Complications
Post-Procedure Complications
Post-procedure complications and their management, including indications for referral to an urologist, are listed here.
Mild scrotal swelling and pain
Ice, acetaminophen or ibuprofen, supportive underwear, and rest help minimize and treat these normal complications.
These should resolve within seven days.
Ecchymosis of the scrotum
Benign, will resolve spontaneously
Scrotal hematoma
Characterized by a collection of blood in the scrotum
Causes significant swelling and pain
Results from bleeding vessels
Risk is minimized by the following:
Adequate hemostasis during the procedure
Using supportive underwear, ice, and limited activity for the first few days after the procedure
Requires urgent referral to an urologist:
It must be determined whether there is neurovascular compromise of the scrotal contents from the swelling/pressure
Evacuation of the blood/hematoma and achieving hemostasis of any bleeding vessels may be required
Sperm granuloma
Occurs when sperm leak from the testicular end of the vas deferens and form a granuloma
Usually asymptomatic but may be identified as a small, firm, palpable mass near the testicle
Rarely causes pain
Referral to an urologist is indicated if symptomatic
Chronic testicular or epididymal pain
May be caused by a sperm granuloma, congestive epididymitis, or a neuroma
Congestive epididymitis: Sperm and fluid produced by the testicle may build up in the epididymis after the vasectomy, causing congestion, pressure, and distention. This is usually asymptomatic, but occasionally can cause significant pain.
Neuroma: Inflammation involving the perivasal nerves, which may cause pain.
Referral to an urologist is indicated
Failure
Defined as two positive semen samples, as previously discussed in Follow-up Care: Semen Analysis
Repeat procedure may be attempted by the physician, or you can refer to an urologist
Infection
As discussed previously in Procedural Step I, if the scrotal hair need be shaved, it should be done by the physician immediately prior to the procedure to decrease the risk of infection.
If infection is suspected, check a urinalysis and culture, and begin empiric antibiotic therapy directed towards skin flora, the most likely cause.