Vasectomy update 2010.

Vasectomy is a safe and effective method of birth control. Although vasectomy is a relatively simple procedure, it is associated with potential minor and major complications. As such, detailed preoperative counselling is required. Failure to provide and document adequate preoperative information and counselling may lead to litigation. Men must be told of the potential for early complications, such as wound infection, scrotal hematoma and primary surgical failure and late complications, including painful vas granulomas, chronic epididymal pain and delayed vasectomy failure. Such information should be given both verbally and in writing. Surgeons should report their own complication rates, whenever possible. The association between vasectomy and prostate disease (cancer) may be discussed if patients voice a concern. The potential reversibility of the procedure should also be discussed. Most men are potentially fertile shortly after the vasectomy. Moreover, in cases of early recanalization or technical failure (e.g., missed vas deferens), men will remain fertile. Therefore, couples must be instructed to use other contraceptive measures until post-vasectomy semen testing has confirmed the absence of motile sperm.