 Another study contacted 470 vasectomy patients and received 182 responses, finding that 18.7% of respondents experienced chronic genital pain with 2.2% of respondents experiencing pain that adversely affected quality of life.The most robust study of post-vasectomy pain, according to the American Urology Association's Vasectomy Guidelines 2012 (amended 2015) found a rate of 14.7% reported new-onset scrotal pain at 7 months after vasectomy with 0.9% describing the pain as "quite severe and noticeably affecting their quality of life".An investigation of peer-reviewed articles published in March 2020 examined 559 articles, performed meta-analysis on 25 separate datasets, and concluded that the incidence of post-vasectomy pain syndrome is 5% (95% CI 3% to 8%) with similar incidence of PVPS for both the scalpel and the no-scalpel technique.