Vasectomies less likely to cause complications than expected, study shows

Vasectomies are much less likely to cause complications than expected, according to a new UK study reviewing the outcomes from over 90,000 vasectomies performed over 15 years.

The study, led by researchers from Gloucestershire Hospitals NHS Foundation Trust, is being presented today at the European Association of Urology (EAU) Congress in Milan.

It shows that existing leaflets explaining the potential complications to patients are based on outdated figures.

Around 11,000 vasectomy operations are performed every year in the United Kingdom, the majority in primary care settings by specialist general practitioners.

The Association of Surgeons of Primary Care, led by Dr Gareth James, gathered data from 94,082 vasectomies between 2006 and 2021, mostly through patient questionnaires; one completed on the day of surgery and the second sent to patients four months post-operation.

Over 80% (around 77,000) of patients filled out the initial questionnaire and just under 40% (36,500) of patients completed the second.

Mr Julian Peacock, a Senior Registrar at Gloucestershire Hospitals NHS Foundation Trust who headed the review along 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."

For example, one of the most significant complications of a vasectomy is chronic scrotal pain, which is quoted as affecting 'up to 5% of all patients' in the British Association of Urological Surgeons (BAUS)' patient information leaflet about vasectomies. Reviewing the more recent data, the team found that the rate was in fact as low as 0.12% of patients.

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."

Mr Julian Peacock, Senior Registrar, Gloucestershire Hospitals NHS Foundation Trust

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%.

Haematoma rates in patients is quoted at 2-10% in BAUS statistics, but the updated information suggested this could be as low as 1.4%.

Vasectomy failure rates were available for 70,947 patients. The early failure rate - that's finding motile sperm at 3 months - was very slightly higher than previously quoted, occurring in 360 patients, or 0.5%, vs BAUS's figure of 0.4%. Late failure - which occurs when the severed ends of the vas deferens join up - occurred in just 10 patients – or 0.014%. vs BAUS figure of 0.05%.

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. "

Dr. Marij Dinkelman-Smit, Assistant Professor of Urology at Erasmus University Medical Centre in Rotterdam, Netherlands, and a member of the EAU's section of Andrological Urology, said: "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."