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Br J Gen Pract. 1997 Jun;47(419):381-6.

Is vasectomy harmful to health?

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  • 1University of Glasgow.

Abstract

Since the late 1960s, vasectomy has been a popular and widely used form of contraceptive in Britain for couples who do not want to have any more children. However, throughout the past decade there has been considerable concern about the safety of this procedure. This paper reviews the current opinion on the possible health considerations associated with this operation and shows that the latest news is mostly reassuring.

PIP:

Since the late 1960s, vasectomy has been a popular contraceptive option in Great Britain for couples who have achieved their desired family size. In recent years, however, considerable concern has been expressed about possible associations with cardiovascular disease and testicular and prostate cancer as well as long-term localized effects. This article reviewed the literature published during 1986-96 on these health concerns. Although vasectomized monkeys fed atherogenic diets appear to have a higher risk of peripheral artery disease, long-term studies of vasectomized men have failed to detect increased cardiovascular disease. No evidence has been found that vasectomy predisposes to testicular cancer or accelerates the growth of early testicular cancer. Studies demonstrating a 2-fold increase in the risk of prostate cancer after vasectomy were conducted in the US, where prostate cancer is common, and contained possible biases. European studies have not detected such an increased risk. Even if a relationship between vasectomy and prostate cancer is proven, further investigations would be required to determine if vasectomy causes prostate cancer through mechanisms such as hormonal changes, immunologic responses, or failure of growth inhibitors to reach the prostate due to obstruction of the reproductive tract, or whether vasectomized men are more exposed to the real causal agent. Moreover, even if the risk for vasectomized men in the UK is doubled, only 6/1000 men 65-74 years old would be expected to develop prostate cancer each year. The local effects of vasectomy on the reproductive tract are not fully determined. Distention of the epididymal duct occurs in most patients and granuloma formation is common. Vasectomy may also induce autoimmune orchitis. While many men develop structural changes in the reproductive tract after vasectomy, only a minority report discomfort. Although men considering vasectomy should be told that some studies have suggested a small increased risk of prostate cancer, they can be reassured that other health concerns are without foundation.

PMID:
9231476
PMCID:
PMC1313033
[PubMed - indexed for MEDLINE]
Free PMC Article
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