Post Vasectomy Pain Forum

Incidence of Post-Vasectomy Pain: Systematic Review and Meta-Analysis

Published to International Journal of Environmental Research and Public Health on March 10, 2020

Incidence of Post-Vasectomy Pain: Systematic Review and Meta-Analysis

This is the first systematic review and meta-analysis to ascertain incidences of post-vasectomy pain following traditional scalpel, or non-scalpel vasectomy. Electronic databases PubMed, Embase and PsycINFO were searched up to 1 July 2019 for peer-reviewed articles recording post-vasectomy pain. We identified 733 publications, screened 559 after removal of duplicates and excluded 533. Of the remaining 26 full-text articles, 8 were excluded with reasons, leaving 18 for detailed analyses. Meta-analysis was performed on 25 separate datasets (11 scalpel, 11 non-scalpel, 3 other/combined). Study follow-up ranged from 2 weeks to 37 years and sample sizes from 12 to 723 patients. The overall incidence of post-vasectomy pain was 15% (95% CI 9% to 25%). The incidences of post-vasectomy pain following scalpel and non-scalpel techniques were 24% (95% CI 15% to 36%) and 7% (95% CI 4% to 13%), respectively. Post-vasectomy pain syndrome occurred in 5% (95% CI 3% to 8%) of subjects, with similar estimates for both techniques. We conclude that the overall incidence of post-vasectomy pain is greater than previously reported, with three-fold higher rates of pain following traditional scalpel, compared to non-scalpel vasectomy, whereas the incidence of post-vasectomy pain syndrome is similar.

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Just forwarded the study to my GP. He’s neutral, at best, on vasectomy and has forewarned patients based on knowing me (I came to him 7 years after my vasectomy). He’s very open to seeing real evidence.

I will also forward onto the Cleveland Clinic.

This meta-study finds an incidence that is 50,000 times higher than the statement by the Cleveland Clinic. :roll_eyes:

My take away is the 5% (1/20) for pvps. That is shockingly high for an elective procedure. Cigarettes come with a stronger warning than a vasectomy. Could you imagine if 5% of Lasik patients went blind. I only wish I had that stat before I agreed to play Russian roulette with my nuts. This has me all pissed off.

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Got a call back from the Ombudsman’s office. They’re going to have a talk with the Urology Department.

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I won’t name names, but got feedback today from a Cleveland Clinic urologist who treats PVPS including, but not limited to, spermatic cord denervation. Paraphrasing: I have no idea who writes that stuff on our website.

Given the current medical conditions in the world, I don’t plan to press this issue right now, but when the pandemic is over, I think we’ll see the website changed.

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I find it interesting that there is a three fold difference between scalpel vs non-scalpel. I think that is very telling and somewhere in there lies the answer to the cause of our ailments. Clearly something is being cut that shouldn’t be. My guess is very fine nerves that aren’t seen or even considered during the procedure. Non scalpels vasectomies focus on being minimally invasive. Something is getting cut during the scalpel procedure. Most of us are here from incidental damage. Nothing else explains the three fold difference between the two techniques. I find that significant.

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When I read the study in the OP, some things stand out as unknowns to me. If we are going to compare scalpel versions to no scalpel versions, we certainly need some more data to draw better conclusions. Without it, we are drawing assumptions.

I didn’t see anything about what kind of vasectomies these men had. Open ended, closed ended, other tricks, techniques, and so on. It’s easy to look at the data in the OP and think it speaks volumes, but I’m not seeing it. The only thing I am seeing is - vasectomies are far from a low risk procedure, and the NSV seems superior over it’s predisesor.

I feel pretty confident saying that scalpel versions done over the last many decades did not deliver superior statistics such as the risk of pvp/s, among other complications, as the NSV technique, but again, we have more variables to consider than just that. How many surgeons were involved in the OP study? How many scrotal incisions were made? And so on. All of these things matter.

Just some thoughts

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