Vasectomies are much safer than reported and patient information leaflets need updating to reflect this, says a team of UK doctors after their comprehensive review of nearly 95 000 vasectomies.
Some post-op swelling and soreness is to be expected but serious risks are extremely rare, they added, presenting their findings at the European Association of Urology Congress 2023 in Milan this month.
The Association of Surgeons of Primary Care, led by Dr Gareth James, examined data on 94 082 vasectomies conducted between 2006 and 2021. Most of the data came from patient questionnaires, completed on the day of surgery and again four months after the operation, reports StudyFinds.
More than four out of five patients (around 77 000 men) filled out the initial questionnaire. Just under 36 500 patients completed the second 16 weeks later.
“This large dataset had never been independently analysed, and doing so has enabled us to update the standard complication rates, some of which dated back to the 1980s,” said Julian Peacock, a senior registrar at Gloucestershire Hospitals NHS Foundation Trust.
One of the most significant complications of a vasectomy is chronic scrotal pain, he added. This symptom affects “up to 5% of all patients”, according to leaflets about vasectomies published by the British Association of Urological Surgeons (BAUS).
Reviewing the most recent data, however, the team found that the rate was actually as low as 0.12%.
Only about two in every 1 000 experienced chronic scrotal pain, and similarly, rates of post-op infection needing antibiotics are quoted as 2%-10% but the team found it was just more than 1%.
And only about 1.4% of the men in the study developed a blood clot or haematoma of the scrotum, while patient leaflets say the risk is 2%-10%.
To reach these new findings, the team examined the vasectomy failure rates for more than 70 000 procedures.
The findings show that the early failure rate – defined as finding sperm capable of motion after three months – was only slightly higher than previously quoted, occurring in 360 patients (0.5%) compared with the BAUS figure of 0.4%.
Late failure – which occurs when the severed ends of the vas deferens reconnect – occurred in just 10 patients (0.014%). That’s compared to the BAUS figure of 0.05%.
“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,” said Dr Marij Dinkelman-Smit, an assistant professor of urology at Erasmus University Medical Centre in Holland.
Dr Sophie Nicholls from the Faculty of Sexual and Reproductive Healthcare told the BBC: “It’s really good to have up-to-date information that we can provide to patients so that they can make an informed choice about their care.”
Study abstract unavailable
A0680 – Complications of vasectomy: Results from a prospective audit of 94,000 procedures
BBC article – Vasectomies even safer than reported, doctors say (Open access)
See more from MedicalBrief archives:
Most promising study to date on male contraceptive pill
No benefits from androgen deprivation therapy
Mpumalanga holds men’s health dialogues