Side effects of vasectomy.

Less than 1% of all vasectomies give rise to epididymitis, or swelling and tenderness near the testes. The condition is usually caused by engorgement of the epididymal tubules with sperm rather than bacteria. Epididymitis is managed by application of heat and wearing of support. Epididymo-orchitis, a painful enlarged testicle often associated with acute epididymitis is managed by antibiotics and bedrest. Infection following vasectomy is infrequent and may occur at any of the following sites: incision, vas, epididymis and testes. Sperm granulomas (inflammatory response to the leakage of sperm from the vas or epididymis into surrounding tissues) occur in 0.1 to 3% of vasectomy cases and are usually so small and harmless that they may go unnoticed except in cases of later surgery. Their true incidence may thus be as high as 20%. Fulguration reduces the incidence of sperm granulomas but should be used with caution. Vasectomy failures are caused by 1) spontaneous recanalization; 2) division of the wrong suture; 3) inadequate occlusion of the vas; 4) duplication of vas; and 5) unprotected intercourse.