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Post-Vasectomy Syndrome

Chronic pain rare side effect of vasectomy

NEW YORK, (Reuters) -- Some men may experience chronic pain after vasectomy, however, the evidence still shows that the surgical procedure does not increase the risk of prostate cancer, according to a National Institutes of Health (NIH)-sponsored meeting that took place recently in Bethesda, Maryland.

Dr. Harry Guess of the University of North Carolina in Chapel Hill noted that an NIH expert panel concluded in 1993 that there was no biologic mechanism for a link between vasectomy and cancer. Studies that suggested an association were inherently flawed, he said.

Noting that prostate cancer screening and prostate cancer incidence have increased markedly in the last decade, Guess commented, 'The more you look, the more you find.'

Vasectomy has several known potential complications, including hematomas (bleeding) and sperm granulomas (an inflammatory response to sperm leakage). Chronic pain syndrome may also be a side effect of the procedure, Guess said.

Pain syndrome -- defined as chronic testicular pain lasting longer than 3 months after the operation in men who had no similar type of pain before the procedure -- was first defined in 1985, noted Dr. Allen Seftel, an associate professor of urology at Case Western Reserve University, Cleveland, Ohio.

The incidence of the syndrome is unknown, but it probably affects 6% or fewer of the 500,000 men who undergo vasectomy in the US each year. It is more common after a "difficult" vasectomy. The pain could be due to surgical trauma to the structures around the vas deferens, resulting in "chronic neuralgia," according to a statement from Seftel's group. In affected patients, pain may occur 'anywhere along the epididymis or vas deferens. The pain may (also) radiate to the groin.'

The condition can be treated with reverse vasectomy, the drug gabapentin, which relieves pain in about 30% of cases, or a nerve block, which can help another third of patients, according to Seftel.