Chronic pain possible after vasectomy

By Amy Norton

NEW YORK (Reuters Health) - Some men who undergo vasectomy may have some pain for months afterward, a new study suggests.

British researchers found that of 593 men who had a vasectomy at their center over two years, 15 percent developed pain in the scrotum that was still present seven months after surgery.

During a vasectomy, a surgeon cuts the tubes through which sperm move from the testes into the semen. This is done through a small cut in the scrotum; in more recent years, many surgeons have begun using the "no-scalpel" technique, in which the surgeon makes a tiny puncture in the scrotum, rather than a traditional incision. This way, stitches are unnecessary.

Men often have some soreness in the scrotum shortly after a vasectomy, but there has been little research into whether lasting pain is common.

The new findings indicate that chronic scrotal pain after vasectomy is, in fact, a "genuine entity," Dr. Thomas A. Leslie and colleagues report in the medical journal BJU International.

Still, men should not be discouraged from having a vasectomy based on these findings, according to Leslie, of the Churchill Hospital in Oxford.

Only four of the men who reported new pain after their vasectomy described it as severe, he noted. The rest were "satisfied" or "very satisfied" with the procedure despite their lingering discomfort.

"I don't think men should be concerned about the incidence of scrotal pain following vasectomy," Leslie told Reuters Health, "but they should be aware that it is not a painless procedure and that the post-operative discomfort may be prolonged."

The type of vasectomy did appear to make a difference. Many of the study patients had undergone a no-scalpel vasectomy, and their rate of long-term pain was lower than that of men who'd had a traditional vasectomy -- about 12 percent, versus 19 percent.

According to Leslie's team, there are a number of reasons that men may have lasting pain after a vasectomy. They note that 60 percent of the men who reported the problem also felt a lump at some point after surgery -- which may indicate a hematoma or a mass of inflamed tissue.

Longer-term studies are now needed to see how post-vasectomy pain changes over time, the researchers conclude.

SOURCE: BJU International, December 2007.