PIP: The chief of the women's health and fertility branch of the Centers for Disease Control's Division of Reproductive Health in Atlanta, Georgia and other reproductive health specialists have determined that vasectomies are very safe and adequately protect against pregnancy. The most common method to occlude the vas deferens is ligation. If the clinician ties the ligatures too tightly or loosely, sperm can enter adjacent tissues causing sperm granulomas and fistulous tracts. Up to 40% of vasectomies result in sperm granulomas, consisting of sperm, epithelial cells, and lymphocytes, either at the vasectomy site or the epididymis. This condition can cause the vas ends to rejoin spontaneously. Coagulation of the vas mucosa reduces sperm granulomas but it makes it more difficult for clinicians to perform vasectomy reversal. Reversal is more likely to occur if the interval between vasectomy and reversal procedure is 10 years. Vasectomy failure rates vary from 0% to 2%. Failures tend to happen because men fail to use a condom soon after the procedure or the vas has rejoined spontaneously. So the Association for Voluntary Surgical Contraception suggests that couples practice other family planning methods for the 1st 15 ejaculations after vasectomy or for 6 weeks after vasectomy. As of late 1990, 160,000 men had undergone a vasectomy and only 2 died from the procedure. 1 man suffered scrotal hematoma formation and infection while the other man died from general anesthesia when his health provider had to drain a scrotal hematoma which developed after the vasectomy. Hematomas tend to happen when physicians with no to limited experience perform the vasectomy (4.6% for physicians who do 1-10 vasectomies/year vs. 1.6% for 50 vasectomies/year). Overall hematoma incidence is 2%. Infections are limited to 2% of vasectomies. Epididymitis occurs even more rarely than infection (1%). Vasectomy does not appear to be correlated with increased risk of atherosclerosis or urogenital tract disease.