Risk
The procedure can occasionally trigger a faint or vasovagal in a small number of men. If this was going to happen it would occur within 30 minutes of the procedure while they are still in the clinic. This is treated quickly and very effectively with a drug that reverses these unpleasant feelings.
Some men experience swelling and discomfort after day 4 . This is due either to infection or bleeding (haematoma). Bleeding is usually related to over activity in the first week after the procedure, and swelling due to a haematoma is treated with supportive underwear, warm compresses and pain relief. Infection will need antibiotics and rest.
Occasionally a lump becomes noticeable above one of the testicles at about 3-5 weeks after the surgery. This is usually due to a collection of sperm at the lower end of the vas. This gradually resolves with the use of ibuprofen and supportive underwear.
Chronic pain (6 months) after vasectomy is rare, and not fully understood. It seems to be reduced by a single midline incision and a well experienced surgeon.
Vasectomy failure, is the persistence of sperm in the ejaculate 6 months after the procedure. This is rare and occurs about 1 in 10000 cases when the 2 ends of the divided vas manage to reconnect through early scar tissue, or when an individual has 3 vas and the third is still functioning normally. The reason is usually diagnosed by ultrasound if consistent specimens still have sperm.
Long term issues
Testosterone and sexual function, is not affected by the vasectomy procedure although we will advise you against sexual activity for the first 5 days. Testosterone is produced by a different part of the testicle from sperm production. Testosterone is released into the blood stream via the testicular vein and this means that testosterone continues to affect every part of the body as before the procedure. There is no change in sex drive, muscle bulk, strength, hair distribution and voice pitch. Often men feel their sex life improves after a vasectomy as the fear of pregnancy is not inhibitive. Some men report a reduction in the volume of ejaculate.
Vasectomy should always be considered as a permanent form on contraception. Future restoration of fertility after a change in domestic circumstances is not easy. The current advice is not to embark on reversal surgery, because even if the microsurgery appears to be straight forward and successful, this does not equate to restoration of fertility. The presence of anti-sperm antibodies is partly responsible. These days it is most effective to work with an IVF clinic to harvest immature sperm from the testicle by a biopsy and fertilize a harvested egg in vitro. Thjs method has the best and fastest chances of pregnancy in the circumstances but is expensive and involves considerable physical and emotional commitment from the man and woman involved.