Abstract Introduction Vasectomy is an increasingly utilized method of permanent male contraception. No-scalpel vasectomy (NSV) is the preferred technique due to its favorable safety profile and low complication rates. However, complications such as infection, hematoma, and chronic post-vasectomy pain syndrome (PVPS) can occur. The true incidence and risk factors for PVPS remain uncertain. Objective This study aims to evaluate the rates of PVPS and other complications following vasectomy, as well as to identify associated risk factors. Methods This retrospective study evaluated 1,774 sexually active men undergoing vasectomy between 2016 and 2024 at a single tertiary-referral center. Baseline data, including age, number of children, and BMI, were collected preoperatively. Postoperative follow-up assessed complications, need for repeat surgery, and results of post-vasectomy semen analysis (PVSA) performed three months after the procedure. Statistical analysis utilized nonparametric tests and multivariate logistic regression to identify independent risk factors for complications (significance: p 0.05). Results Patients had a median age of 42 years (IQR 7.0), median BMI 26.95 (IQR 4.96), and median follow-up of 101 months (IQR 97–104). Most (90%) completed PVSA; 94.9% achieved azoospermia at first analysis, with 2% requiring re-vasectomy, and 0.2% undergoing vasovasostomy or TESE for regret. Postoperative recovery was uneventful in 97.3% of cases; infection and hematoma rates were 1.5% and 1.1%, respectively. PVPS occurred in 0.7% (n = 14); most were managed with NSAIDs, a minority (n = 3) required escalated treatment, including one surgical re-intervention. Multivariate analysis identified postoperative complications (p 0.001) and higher BMI (p = 0.012) as independent risk factors for PVPS; age was not significant. Conclusions No-scalpel vasectomy offers high efficacy and safety for male sterilization, with rare complications and a low PVPS incidence. Postoperative complications and elevated BMI independently increase PVPS risk and may merit consideration during preoperative counseling and risk stratification. Disclosure No
Ponce et al. (2026) studied this question.