Weird Vasectomy Complications: Rare But Possible!
February 11, 2025
Vasectomy is safe and easy. In fact, vasectomy is the safest of all the permanent birth control methods, including tubal ligation.
Although vasectomy is incredibly safe, a vasectomy procedure is not without risk.
If you are having a minimally invasive, no scalpel vasectomy like the His Choice No Cut vasectomy method then your vasectomy is going to be even safer than a scalpel vasectomy procedure.
Chances of having a minor complication after vasectomy are low. Chances of having a serious complication are rare.
There are ‘weird’ vasectomy complications that are rare but possible. The four weird, rare vasectomy complications are:
- Impaired testicular blood flow resulting in loss of or shrinkage of a testicle
- Emotional reactions
- Sexual dysfunction
- Allergy or adverse reactions
We consider these weird because people don’t always think of these problems when considering vasectomy.
Losing a testicle after vasectomy: Our experience
It is possible but rare that a vasectomy procedure can cause impaired blood flow to one or both testicles. Impaired, or decreased, blood flow could result in atrophy… (shrinking) of one or both testicle… or the complete loss of a testicle.
In our first 10,000 vasectomy procedures, we have not had a patient lose a testicle as a result of having a vasectomy. To date, we have never had a patient lose a testicle as a complication of having vasectomy.
Losing a testicle is an extremely rare but possible complication of vasectomy.
How could you lose a testicle after vasectomy?
To lose a testicle as a result of vasectomy, you would need to have either an isolated, severe vasectomy complication or a vasectomy complication with at least one of two preexisting conditions.
- History of prior scrotal surgery impairing scrotal circulation.
- A preexisting medical condition impairing circulation.
You would need to have bad luck combined with one or more pre-existing conditions.
What medical conditions could increase the chance of losing a testicle?
Patients who have a combination of previous scrotal surgery and severe medical conditions could have an increased risk of losing a testicle after vasectomy.
Prior scrotal surgery that could decrease testicular blood flow
Prior surgeries that could impair scrotal blood flow:
- Inguinal (groin) hernia surgery
- Surgery for cryptorchidism (undescended testicle)
- Surgery to remove hydrocele/spermatocele (large fluid collection)
- Surgery for testicular torsion (twisted testicle)
- Surgery to treat varicocele (varicose veins of scrotum)
- Prior vasectomy and vasectomy reversal surgery
These surgeries can insult the blood flow to the testicles but not enough to cause a noticeable problem for the patient. If you have impaired testicular blood flow after a prior surgery and then have a vasectomy, you could experience greater impaired blood flow to the testicles.
A patient with prior scrotal surgery may not have any noticeable dysfunction, but if they have a vasectomy … and especially a vasectomy with a complication (ie large hematoma) then these patients could sustain more serious insult to the testicular blood supply.
These unique circumstances could cause atrophy (shrinking of one or both testicles) or complete loss of a testicle.
It is important to be aware that in our first 10,000 patients we had many patients with the above surgeries who did not experience a vasectomy complication or loss of a testicle. Many of the above surgeries are common in the population of patients seeking vasectomy.
Usually a patient who has a severe insult to the testicular blood supply is going to have prior scrotal surgery but they may also have medical conditions that make their circulatory system less healthy.
Co-existing medical conditions that impair the circulatory system
Medical conditions and behaviors which can damage the circulatory system are:
- Poorly controlled diabetes
- Atherosclerosis
- Auto-immune illnesses like, Systemic lupus erythematosus
- Blood clotting disorders that increased the risk of blood clot formation inside the vessels
- Platelets disorders causing elevated platelet levels
- Heavy cigarette smoking
Poorly controlled diabetes, atherosclerosis, and heavy cigarette smoking are probably the most common conditions that damage the circulatory system.
Although many of the above conditions are common, we want patients to realize it usually takes a combination of the above conditions to cause enough damage to the circulatory system to result in testicular loss after vasectomy.
Emotional reactions after vasectomy
Occasionally, we will have a patient who has extreme remorse or regret over their vasectomy within the first several days to weeks of having a vasectomy. These patients often have ‘buyers remorse’ and continually ask themselves ‘ Oh my God, what have I done?’.
They obsesses over the fact they did something permanent and it is hard to go back. Many of these patients may focus on the loss of their reproduction and stress over their perceived self-inflicted insult to their fertility.
Although this can be considered a complication of vasectomy, these emotional reactions after vasectomy are more likely to be associated with certain personal characteristics or personality types. These people tend to be your ‘over thinkers’ and the obsessive compulsive personality types. The reality is they may have these very same feelings with other permanent things they have done in their lives, ie getting a tattoo, getting married, or having a child.
Vasectomy is not a treatment for depression, anxiety, obsessive compulsive behavior, or trouble with making important life’s decisions. Vasectomy can sometimes be a trigger for those conditions to get worse.
Sexual dysfunction after vasectomy
Vasectomy research studies demonstrate most couples experience and increase in sexual pleasure after vasectomy.
This increase in pleasure is thought to be derived from decreased anxiety over the fear of an unplanned pregnancy.
Although most people report improvement in sexual pleasure after vasectomy, some patients will report a decrease in sexual pleasure after their vasectomy procedure. Many people will blame their vasectomy for their perceived troubles with their sexual function.
Vasectomy could cause problems with sexual function if a patient is experiencing pain or discomfort after vasectomy.
Usually episodes of discomfort after vasectomy resolve within the first 3 months of having a vasectomy; however, some patients can have episodic discomfort the first 12 months after their vasectomy. If you have discomfort in your scrotum then, naturally, you are going to have reservations about engaging in sexual activity. In this group of patients, vasectomy can cause temporary sexual dysfunction.
Some patients may report sexual dysfunction not because of pain but because of the fear of causing pain with sex or ‘messing something up’. If you have anxiety about possible adverse effects then anxiety can manifest itself as sexual dysfunction.
The same personality types that have emotional reactions after their vasectomy are also at risk for perceiving decreased sexual function after vasectomy.
We like to reinforce the concept that vasectomy only prevents pregnancy. Vasectomy does not treat depression, anxiety, obsessive compulsion, or fear of future outcomes whether real or imagined.
Most studies report improvement in sexual satisfaction. Some patients will report sexual dysfunction after vasectomy. Often these patients have other contributing factors that influence how they perceive effects from their vasectomy.
Allergy or adverse reaction to an anesthetic or medication
During a His Choice Vasectomy, we only use four substances: two antiseptic agents to prevent infection and two local anesthetic for pain control.
Combination antiseptic. We use an antiseptic that is a combination of alcohol and chlorhexidine. These two substances when used together are superior to other antiseptics for reducing the risk of bacterial infection after surgical procedures.
Alcohol. It is rare to be allergic to alcohol; however, alcohol use on the skin can cause drying of the skin and increased skin hypersensitivity. Some patients may report irritation or dryness of the scrotal skin after their vasectomy procedure.
Chlorhexidine. Chlorhexidine is an antiseptic agent with a broad spectrum of antimicrobial activity. It is commonly used in healthcare settings and consumer products. This agent is fantastic at killing bacteria on the skin.
The most common reactions to chlorhexidine are dry, red, itchy skin. This can occur within hours to days of administration. Rare but serious side effects, including fatal anaphylaxis (life threatening allergy), from exposure to chlorhexidine are possible. The symptoms of severe allergy to chlorhexidine would be:
- Itching
- Hives (urticaria)
- Swelling of the face, lips, tongue, or throat
- Wheezing
- Tightness in the chest
- Non-productive cough
- Dyspnea
It is difficult to estimate the percentage of people in the population who are allergic to chlorhexidine. It is estimated that about 5 patients each year in the United States have a severe allergy to Chlorhexdine.
We have performed over 10,000 vasectomy procedures. Other than minor scrotal skin redness, itching, and dryness, we have never had a patient with anaphylaxis to chlorhexidine.
Lidocaine and bupivacaine local anesthetic
Lidocaine (Xylocaine) is a local anesthetic that starts working quickly but only last for 1 to 2 hours. Bupivacaine (Marcaine) is a local anesthetic that takes longer to start working but last for 3 to 5 hours.
Allergic reactions to these medications are commonly reported but, in fact, are very rare.
Most of the abnormal symptoms reported by patients are due to the other agents commonly found in the pharmaceutical preparation of these anesthetics during packaging. The chance of having an adverse reaction to these medications is less than 1%. Most of the adverse reactions are minor and short lived. It is extremely rare to have anaphylaxis to these medications.
More commonly patients report resistance to local anesthetics. We have had a good experience with this combination anesthetic. This combination of local anesthetic is especially helpful in patients who report resistance to local anesthetics.
Using the two medications together provides better pain control and a longer duration of pain relief.
Looking for a safe vasectomy?
If you are looking for a safe and effective minimally invasive vasectomy then a His Choice Vasectomy is the procedure for you.
To find the nearest His Choice Vasectomy provider visit: His Choice Vasectomy Near Me
When you have vasectomy with our office, you can be reassured that your vasectomy will be easy and safe. You can schedule a single visit vasectomy and easily get on with your life after your procedure. You will be in the best of hands with our office!
