Vasectomy complications advice ‘outdated’

Advice given to men about potential complications following a vasectomy is outdated, British researchers say.

A UK study by researchers from Gloucestershire Hospitals NHS Foundation Trust reviewed the outcomes of more than 90,000 vasectomies over 15 years and found the procedure is much less likely to lead to complications than previously thought.

The findings are being presented today at the European Association of Urology (EAU) Congress in Milan, Italy.

Dr Gareth James, of the Association of Surgeons of Primary Care, and colleagues gathered data from 94,082 vasectomies that were carried out between 2006 and 2021. Most of these were patient questionnaires – one that was completed on the day of surgery and a second that was sent to patients four months post-operation.

About 77,000 (80%) completed the initial questionnaire and 36,500 (40%) of patients completed the second.

Mr Julian Peacock, a senior registrar at Gloucestershire Hospitals NHS Foundation Trust who headed the review with Mr John Henderson, consultant urological surgeon, said: “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.”

One of the most significant complications of a vasectomy is chronic scrotal pain, which the British Association of Urological Surgeons (BAUS)’ patient information leaflet says affects up to 5% of all patients.

However, when the team reviewed the data, the rate was 0.12% of patients.

Mr Peacock says: “The chances of chronic scrotal pain could be very off-putting, especially as it’s a difficult condition to manage. So we hope that this more up-to-date rate gives a better picture of the small chance of this happening.”

The chances of post-operative infection, and of haematoma – when blood forms a clot in the scrotal tissue – were also reviewed. The rates of infection – taken as any case or condition that had been treated with antibiotics – are quoted as 2-10% of patients in the BAUS statistics, but the team found this was closer to 1.3%.

The leaflet says haematoma rates are 2-10%, but the updated information suggests it could be as low as 1.4%.

Vasectomy failure rates were available for 70,947 patients, with the early failure rate being 0.5% compared to BAUS’s figure of 0.4, while late failure rate was 0.014% compared with the 0.05% BAUS figure.

Mr Peacock added: “Vasectomy is a very reliable and safe contraception method. These figures might encourage more men to undergo the procedure, so we hope our research will be incorporated in the guidelines that provide information for pre-vasectomy counselling and leaflets. “

‘Complications of vasectomy: Results from a prospective audit of 94,000 procedures’ presented at EAU23 in Milan on Sunday 12 March, 2023.

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