Vasectomy, Management, and Pain: A Natural Language Processing Analysis of Online Communities

Abstract

Is the use of vasectomy in the United Kingdom experiencing a significant decline due to knowledge of post-vasectomy pain syndrome transmitted through online public forums? Although vasectomy is regularly used as a form of contraception and is generally considered to be safe, the frequency of use within the United Kingdom has fallen very significantly over the past few decades. The greatest risk of the surgery is arguably post-vasectomy pain syndrome, and it is debated how frequent this outcome is, how men emotionally react to such pain—or anticipated pain related to vasectomy. This has implications for counselling men prior to surgery and management. We use public data from Reddit to analyse the perceptions of pain, the frequency of post-vasectomy pain syndrome, and how such pain is resolved. We perform a systematic natural language processing assessment of the largest Reddit communities discussing vasectomy for the first time. We show that the dominant emotional reaction to vasectomy is that of fear—especially in relation to perceived or anticipated pain. Despite this, most men ultimately hold a positive sentiment about vasectomy, albeit at various levels of subjectivity. There are, however, a significant percentage of men who experience strong and negative emotions and experiences of vasectomy—including both the procedure and post-vasectomy pain syndrome. We place a new upper limit on post-vasectomy pain syndrome of 8% using 11 244 posts and estimate life-affecting pain has an upper limit of 2%, with a similar rate of surgery regret. We show that reversal is the most frequently discussed solution to this pain by a factor of approximately 4 compared to other invasive methods. We suggest that any information and consent forms issued to prospective men no longer ethically describe vasectomy complications as “rare” or “very rare”. New onset pain is common for vasectomy. With such public discussion now firmly in place, we hypothesise that vasectomy will see further decreased use in the short term.