(117) RETROSPECTIVE EVALUATION OF POST-SURGICAL ORCHALGIA IN MEN UNDERGOING NO-SCALPEL VASECTOMY

Abstract Introduction Vasectomy is a form of permanent contraception in men that is safe, effective, and widely utilized. While complications are relatively uncommon, patients may experience post-vasectomy pain syndrome (PVPS) postsurgically. Current literature quotes a broad range in the incidence of chronic orchalgia following no-scalpel vasectomy from 0.6% - 26%. Chronic scrotal pain associated with a negative impact on quality of life, occurs after vasectomy in about 1-2% of men. Current guidelines state that few of these men require additional surgery, but there is scarce data on the actual proportion of men who will go on to receive surgical treatment for pain. Objective We sought to evaluate our incidence of post vasectomy pain as well as the rate of surgical management of post vasectomy pain with the objective of better counselling patients on the risks of vasectomy and subsequent surgeries. Methods A chart review was performed for all men who underwent a vasectomy at the Men's Health Clinic during a 20-month period. Their baseline characteristics were collected including age, previous scrotal surgery and history of orchalgia. The presence of pain or complications was collected at a 3 month follow up appointment. Patients with pain were then followed every 6-8 weeks for continued management. Results A total of 350 men underwent elective no scalpel vasectomy during this period, with a median age of 37. The majority of patients had no previous history of orchalgia (98%), or history of previous scrotal surgery (94%) and there was no association between these variables on post vasectomy pain. At 3 months post vasectomy, 38/350 (11%) of patients had ongoing pain, while 89% did not report post-operative issues or pain. There was no statistical difference in age between both groups. Semen analysis was only completed by 227/350 (65%) of patients, with 96% of those patients azoospermic. One patient has required surgery (epididymectomy) for management of post vasectomy pain 3 months following vasectomy and now has complete resolution of his pain. Conclusions Our retrospective analysis of 350 men who underwent no scalpel vasectomy shows a significant proportion of post vasectomy pain of some degree at the 3-month follow-up appointment, although most cases are resolving or minor and only one patient has required surgical management. This data highlights the importance of counselling men undergoing vasectomy regarding the risks of post procedure orchalgia and the small proportion of men who will require additional surgical intervention. Disclosure No.