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How Common Is Infection After Vasectomy?

February 2, 2025

How common is infection after a vasectomy procedure? You can be reassured the chance of getting an infection after a vasectomy procedure is extremely low if you have the right kind of vasectomy procedure.

infection-after-vasectomy-is-a rare-risk-of-vasectomyWhat is the right kind of vasectomy? A minimally invasive (one skin opening) no scalpel vasectomy can provide the lowest risk of infection.

If you have a minimally invasive vasectomy performed by a skilled provider, a scrotal infection is a rare complication.

In fact, infections are so rare with minimally invasive vasectomy that routine antibiotics are not necessary.

Infection is a risk of any surgical procedure that creates a break in the protective layer of the skin. Most surgical procedures can only be performed by going through the skin. The larger the skin incision the higher the risk of infection. The smaller the skin incision the lower the risk of infection.

Minimally invasive vasectomy only requires one, sometimes two, small scrotal skin opening(s).

So if you are considering a minimally invasive vasectomy like the His Choice No Scalpel Vasectomy, you can be reassured the risk of infection after vasectomy is low.

Older traditional vasectomy techniques require the use of a scalpel to make two skin openings (incisions) on each side of the scrotum. These scalpel incisions are usually larger than no scalpel openings and cause full thickness skin damage.

The two skin incisions created with traditional vasectomy are usually larger than the single skin spread opening created during a His Choice Vasectomy.

Some medical studies have demonstrated traditional scalpel vasectomy procedures can have an infection rate after vasectomy that is four times higher than no scalpel vasectomy procedures.

Minimally invasive vasectomy procedures like His Choice No Scalpel procedure only require a single, small opening in the center of the scrotum. Not only are the skin openings small but there also minimal surgical instrumentation inside the scrotum during the vasectomy procedure.

A smaller skin opening combined with minimally instrumentation results in a lower risk of bacteria being introduced inside the scrotum. Creating one skin open with minimal instrumentation can provide an infection rate that is less than 1%.

What are symptoms of infection after vasectomy?

Most vasectomy infections will cause redness in the scrotal skin. The redness results from the inflammatory system trying to fight the infection. If the infection is allowed to persist, the redness will travel through the skin layers and will gradually expand outwards. As the redness expands, the skin will become thicker and more painful due to the inflammatory process. In the later stages of infection, fever, body aches, and drainage from the skin opening can occur.

risks-of-infection-are-low-with-minimally-invasive-vasectomyIt can be common to have a small amount of redness and swelling around a normal vasectomy scrotal skin opening. It usually improves within the first week. If you have an infection the redness and swelling will only get worse… not better.

Contrary to what most people may think, infections are not obvious or symptomatic within the first several days of a surgical procedure. It takes time for an infection to develop. Most infections take 5 to 7 days after a procedure to become clinically obvious.

Infections can occur within anytime within the first 30 days of having a surgical procedure. It would be very rare to get an infection more than 30 days after any surgical procedure.

Infections after vasectomy are rare. Infections after vasectomy are most commonly diagnosed between 7 to 14 days after vasectomy. When an infection is diagnosed patients will usually require oral antibiotic treatment. In some very rare cases, IV antibiotics and hospitalization may be required.

Where are vasectomy infections located?

Infections after minimally invasive vasectomy are rare but can occur in the scrotal skin, superficially underneath the skin, deep inside the scrotum, in the epididymis, or higher up the genital tract in the prostate. Most infections after vasectomy are in the scrotal skin and around the skin opening(s).

Scrotal skin. Scrotal skin infections are either from the patient’s normal skin bacteria, from bacteria introduced during the vasectomy procedure, or bacteria from the patient’s environment (ie showers, bath tubs, etc). These infections are easily diagnosed after observing expanding skin redness, fluid drainage from the opening, and/or fevers and chills.

Superficial scrotal abscess (underneath the skin). These are infections caused by bacteria that gain access to the scrotum during or after the vasectomy procedure. This bacteria may collect underneath the skin and form an abscess. An abscess is a collection of infection. An abscess may feel like a large tender mass the size of a grape or larger. Usually these will continue to grow until they spontaneously drain or they are drained by a medical professional.

The symptoms from a vasectomy abscess do not usually begin until about 7 days after a vasectomy procedure. Once they are detected, they gradually increase in size. As the size increases, the symptoms increase. Once they are drained rapid improvement is experienced. Drainage and antibiotics are usually required for treatment of an abscess.

Deep scrotal abscess (deep inside the scrotal space). These are collections of infections that are deeper in the scrotum. They are not just underneath the skin but deep inside the scrotum in the same area where the vas deferens and testicles reside. These infections may feel about the size of a third testicle or larger. They are usually very symptomatic causing severe scrotal pain, fevers, and chills.

A scrotal abscess can cause severe pain, fevers, chills, and body aches. A testicular abscess usually is a deep scrotal infection that also involves the testicle.

Deep scrotal abscess are serious and often require hospitalization, surgical drainage, and intravenous antibiotics.

Bacterial epididymitis. Bacterial epididymitis is inflammation in the epididymis caused by bacterial infection.

The epididymis is a structure that is below the vasectomy site and low in the scrotum. The epididymis is a soft “C” shaped structure that lies on the back of each testicle. If bacteria are able to gain access to the epididymis then you can get bacterial epididymitis.

  • Bacterial epididymitis after vasectomy is extremely rare.
  • Inflammatory epididymitis after vasectomy is extremely common.

Most cases of epididymitis after vasectomy are misdiagnosed as bacterial epididymitis. The term epididymitis simply means ‘inflammation of the epididymis’.

Most cases of epididymal inflammation after vasectomy are not caused by bacterial infections. Instead, most cases of epididymitis after vasectomy are caused by back up of sperm that causes congestion, distention, and inflammation in the epididymis. This is ‘inflammatory epididymitis’. This is very common after vasectomy.

scrotal-abscess-is-a-rare-complication-of-vasectomy-requiring-antibioticsIf you go to an urgent care after vasectomy complaining of scrotal discomfort there is almost a 100% chance you will be diagnosed with the generic term ‘epididymitis’, given antibiotics, and asked to follow up with your vasectomy provider.

In almost all cases the antibiotics are unnecessary because most patients do not have a bacterial infection in the epididymis after vasectomy. The symptoms are due to sperm back up and inflammation.

Inflammatory epididymitis usually occurs between one week and three months after vasectomy. This condition is best treated with over the counter non-steroidal medications (ibuprofen or naproxen). These medications provide immediate relief. With time your body can adapt, heal, and the symptoms will gradually go away.

Bacterial prostatitis. This is an uncommon complication after vasectomy. It is caused when bacteria travel upstream from the vasectomy site and enter into the prostate. Bacteria in the prostate cause bacterial prostatitis, which is an infection of the prostate gland. Symptoms occur later than other vasectomy infections and usually occur 10 to 28 days after a vasectomy procedure.

Usually patients report difficulty peeing, pain in the area where the penis inserts into the abdomen, and flu like symptoms. Sometimes they may have fevers. This condition is best treated with a prolonged (3 weeks) treatment with oral antibiotics.

Many vasectomy providers do not agree that prostate infection is a risk of vasectomy; however,  in our experience we have observed this infection in about 1 out of every 1200 of our vasectomy patients.

What is the chance of getting an infection after vasectomy?

Most people cannot easily apply risk statistics to their personal experience. Many cannot adequate relate these statistics to themselves. Their interpretation of risks may seem unusually high or low depending on their personal perspective.

chances-of-infection-after-vasectomy-are-lowFor example…when we say an infection rate is low. What does low really mean? The words low, high, rare, and uncommon are vague term that mean different things to different people.

We can say the chance of getting a rash after a procedure is low at 2% but we can also say the chance of dying after a procedure is low at 2%. Which 2% actually feels low to you?

Obvious the 2% chance of a rash seems low and minor but the 2% chance of dying is way too high!

Percentages of risks can often be difficult for people to interpret. We may say the chance of infection is 10%.

Some people see 10% as low…others see 10% as high. Some people don’t think 10% is a big deal but when you tell them they have a 1 out of 10 chance of something bad happening they perceive that as too high of a risk! The reality is 10% is the same as 1 out of 10 but different people process 10% and 1 out of 10 differently.

The chance of risk is interpreted and perceived differently depending on the person’s outlook, understanding, and the severity of the risk in question.

What is the risk of infection after a His Choice Vasectomy procedure?

We like to explain the chance of infection in a way that, we believe, most of our patients can better understand. To better explain, we would like to use the experiences of our patients to convey how low the risk is of an infection after vasectomy really is.

In the first ten years of performing His Choice vasectomy, we performed our technique on over 8,000 patients.

  • Less than five patients had minor skin infections
  • Approximately seven patients had prostate infections
  • One patient had a superficial scrotal abscess

Out of 8,000 patients, approximately 13 patients had an infection after vasectomy…or 0.2%. This also means 7,987 patients did not get an infection.

Minor skin infections. These infections usually present 5 to 7 days after vasectomy. Usually the skin around scrotal opening is red and irritated. There can be some drainage from the skin opening. Typically a short course of oral antibiotics will treat the infection. Some of these patients may not have had infection but may have had skin inflammation or irritation due to delayed healing from compulsive cleaning of the skin opening which can cause skin irritation.

It can be common to have redness and minor swelling immediately around the scrotal opening the first several days. This is the body’s immune system responding to the insult and beginning the healing/repair process. Healing responses usually get better in the first week. Infections of the scrotal skin usually expand outward from the skin opening and get worse the first week after having a vasectomy..

antibiotics-may-be-required-if-you-get-an-infection-after-vasectomyProstate infections. Infections of the prostate after vasectomy are uncommon. In fact, many health care providers do not believe prostate infections are a risk of vasectomy. In our experience, approximately 1 out of 1200 of our patients will develop a prostate infection after vasectomy.

The classic symptoms are pelvic pain (perceived around the area where the penis inserts into the abdominal wall), fevers, and difficulty urinating. Patients sense an overall feeling of pelvic heaviness, discomfort, and body aches. These symptoms usually occur 10 to 30 days after the vasectomy procedure. In all cases, patients with prostate infections were treated with three weeks of oral antibiotics and they all achieved full resolution of their symptoms.

Superficial abscess. One patient had a superficial abscess beneath the skin. This is a collection of infection that can be about the size of a golf ball or larger. The mass usually causes pain and fevers. These can slowly grow in size until they start draining. In our patient with this complication it started draining spontaneously and oral antibiotics helped the infection dissolve quicker. The patient did not have any long lasting complications.

No risk is ever going to be zero…but the chance of infection after a His Choice Vasectomy is so close to zero that you should not be overly concerned about getting an infection after having a vasectomy at our office.

Developing a scrotal infection after a vasectomy procedure is always possible but not very likely.

Infection after His Choice Vasectomy: Possible but rare

You can be reassured that getting an infection is a rare outcome after having one of today’s modern, minimally invasive vasectomy procedures.

The chance of getting an infection after a His Choice Vasectomy is less than 1%. The infection rate is so low that routine antibiotics are not indicated when having a vasectomy with our office. The chance of developing an infection after our vasectomy is closer to zero than it is to 1%!

Not only are frozen peas and ice not required…but thankfully neither are antibiotics when having a vasectomy with our office.

 

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