Source: ForeignAffairs4
Source: The Conversation – UK – By Kevin Pimbblet, Professor and Director of the Centre of Excellence for Data Science, AI and Modelling, University of Hull
Vasectomy has long been regarded as a permanent, safe and effective form of contraception. Its benefits are often summarised as minimally invasive and largely risk-free.
But that may not be the full story.
In recent years, vasectomy rates in the UK have declined significantly. It’s a puzzling trend, given that the procedure’s efficacy hasn’t changed. What has arguably shifted is how men talk about it. Not in doctors’ offices, but online.
As an AI researcher working with large-scale public data, I led a 2025 study using natural language processing (NLP) – a branch of artificial intelligence that analyses patterns in human language – to examine thousands of posts from r/vasectomy and r/postvasectomypain, which are subreddits (topic-specific discussion forums) on Reddit, a social media platform where users share and comment on content in themed communities.
My goal wasn’t to weigh in on urology (I’m not that kind of doctor), but to explore the emotional tone and self-reported outcomes in digital spaces where users speak candidly and in real time.
The findings are revealing and raise important questions about informed consent, online health discourse and the growing influence of social data on healthcare communication.
Fear, regret and pain?
The most common emotional response to vasectomy, whether being considered or already undergone, is fear. To assess this, we used a tool called NRClex, a crowd-trained emotion classifier. This is an AI model trained on thousands of labelled examples to detect emotional tone in text. It found that “fear” dominated more than 70% of user-generated content.
This isn’t surprising. Men on Reddit ask questions like “How bad is the pain?” “How long does it last?” and “Will I regret this?” These are not rare concerns: they’re central to the conversation.
While overall sentiment analysis shows that most users report positive outcomes, a significant minority express deep regret and ongoing pain – sometimes lasting for years after surgery.
This pain is often described as post-vasectomy pain syndrome (PVPS), a relatively little-known condition defined by new or chronic scrotal pain that continues for more than three months after the procedure.
PVPS is poorly understood and may have multiple causes, some anatomical, some neurological and some still unclear. Though some health authorities describe it as “rare,” our Reddit data suggests it could be more common, or at least more disruptive, than currently acknowledged.
We analysed more than 11,000 Reddit posts and found that the word “pain” appeared in over 3,700 of them; roughly one-third. In many cases, the pain described persisted well beyond the expected recovery period. The word “month” appeared in nearly 900 pain-related posts, while “year” appeared in over 600.
This is noteworthy. Post-surgical pain is typically expected to resolve within days or weeks. Yet our dataset suggests that 6%–8% of Reddit users discussing vasectomy report longer-term discomfort – a rate that aligns with the upper estimates in the urological studies. More recent research, including a large-scale postoperative study, argues that the incidence is likely much lower, perhaps under 1%.
Of course, we must emphasise that these are self-reported experiences. Not all mentions of “pain” equate to a formal PVPS diagnosis. It’s also important to acknowledge that people who are dissatisfied with a medical procedure are generally more likely to post about it online – a well-recognised bias in social data. Even so, the volume, consistency and emotional intensity of these posts suggest the issue warrants closer attention from clinicians and researchers alike.
Even more strikingly, around 2% of posts mention both “pain” and “regret”, implying serious, potentially life-altering consequences for a small but significant group of people.
On r/postvasectomypain – a subreddit specifically dedicated to discussing PVPS – the tone is even more sobering. Unsurprisingly, 74% of posts describe persistent, long-term pain. Additionally, 23% mention pain during sex and 27% report changes in sensitivity.
Posts on this forum also frequently reference vasectomy reversal surgery far more often than more specialised interventions such as microsurgical denervation: a complex nerve-removal procedure used in severe cases of chronic testicular pain, typically when other treatments have failed.
From AI to andrology: an ethical crossroads
Why is a professor of AI and physics analysing pain in urology forums?
Because in today’s digital world, people increasingly turn to online platforms like Reddit for health advice, peer support and decision-making – often before speaking to a clinician. As an AI researcher, I believe we have a responsibility to examine how these discussions shape public understanding, and what they can teach us about real-world healthcare challenges.
In this case, it’s possible that the drop in vasectomy uptake is linked, at least in part, to the open and emotional sharing of negative outcomes online. These posts are not scaremongering. They’re detailed, candid and often highly specific. They represent a type of real-world evidence that clinical trials and formal studies don’t always capture.
So, what should we take from all this?
Terms like “rare”, often used in consent forms and clinical conversations, can obscure the complexity and variability of patient outcomes. Pain following vasectomy, whether mild, temporary, chronic or debilitating, appears common enough to warrant more transparent and nuanced communication.
This is not an argument against vasectomy. It remains a safe, effective, and empowering option in reproductive planning. But truly informed consent should reflect both the clinical literature and the experiences of those who undergo the procedure, especially when such experiences are now publicly available in large volumes.
In a world where online forums double as health diaries, support networks and informal research registries, we must take them seriously. Medical language matters. Terms like “rare”, “uncommon” or “low risk” carry real emotional and moral weight. They shape expectations and influence decisions.
If even a small percentage of men experience long-term pain after vasectomy, that risk should be communicated clearly, in plain English – ideally with a range of percentages drawn from published studies.
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Kevin Pimbblet currently receives funding from STFC, EPSRC, The British Academy, The Royal Astronomical Society, The British Ecological Society, and The Office for Students. None are in direct relation to this work.
– ref. Vasectomy, pain and regret: what online forum Reddit reveals about men’s experiences – https://theconversation.com/vasectomy-pain-and-regret-what-online-forum-reddit-reveals-about-mens-experiences-261633