After millions of “successful” vasectomies around the world there are still questions about the long term health risks of the procedure. While surveying the current information explaining the pros and cons of vasectomies, one will find almost total agreement on the safety of the procedure. The procedure is so common and popular that it appears as if this procedure has been given a “free pass” concerning its long term health/safety risks.

This is fine as long as health professionals are making global policy, but what about when an individual has to decide if they will actually have this procedure done to them? Hopefully the following information will allow possible candidates to evaluate the current risks.

Two potential health risks that merit further research include:

PVPS – post vasectomy pain syndrome. CORY G. CHRISTIANSEN AND JAY I. SANDLOW in their Review of Postvasectomy Pain Syndrome for the university of Iowa Urology department in 2002 state that “Postvasectomy pain syndrome is a poorly defined entity that although uncommon, presents a diagnostic and treatment challenge for physicians. Although the definitive cause for postvasectomy pain may be unclear, it is evident that traditional treatments such as antibiotics, excisional surgery, and chronic pain medication are unlikely to result in a successful outcome. Multimodal therapy, including nerve blocks, medical management, psychiatric referral, and in select patients, vasectomy reversal, are most likely to result in improvement in the quality of life for these men.”

In other words, the Doctors don’t know exactly why the chronic pain is there, and they don’t really know how to successfully treat it. Many patients can never remove the pain even with additional surgeries. Christiansen and Sandlow hope that…”Further investigations of vasectomy associated autoimmunity and the origins of neuropathic pain will hopefully provide insight into the etiology and focal therapy for these patients’ pain.

There is almost always short term pain associated with a vasectomy, but “Estimates on the rates of chronic pain, however, range widely. In a variety of studies, anywhere between 1% and 50% of men complained of sore testicles, including epididymitis (“blue balls”) for up to a year. As many as 15% described the pain after vasectomy as seriously aggravating.”(Arthur Allen, WebMD)

The second side effect of a vasectomy which needs to be studied has to do with the auto-immune reactions that occur when sperm is attacked by your own antibodies. This occurs because testes continue to produce sperm yet the immune system must attack and fight off those sperm (which it sees as foreign invaders inside the body). In essence, you have the immune system doing heated battle with the reproductive system. In a healthy Male, the testicles keep the sperm away from the blood stream, but in the case of a ruptured or cut vas (which eventually occur in many if not all vasectomies) the immune system will fight what it sees as invaders.

“Ordinarily, sperm do not come in contact with immune cells, so they do not cause an immune response. But a vasectomy breaks through the barriers that separate immune cells from sperm, and many men develop anti-sperm antibodies after undergoing the procedure. This has caused concern on the part of doctors and researchers, because immune reactions against parts of one’s own body sometimes cause disease. Rheumatoid arthritis, juvenile diabetes, and multiple sclerosis are just some of the illnesses suspected or known to be caused by immune reactions of this type.” (WebMD, Birth Control and Sterilization) Christiansen and Sandlow recognize that ”At 1 year after vasectomy, 60%–70% of men have antisperm antibodies present in their serum (Linnet and Hjort, 1977; Linnet et al 1981). Significant controversy exists over possible side effects of these circulating antibodies.”

The real question here has to do with the long term immunological results of this internal battle that many men willingly subject their bodies.

Further study needs to be done on both of these clear problems with vasectomies. The pain may not affect all men with vasectomies, but it seems very clear that the immunological danger is there for anyone who undertakes a vasectomy. These potential side effects of a Vasectomy are serious and should be considered earnestly by anyone about to undertake the procedure or who has a spouse/partner/friend who is about to undertake the procedure.