Retrospective evaluation of post-surgical orchialgia in men undergoing no-scalpel vasectomy.

Introduction: Vasectomy is a form of permanent contraception in men that is safe and effective. Complications are relatively uncommon, although patients may experience postoperative pain. Current literature quotes a broad range in the incidence of chronic orchialgia following no-scalpel vasectomy from 0.6-26%, while pain negatively affecting quality of life is about 1-2%. We sought to evaluate our incidence of post-vasectomy pain and surgical management for this pain.

Methods: A retrospective chart review was performed for all men who underwent a vasectomy at Men's Health Clinic Manitoba during a 22-month period. The presence of pain or complications was collected at a three-month followup appointment. Patients with pain were then followed every 6-8 weeks for continued assessment and management.

Results: A total of 350 men underwent elective no-scalpel vasectomy during this period. The majority of patients had no previous history of orchialgia (98%) or history of previous scrotal surgery (93%). At three months post-vasectomy, 38/350 (11%) of patients had ongoing pain and one patient required surgery (epididymectomy) for management of post-vasectomy pain syndrome three months following vasectomy.

Conclusions: Our retrospective analysis of 350 men who underwent no scalpel vasectomy shows a significant proportion of post-vasectomy pain at the three-month followup appointment, although most cases are resolving or minor and only one patient has required surgical management. This highlights the importance of counseling men undergoing vasectomy regarding the risks of post-procedure orchialgia and the small proportion of men who will require additional surgical intervention.