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For more stories about chronic pain resulting from vasectomy, check out www.reddit.com/r/postvasectomypain

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Prior to my vasectomy, I was given a pamphlet that explained the risks of the procedure. I think the pamphlet does a poor job educating men and wanted to post my analysis of the statements made there. I’m hoping that perception of vasectomy will change over time so that men can properly weigh the risks and rewards of the procedure.

Pamphlet Statement:

Vasectomy is a safe procedure. But it does have risks, including bleeding and infection. You may also have any of the following after surgery.

Analysis:

This is contradictory language that disarms the reader. To say something is “safe” is to claim that it does not have risks that are significant enough to be worth taking into consideration. Calling vasectomy “safe” just before discussing the risks tells the reader how to feel about and interpret all of the bullet points that follow.

The two complications that are mentioned here are not ones that would tend to grab the reader’s attention. Infections almost always go away quickly with antibiotics. Bleeding is something everyone is is familiar with and expects to fully resolve in a short period.

Better wording:

Vasectomy is safer than other sterilization options and safer than pregnancy, but it does carry certain risks, including short term complications such as bleeding and infection, and long term complications such as chronic pain or discomfort.

Pamphlet Statement:

Sperm granuloma is a small, harmless lump that may form where the vas deferens is sealed off.

Analysis:

Calling a granuloma “harmless” misleads the reader into thinking that there will be no negative consequences of this complication, which is not true.

Better wording:

After vasectomy, sperm may escape and form a small lump called a granuloma. These lumps are not usually a problem, but sometimes they are painful to the touch or hurt during sex. Ibuprofen may make the pain go away, but sometimes granulomas must be surgically removed. Surgery to remove the granuloma may not relieve pain, especially if the pain is due to scarring or nerve damage.

Pamphlet Statement:

Sperm buildup (congestion) may cause soreness in the testes. Anti-inflammatory medications can provide relief. Epididymitis is inflammation that may cause scrotal aching. This often goes away without treatment. Anti-inflammatory medications can provide relief.

Analysis:

The following sentence gives a misleading first impression:

“Anti-inflammatory medications can provide relief.”

What this sentence looks like it says is this:

“Anti-inflammatory medications cure epididymitis that is not going away without treatment.”

This miscommunication happens partly because this sentence follows the sentence that says the problem may go away without teatment. If the two sentences are taken together, the intuitive interpretation would be that they mean that:

“Sometimes the problem goes away without treatment. Sometimes treatment is required to make the problem go away. The treatment that makes the problem go away is anti-inflammatory medication.”

On a careful read, it becomes clear that all this sentence really commits to is the following:

“Anti-inflammatory medications may provide temporary relief, or may not.”

Another reason why this section is misleading is that there are three outcomes being discussed, but two of them are made explicit, and the other one is left for the reader to infer:

1. The congestion problem goes away without treatment. (Explicit)

2. The congestion problem does not go away, but anti inflammatory medications ‘provide relief’ (Explicit)

3. The congestion problem does not go away, and anti-inflammatory medicine does not provide relief. (Implied)

Better wording:

After vasectomy, it is normal for the epididymis to be permanently enlarged. For most men this does not cause any discomfort but some men experience soreness. We do not have precise numbers for the percentage of men that experience discomfort resulting from congestion. Soreness can be made worse by certain activities such as riding a bicycle, walking, driving a car or sitting for long periods. The discomfort may go away, or it may be permanent. Anti-inflammatory medications may temporarily reduce congestion and the associated discomfort.

Pamphlet Statement:

The vas deferens can reconnect in rare cases. This makes you fertile again and can result in an unwanted pregnancy.

Analysis:

Vague language. What does “rare” mean?

Also, as a technicality, it is not necessary for the vas to reconnect for fertility to be restored.

Better wording:

In rare cases men can become fertile again after vasectomy, which could result in an unwanted pregnancy. Chance of conceiving after vasectomy is about 1 in 1000.

Pamphlet Statement:

Long-term testicular discomfort may occur after surgery, but this is very rare.

Analysis:

Vague language: What does “very rare” mean?

Since men becoming fertile after vasectomy is “rare” and men having long-term testicular discomfort after surgery is “very rare” then we might conclude that the chances of long term discomfort are much less than the chances of becoming fertile again.

Right?

In fact, the chance of long term discomfort is between 1% and 14% — or in other words it is 10 to 140 times more likely than becoming fertile again.

Better wording: