your doctor.

Pain and discomfort

While the procedure is usually very short, it’s not unusual to experience some discomfort and pain afterward. If this occurs, taking over-the-counter (OTC) pain relievers, such as ibuprofen, may help.

Another option is to wear supportive underwear that lift the testicles. This may provide some pain relief, too.

Discoloration of the scrotum

Some bruising and swelling in the scrotum is to be expected following a vasectomy. This isn’t usually cause for concern. It often quickly resolves.

Some doctors may recommend applying cloth-covered ice packs to the scrotum in 10- to 15-minute intervals. They may also recommend taking OTC anti-inflammatory medications, such as ibuprofen or naproxen, to reduce inflammation.

Bleeding or hematoma

Short-term bleeding-related complications after a vasectomy may sometimes occur. These include bleeding from the surgical site or a hematoma. A hematoma is a collection of blood that can press on other nearby structures in the body.

Experts estimate bleeding or hematoma occurs in 4 to 20 percent of vasectomies. However, bleeding will usually resolve on its own following the procedure.

If you have continued bleeding that soaks a dressing, call your doctor.

Surgical site infection

Any time incisions or instruments are inserted into the body, there’s potential risk for infection after the procedure. Your doctor will take steps to keep this risk to a minimum. This includes things like washing their hands, wearing sterile gloves, and cleaning the area with a special soap solution before making an incision.

Your doctor won’t usually prescribe antibiotics to prevent infection unless you currently have an active infection or other risk factors, such as a history of surgical site infections.

Swelling

Swelling after a vasectomy can be due to a number of reasons, such as:

  • bleeding
  • hematoma
  • formation of simple postsurgical fluid collection

The swelling related to these side effects will usually subside with time. If it doesn’t, your doctor may need to drain the affected area.

Procedure failure

Having a vasectomy isn’t an immediate birth control method.

Instead, your doctor will recommend you come back 8 to 16 weeks after the procedure to provide a semen sample. They’ll test the sample for the presence of sperm to determine if you and your partner can forego other birth control methods.

The risks for pregnancy after vasectomy are 1 in 2,000 for men who previously had a semen sample that didn’t show sperm were present, notes the AUA.

If you come back to your doctor and your sperm counts are still present, you may need another vasectomy. This is necessary in less than 1 percent of all men who have vasectomies.

While there are potential risks that can occur with a vasectomy, there are also misconceptions surrounding the procedure in terms of side effects. For example, a vasectomy shouldn’t:

  • affect a man’s sexual performance
  • increase cancer risks
  • cause significant pain

If you have any concerns surrounding a vasectomy, talk to your doctor and address these before surgery.