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My husband had a vasectomy about 6 weeks ago. He has had nothing but trouble ever since. Hemotoma, swelling, pain. After four weeks, after having intercourse only for the second time since, he had a feeling like he “blew up” in severe pain during ejaculation and realized it was mostly blood. He has swelling on the right side about the size of a thumb and even swelling into his abdomon. and alot of pain that it is interfering with his work. He saw the doctor who told him he’d never seen anything like this before (no explanation) and has been taking strong meds for 2 weeks after with little or no relief. He has been in too much pain to have sex. He has been wearing supportive underwear which helps keep things from bouncing too much, but has a very active lifestyle/career and no down time. Although he did take it easy for the first days. What’s the problem and what should he do? He’s becoming very depressed.

Complications can occur after a vasectomy and scrotal hematoma is a known complication of the procedure. Complications such as a hematoma can be associated with variable amounts of bruising, swelling and pain. The resolution of the symptoms is equally variable. Unfortunately, only time will tell tell how quickly someone will improve after a complication from vasectomy. It is important to follow-up with a surgeon to help guide the patient through the slow recovery process. Oftentimes, several visits will be required to the surgeon’s office to ensure that the normal course of events is happenning.

Dr. Karpman’s website

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From Gary:-
Hi Dr. Karpman. I had a vasectomy procedure performed on Friday. How soon can ejaculations begin?

Ejaculations after a vasectomy can begin as soon as the patient feels comfortable to do so. It is important to remember that men are not considered sterile until they demonstrate no sperm in the ejaculate. Men should utilize some type of alternative contraception until they are cleared by their physicians for unprotected intercourse.

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From Dale:-
Hi, I had a vasectomy 15 years ago, could you tell me whether it is possible to have torsion of the testis? I believe I may have partial torsion, but surely after a vasectomy the spermatic cord wouldn’t be attached to the testis to cause this problem?
Many thanks,

It is possible to have testicular torsion after a vasectomy. The vasectomy procedure only divides the vas deferens and not the remainder of the spermatic cord. The remainder of the spermatic cord contains the blood vessels essential for testicular health. Torsion occurs when the blood supply to the testicle in the spermatic cord is twisted on itself, preventing the flow of blood to the testis. I am not familiar with the term partial torsion. Some men experience intermittent torsion where the testicle will twist and un-twist spontaneously. Intermittent torsion can lead to the same devastating consequence of loss of the testicle. Men suspected of having torsion or intermittent torsion should seek medical attention immediately.

Dr. Karpman’s website

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From ML:-
I have had a vasectomy that also utilized clips in addition to removing a section of the vas deferens and have a question concerning the clips. I am not close to the doctor any longer or would ask him but what are the clips made of and would that be of concern in the event of needing a MRI do to the strong magnetic draw?

Currently, clips used for vasectomy are made of titanium which is not considered to be a contraindication for MRI scans. However, clips can be made of several different metals and depending on the era in which the clips were placed, one might not have had clips made from Titanium. Unfortunately, the only sure way to tell is to ask the surgeon who performed the vasectomy what type of clips were used.

Dr. Karpman’s website

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From John:-
I had a vasectomy Feb of 09. As a child, I had an undescended testicle until I had it operated on at the age of 7. When I had my vasectomy done, my doctor did not cut the vas on the testicle that was undescended because there was a lot of scar tissue and he was pretty sure that it was non-functional. 2 months after my vastectomy, I had my 1st test on my semen, which came back absent, but a week later, I had another test and there WAS sperm present. I would understand there was sperm present in my 1st test and absent on the 2nd, but I am a little puzzled by the 2nd one coming back positive for sperm. Is it possible that my testicle that was undescended as a child be somewhat functioning? Where it sometimes produces sperm and sometimes it doesn’t? Please let me know your opinion. Thank you.

Undescended testes (UDT) are usually considered as having poor function, but this is not universal and even very dystrophic testes will produce some sperm. UDT can intermittently produce enough sperm to be seen in the ejaculate. This may explain why sperm were seen on the second and not the first semen analysis. Unless a biopsy of the testicle has been performed demonstrating absent sperm production, UDT should also have the vasectomy procedure perfomed. Granted, this is a more difficult operation, but not impossible to perform by the experienced vasectomy surgeon.

Dr. Karpman’s website

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My question is about pregnancy after a vasectomy. I know that this topic has been covered, but I while I have been
reading up on the statistic’s on failure rates ect , I have become worried about the time it took for my husband’s Vasectomy !!!! In most of these case’s people have said it took about 30 mins to have done , but my Husband was in and done within around 7 mns !!! I was taken to another room a little further down the corridor than my husband and shown where the coffee making facilities were so I made myself a coffee , sat down made myself comfy took a sip of my coffee , and was called back through all done ! Unbelievable really. He had the procedure done when we lived in the UK and had 2 samples done at the specified times and got the all clear but my period is late and I ‘feel’ pregnant although I am waiting for another week before taking a test to confirm this either way. I know pregnancy is possible as the tubes can re-connect themselves but should his procedure taken longer than it did ?????

The amount of time it takes to perform a vasectomy does not correlate with success rates. The average amount of time it takes an experienced surgeon to perform a vasectomy is usually less than 10 minutes. In fact, those surgeons that require more than 15 minutes to perform a vasectomy are likely less experienced and require more time for the procedure. Certain situations such as a tight scrotum, undescended testis or previous scrotal surgery may require additional time to perform the vasectomy. I have published an entire unedited video of a unilateral vasectomy procedure on this website. The entire procedure on one side is performed in approximately 3 minutes.

Dr. Karpman’s website

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From Natasha:-
My husband had a vasectomy 13 years ago. He has 3 children with his ex-wife. We have tried IVF however it failed as I miscarried. Last week he underwent a reversal. The doctor said after the procedure he cut away quite a bit of the vas deferens as it was blocked and reopened it. Was this the right way to proceed? What do you think the success will be? I am trying to be very positive.

It is imperative to cut back to the healthy portion of the vas deferens in order to do a vasectomy reversal. If it was necessary to cut that far back it means that whoever did the initial vasectomy damaged a large segment of the vas deferens. There is nothing you can do about that during the reversal. More importantly, were sperm identified in the fluid of the vas deferens and was an adequate amount of vas deferens available to complete the surgery? A well done anastomosis will work as long as the tubes could be re-sewn in a tension free manner. I assume that a vasovasostomy and not the bypass procedure was performed? Every surgeon should be able to give you their own success rate based on the operation that was performed.

Dr. Karpman’s website

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From Mike:-
I am 21 years old and have been looking into a vasectomy since I first studied the procedure in a Human Sexuality class. My interest in Vasectomy is a result of a few thought processes, the most important of which is my lack of desire to have children of my own. I feel that becoming a Father at any age is nothing to be left to chance. I always use condoms, and even if I were infertile I still would for the prevention of HIV/STI’s. I understand that if I undergo the procedure that my mentality about fatherhood may change in the future, which is something that I take seriously, and with full responsibility on my part. I have studied the procedure for close to two years on and off, and have consistently felt that a Vasectomy is right for me. I know that in many Cases a Vasectomy is Reversible, and barring a Reversal there are some procedures used to extract sperm from the testicles to use in invetro fertilization. There is also the possibility of storing sperm at a sperm bank. My question for you is this, I wish to explore the idea of a vasectomy with a professional with your kind of expertise, what Criterion would I have to meet to have the procedure at my age, 22? I am committed to my ideals, but your opinion would largely effect my perspective on the matter.

It seems that you are an individual that has given this subject a significant amount of thought and are aware of the consequences of this procedure. There is no obligation in life to procreate and if you have made a sound decision that having children is definitely not in your future then vaectomy is an option. I always recommend that men who have not had any children strongly consider sperm banking prior to undergoing vasectomy in case there is a change of heart in the future. Vasectomy reversal and sperm retrieval with IVF are other highly successful alternatives if you should change your mind. My only age criteria is that the man be of legal age and sound mind when making the decision to proceed with vasectomy. I usually give patients some time to think about the procedure prior to performing a vasectomy in such a situation. However, you seem to be very informed about the subject through your own research and have given this extensive thought. Discussing this subject with your chosen surgeon would be the next course of action.

Dr. Karpman’s website

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Good evening,

I would like to ask a question if I may:- Is the amount of bruising something I should be worried about?

These pictures represent some greater than expected bruising after vasectomy. The bruising extends to the base of the penis and across both hemiscrotal areas. There seems to be minimal swelling which would suggest that the bruising is due to some bleeding in the skin layer and not a hematoma in the scrotum. The second picture demonstrates one of the incision sites that appears to be healing appropriately.

The following pictures have been sent in as updates:-

Day 7

Day 9

Day 9 with incision site marked

Day 11

Day 13

Day 16 close up on the scar

All of the pictures above are available with full sized image here.

Dr. Karpman’s website

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From Alfred:-
Hello. I had a vasectomy 8 1/2 yrs ago. Never did any follow-up tests. My wife became pregnant. Had a semen analysis which came back zero. I knew this was incorrect because my wife wasn’t with anyone else. Had a ‘complete semen analysis’ done and the results are:
ANALYSIS TIME, SEMEN 11:57
SEMEN VOLUME 3.0 >1.9 (standard)
mL
SPERMATOZOA, NORMAL % >29 % (standard)
WBC COUNT, SEMEN <=1 <=1 (standard)
SPERM COUNT, SEMEN <2 >19 M/mL(standard)

Thank you for your help

Recanalization of the vas deferens can occur many years after the vasectomy. Potent growth factors are released after the vasectomy procedure which stimulate re-growth of the ends of the vas deferens. Histologically this is characterized by tiny channels with sperm between the cut ends of the vas deferens and with certain types of vasectomies (VasClip) it has been reported to be as high as 25%. The total sperm count in this semen analysis is less than 6 million, however it is not clear if any of the sperm were motile or alive based on the results presented here. It appears that the morphology, a predictor of fertilization potential of sperm, was not done here. It is dificult to predict if this number of sperm will increase, stay the same or decrease over time and so long as there are live sperm in the ejaculate then pregnancy is possible.

Dr. Karpman’s website

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