What Are the Side Effects of Vasectomies?

Vasectomies are a safe and effective method of birth control. Even so, men thinking about getting one are bound to have questions and sure to worry about what to expect in the days and months afterward. They would be remiss if they didn't wonder about the side effects of vasectomies.

A vasectomy is a simple procedure that stops the flow of sperm to the semen by cutting and sealing the vasa deferentia, the tubes that carry sperm from the testicle to the urethra. You're typically awake (but numb) for the procedure.

There are a few ways to perform a vasectomy, but they're similar and about 99 percent successful at preventing pregnancy. Plus, they're one and done. Unlike female birth control pills or IUDs, you don't need to remember to take a pill every day or have your vasectomy performed every few years to maintain its efficacy.

But as highly touted as vasectomies are, like any medical procedure, they do have a few side effects. Fret not, however, because most of them resolve on their own and are not long-term issues.

Pain or discomfort

Mild pain and discomfort following a vasectomy are to be expected. You may feel as if you got kicked in the testicles. This discomfort should resolve and become more manageable by the day.

"Post-vasectomy pain usually lasts three to five days, and two weeks at most," said Gil Aaron Weizer, M.D., a urologist at Northwell Health at Northern Westchester Hospital in New York. "By adhering to rest for 48 hours after the procedure and using ice locally, even common side effects are minimized and almost always resolve on their own."

Plan to take it easy following a vasectomy and spend as much time sitting down as possible. The first few days are not the time for pickup basketball or a bike ride. You may want to work from home if possible, or even take a break completely before you return to work.

Swelling and bruising

Swelling or bruising of the scrotum is typical after a vasectomy because it's the area where tiny incisions are made to reach the vas deferens.

Applying ice to the scrotum can help with the swelling and pain. Supportive underwear is another option to help with discomfort. You can even find post-vasectomy underwear with a pouch for an ice pack.

Blood in the ejaculate

It's normal to see some blood in the ejaculate for up to a month after the procedure, but you will still ejaculate post-vasectomy. The only change, which should make no tangible difference to sex for you or your partner, is that the semen is free of sperm.

Hematoma (in rare cases)

"Rarely, a hematoma, or a collection of blood, can develop around the testicle," Weizer said.

A hematoma is clotted blood that pools in a certain spot. This side effect is especially rare in no-scalpel vasectomies where, instead of an incision, a small puncture is made in the scrotum that is then closed without stitches.

One study estimated that bleeding or a hematoma occurs in 4 percent to 20 percent of vasectomies. Most hematomas shrink and resolve on their own, but it's still a good idea to check with your doctor if you're experiencing significant swelling, bruising or bleeding after your surgical procedure.

Sperm granuloma

A sperm granuloma feels like a hard lump in the scrotum or toward the base of the penis, and it can happen in the days, or even several months, following a vasectomy.

"A sperm granuloma is when sperm leaks out of the cut ends of the vas [deferens]. Since your body sees your sperm as 'foreign' because it only contains half of your genetic material, the body will attempt to wall it off by starting an inflammatory response," Weizer explained, adding that it's treated by anti-inflammatories like ibuprofen. "It always resolves with time."

This vasectomy side effect does not happen to everyone. One study found up to 42 percent of vasectomy patients experience sperm granuloma, and the majority of granulomas were less than 1 centimeter and completely asymptomatic.

"Vasectomy is by far the safest surgical sterility option, with the majority of procedures done in the office under local anesthesia," Weizer said. "It is a permanent solution with only a 1 in 2,000 failure rate."