Vasectomy Newsbytes

Menstuff® has compiled newsbytes on the issue of vasectomy. Main vasectomy issues are here.

Study Suggests Vasectomy-Dementia Link
Cancer, Vasectomy Connection Disproved
Vasectomy Link to Prostate Cancer Dismissed
Vasectomy and Cancer Risk

Vasectomy and Prostate Cancer
Are Men With Vasectomies At Greater Risk For Prostate Cancer?
Did Post-Vasectomy Sex Cause A Traffic Jam?
Vasectomies at 18/Tabulations at 21
How Much Will My Vasectomy Hurt?
If He Reverses His Vasectomy, Will I Get Pregnant Soon?
Is A Vasectomy Foolproof?
Do Vasectomies Cause Erectile Dysfunction?
Where Do The Sperm Go After A Vasectomy?
Are Men With Vasectomies At Greater Risk For Prostate Cancer?
Can I Sell My Testicles To A Lab?
The Amazing Success Of Vasectomy Reversal
No-Scalpel Vasectomy As Good As It Sounds
Could Testicular Tenderness Be A Sign Of Cancer?
Lawsuit Burdens For Botched Vasectomies
Vasectomies Not As Foolproof As We Thought

Study Suggests Vasectomy-Dementia Link

Having a vasectomy may do more than previously thought. A new study says the procedure may increase a man's risk of developing a rare form of dementia. And, more research is needed.

It is pointed out that earlier concerns about vasectomies, including research in the 1980s suggesting an increased risk of atherosclerosis in men who had undergone the procedure, and research in the 1990s suggesting a link between vasectomy and prostate cancer. None of those concerns turned out to be valid.

“There have been many large, epidemiological studies comparing vasectomized and nonvasectomized men, and none of them have shown any health risks associated with vasectomy,” Sharlip says.

“Vasectomy is the single most reliable form of birth control that exists. I would hope that men would not be frightened by this study, which is very preliminary,” he says.

Cancer, Vasectomy Connection Disproved

Undergoing a vasectomy does not increase a man's risk of contracting prostate cancer, a study from New Zealand finds. Though some previous studies have produced mixed findings, about a link between vasectomy and prostate cancer, researchers at the University of Otago-Dunedin say their two-year study of 923 prostate cancer victims and 1,224 "control" subjects showed no connection. "Our results are consistent with several recent studies that have not found a significant association between the two."
Source: Journal of American Medical Association

Vasectomy Link to Prostate Cancer Dismissed

Dr Brian Cox and colleagues from Dunedin School of Medicine, Wellington School of Medicine and the University of Otago in New Zealand looked at more than 2,000 men, almost half of whom were newly diagnosed prostate cancer patients, to examine whether a link between this cancer and vasectomy existed. New Zealand was considered to be an ideal country in which to conduct the investigation because of its high incidence of vasectomy and its mandatory policy on cancer reporting. The men, aged between 40 and 74, had all been married at some time and were interviewed via telephone about previous illnesses, vasectomies, smoking and alcohol consumption, prostate specific antigen testing, rectal examination, previous urological symptoms, family history of cancer and socio-demographic characteristics. The researchers found that there was no increased risk of the disease among men who had undergone a vasectomy 25 or more years before they were interviewed. Furthermore, vasectomy carried no greater risk of prostate cancer, even after adjusting for social class, geographic location, religion and family history. "Since vasectomy is so common in New Zealand and all new prostate cancers there must be reported to its National Cancer Registry, that's where you would expect to find a link between the two if one exists," said Dr Steven Kaufman of the National Institute of Child Health and Human Development's Contraception and Reproductive Health Branch. He added, "Also, although the study was more than large enough to detect an increased prostate cancer risk associated with vasectomy, none was found." The findings appear in the Journal of the American Medical Association

Vasectomy and Cancer Risk

Some studies have raised questions about a possible relationship between vasectomy (an operation to cut or tie off the two tubes that carry sperm out of the testicles) and the risk of developing cancer, particularly prostate and testicular cancer. Such a relationship, if proven, would be of importance because about 1 in 6 men over age 35 in the United States has had a vasectomy.

Prostate Cancer

Prostate cancer is the most common cancer in American men and the second leading cause of cancer death, after lung cancer. In March 1993, the National Institute of Child Health and Human Development convened a conference, cosponsored by the National Cancer Institute (NCI) and the National Institute of Diabetes and Digestive and Kidney Diseases, to clarify the available evidence on the relationship between vasectomy and prostate cancer. Scientists reviewed and carefully weighed all of the data available at that time, including results from published and unpublished studies. They determined that the results of research on the association between vasectomy and prostate cancer were not consistent. In addition, the scientists could not find any convincing biological explanation for a link between vasectomy and an increased risk of prostate cancer. Based on these findings, the expert panel concluded that even if having a vasectomy can increase a mans risk of developing prostate cancer, the increase in risk is relatively small.

Since the conference in 1993, more studies investigating the relationship between vasectomy and prostate cancer have been conducted. Although the majority of these studies have upheld the conclusions made at the conference, a few studies have reported a link between vasectomy and prostate cancer. It is possible that other factors, including chance, may be responsible for the increased prostate cancer risk seen in these studies. Scientists expect that additional research will clarify this issue.

Several studies looking at a possible connection between vasectomy and prostate cancer are currently under way. The largest of these studies is the NCIs Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which began in 1992. The PLCO Trial is evaluating screening procedures for prostate cancer and will prospectively examine potential risk factors, including vasectomy, associated with prostate cancer. The PLCO is a long-term study; results are expected by 2015.

Testicular Cancer

Testicular cancer is much less common than prostate cancer, accounting for only 1 percent of cancers in American men. This type of cancer is most often found in men ages 15 to 35. A few studies have suggested a link between vasectomy and an increased risk of testicular cancer, but it is possible that the increase in cases of testicular cancer seen in these studies may be due to factors other than vasectomy. It is also possible that the vasectomy procedure increases the rate at which an existing, but undetected, testicular cancer will progress. At this time, it is believed that there is either no association or a weak association between vasectomy and testicular cancer, but more research is needed before definitive conclusions can be made.

Men concerned about prostate cancer or testicular cancer should talk to their doctor about the symptoms to watch for and an appropriate schedule for checkups.


Vasectomy and Prostate Cancer

A vasectomy is an operation that prevents sperm from traveling from the testicles to the penis, says the Harvard Center for Cancer Prevention. It is one of the most popular forms of birth control in the US. Men who have vasectomies have a slightly higher risk of prostate cancer. Scientists aren't sure why.


Are Men With Vasectomies At Greater Risk For Prostate Cancer?

Ellen: After researching vasectomies on your Web site, I am worried. On the National Cancer Institute's link I found a claim that vasectomies are associated with higher rates of prostate cancer. My husband is scheduled for a vasectomy tomorrow; there's nothing like last minute research!

Dr. Dean: It's funny that you're doing the research and he's not.

Ellen: Well, he asked me to.

Dr. Dean: Ah-ha, chicken. I can definitively say to you that vasectomies do not cause prostate cancer. He should have no fear whatsoever about that. But at one point there was research that suggested a connection.

A couple of studies did find that men with vasectomies had more prostate cancer. Of course, the National Cancer Institute was very interested in these studies, but once news goes into a database on the Internet, it can stay there forever.

Our Web site is huge. The last time I checked we had 40,000 pages, because we want to share information with you. However, keeping material updated can be a challenge.

With further searching, I think you will find that subsequent studies indicate that "detection bias" skewed the earlier reports. Here is how detection bias works.

A man getting a vasectomy will see a urologist. As part of the pre-vasectomy physical, the urologist is going to put his finger where the sun don't shine and examine the patient's prostate. Therefore, prostate cancer is going to be detected more often in men getting vasectomies than in other men. Thus, it appears that men getting vasectomies have more prostate cancer.

There is some research, that is still inconclusive, indicating that primates (monkeys) with vasectomies, may have higher cholesterol levels and greater risk factors for heart disease.

We have NOT found vasectomies to increase heart attacks in humans. Nevertheless, because primates are so close to us, the question, however minimal, lingers.

The question wouldn't stop me from having a vasectomy if I needed one. When I did need one, I didn't do it; and that's why I've got so many kids. And, of course, I'm glad I did.

I tell you in all honesty, Ellen, that when a couple wants permanent birth control, a vasectomy for a man is a much smarter way to go than for the woman to have a tubal ligation. So, I congratulate him.

Did Post-Vasectomy Sex Cause A Traffic Jam?

John: I had a vasectomy six days ago. After having sex with my wife the other night, my testicles became very tender. I went back to the doctor because one of them is still painful. It feels like it is being squeezed.

The doctor poked on the back of my testicle and said I was having a traffic jam. He gave me an injection to stop sperm production, some Vicodin for pain, and some antibiotics. Does this sound right?

Dr. Dean: A few days following a vasectomy, you can feel pain free and in the mood. But the soreness you didn't have before will sometimes hit your testicles following a rollicking time.

The most common side effect of a vasectomy is delayed pain and you are one of the small percentage of men who run into this problem. Six days is a very short time since the surgery. I can't imagine that this will persist.

It seems to me that putting a cool pack on your testicles and just letting some time go by will take care of your problem. An over-the-counter anti-inflammatory drug, like ibuprofen, might make you more comfortable too. Check this out with a urologist.

Your doctor examined you properly. He was feeling for swelling in your epididymis, a structure in the testicle that can become inflamed and sore. Antibiotics would be appropriate if the epididymis is infected, but I doubt that it is because your symptoms would be more severe.

Vasectomies at 18/Tabulations at 21

It wasn't too many years ago that doctors wouldn't perform these surgeries on anyone under 30. Even if you filled out all the necessary release forms. Seems the medical community through you were old enough to make the decision to fight in the military, kill others and die, but you weren't old enough to make a choice to not have children. After all, this society is built on the over-population theory. Well, now in California, men can get a vasectomy at 18+ and women have to wait until they are 21 to get a tabulation. At least there is some progress here. (Check with your local Planned Parenthood or health clinic for the laws in your state. )

How Much Will My Vasectomy Hurt?

Alex: I'm 25 and I have three kids, so I'm having a vasectomy soon. My daughter is seven, and I have two boys aged five and three. I've never had time to myself.

I'm scared out of my mind about doing this. I've heard about erection problems, prostate problems, and pain.

How many men who have had vasectomies have side effects? My doctor says it is 1 in 50.

Dr. Dean: Wow, three little kids should be enough convincing for any guy. If you are looking for permanent birth control, a man having a vasectomy is always better for the sake of the couple than for a woman to have her tubes tied.

Medically, you don't have anything to fear. The myths you've heard about impotence and prostate cancer are just myths. There is an outside chance a vasectomy will affect a man's cholesterol level later in life. The evidence is still inconclusive.

As far as pain is concerned, most men will tell you it's no biggie, just a little discomfort for a day or two. After that, they don't even know anything happened. A small percentage though -- your doctor puts it at 1 in 50 -- complains of pain for a week.

Some doctors are using a Chinese method of vasectomy called scalpel-free vasectomy. It is the most painless way. It also requires a little extra skill on the doctor's part.

I do have to tell you that statistics show that men who have vasectomies when they are less than 35 years old have a high rate of regret. If you someday change your mind, you may be able to reverse it, but you should consider it permanent birth control.

If He Reverses His Vasectomy, Will I Get Pregnant Soon?

May: I want to have a baby, so, I've got some questions about vasectomy reversal for my husband. I've heard the reversals can take up to a year to work, and that they sometimes don't work at all.

If he has the surgery, will he start producing sperm right away, or will it take a long time for me to get pregnant?

Dr. Dean: Under regular, unaltered circumstances, a young and healthy female just doing what comes naturally with her man, takes about six months to become pregnant. So, take that into consideration when you're waiting on post- vasectomy conception.

In a post-vasectomy man, sperm production may return right away, but if the vasectomy happened many years before, the testicles may have turned down the action and be slow to kick in. His sperm count can be measured right after the procedure to give you some information.

If you both check out A-OK physically, you can expect a better than 50 percent pregnancy rate following a reversed vasectomy.

It is a delicate and expensive surgery. You've got to have a doctor with really good hands and lots of experience.

You know, the test tube baby - in vitro fertilization - technique has gotten so good and we have so much control over it that I recommend you consider it as an alternative.

The doctors can fertilize your egg by using sperm that they extract from your husband's testicles - yes, post-vasectomy men have sperm in their testicles. This process - intracytoplasmic sperm injection or ICSI - is called "Ick-see" for short.

During natural conception, out of hundreds of millions of sperm attempting to impregnate a woman, only one is the front-runner that achieves its aim. But with reproductive technology, we can take one sperm and with a very fine, needle-like device inject it right into the egg.

I suppose vasectomy reversal, with its better than 50 percent success rate may be a lot less hassle than ICSI. I just want you to know that you have options.

Do Vasectomies Cause Erectile Dysfunction?

E-mail: My husband's getting a vasectomy, so I've been researching it on the Internet.

Dr. Dean: Be careful!

Where Do The Sperm Go After A Vasectomy?

E-mail question: My wife is bugging me to get a vasectomy. I have a question. Where do the sperm go?

Dr. Dean: They don't go anywhere. They kind of stay there, hang out, get absorbed, and then they die. Yes, they die.

Can I Sell My Testicles To A Lab?

E-mail question: Don't think this is a joke. I am 100 percent serious. I am 29 years old, and had a vasectomy four years ago. A friend told me he read that some laboratories purchase testicles for medical research. Are there any health-related risks to such an operation?

Dr. Dean: Come on! Gotta be a joke.

Of course you need them. They make hormones, sir. If I removed them, you would feminize, lose your hair, and get a higher voice. You wouldn't like that.

Testicles are sometimes removed due to prostate or testicular cancer. I'm sure a lab somewhere might purchase them, for research, from men who have orchiectomies.

Who knows, maybe there's a out there looking for...

Is A Vasectomy Foolproof?

E-mail question: My husband’s vasectomy was successful and there has been no evidence of live sperm, but I’m worried that I might become pregnant. We know of four couples who had children after the husband had a vasectomy. Are there any statistics on how effective they are?

Dr. Dean: Yes, you can become pregnant by a man who has had a vasectomy. I’ve seen statistics from as rare as 1 in 1,500 to as common as one in 200 to 300 showing cases where vasectomies have reversed themselves.

Unfortunately, the first thing people will do when this happens is to call a lawyer because they think the wife has been unfaithful. That is not necessarily so, as the statistics show.

This is why it’s so important to return to your doctor after a vasectomy. Many men have a vasectomy, disappear, and never go back to the doctor to get it checked. Ten years later they have an unplanned baby and they blame the doctor.

This surgery is not 100 percent perfect – nothing is.

No-Scalpel Vasectomy As Good As It Sounds

In case you didn’t know it, about one-third of the vasectomies done in this country involve a no-scalpel approach that started in China 25 years ago.

Since incisions are still made in most vasectomies, a multicenter research group studied 1,429 men to compare the results of surgery to the no-scalpel method. The controlled trials took place in eight sites in Brazil, Guatemala, Indonesia, Sri Lanka and Thailand.

The researchers found both treatments to be safe and effective, but the no-scalpel group had fewer complications, less pain and resumed intercourse sooner after the procedure, according to a report in the Journal of Urology.

One note of caution here is that the no-scalpel procedure, which uses a clamp device, is a little tricky and not a lot of physicians in this country are proficient in this type of vasectomy.

If you’re considering a vasectomy and want to go the no-scalpel route, be sure to choose a doctor who has a track record in performing the operation.

Source: The Journal of Urology, November 1999,

Could Testicular Tenderness Be A Sign Of Cancer?

Gary: I am 47 years old and I had a vasectomy about 11 years ago. For the last two years, I have had some tenderness in my left testicle. There is a history of testicular cancer in my family on my father's side.

I was wondering, if testicles are removed because of cancer, how does that affect ability to have an erection, and more specifically, the feeling of orgasm, and does that feeling or lack of feeling of an orgasm affect the erection post-orgasmic feeling.

Dr. Dean: Okay. Can I read between the lines here?

Gary: Sure.

Dr. Dean: You're a guy who has had a symptom for two years in a family with testicular cancer and you're asking me some questions, which kind of raises a flag to me. I'm going to guess that you haven't been to a doctor because you're afraid of the things you've just asked me about?

Gary: It's not that I'm afraid. It's just that it didn't really dawn on me until recently, when I thought, you know, I don't know if I've just passed this symptom off for years or ...

Dr. Dean: But what did the doctor say?

Gary: I haven't been to one.

Dr. Dean: In other words, Dr. Dean, you're right?

Gary: Yes.

Dr. Dean: Okay. Whatever the reasons are, of course, you've got to go and see your doctor.

And if it's in the back of your mind, you need to deeply bury any fear of these things. You don't have to worry about it, because this is not the effect that it would have, for instance, if they were to remove both of your testicles, which is extremely unlikely.

I've got to tell you - and I don't want to say this to you and discourage you from seeing your doctor - pain or tenderness in a testicle is not the most common first symptom of testicular cancer. I assume that you examine your own testicles and you have not found any lumps, bumps or anything that would otherwise make you suspicious.

Gary: Not noticeable.

Dr. Dean: That is good news. But indeed, if I were to remove both of your testicles, which by the way, we still do in cases of prostate cancer, your testosterone levels would go down, which could affect the libido, but we would replace it - so the organismic reflex, an erection, does not have a lot to do with that. So that would be entirely okay.

And if you did have cancer in one testicle, we might remove the one and that wouldn't make any difference.

Of course, we're making assumptions here that could be incorrect, you know. I kind of don't think you do, but I think obviously you must see your physician and discuss it with him or her.

The Amazing Success Of Vasectomy Reversal

Introduction: There's some good news for men starting second families. If a man has had a vasectomy, there is no guarantee it can be reversed successfully - but new research says the odds are better than we once thought.

Dean Edell, M.D. "Most of us like to assume life progresses in a logical plan: get married, have babies, then, after all the kids you want, perhaps Dad gets a vasectomy.

"But sometimes plans change, and you start all over again."

David/Had Vasectony Reversal: "When I had my vasectomy in 1989, I didn't know that a reversal was even possible. I had no idea whatsoever, no thought that I would ever want to have another child."

Dean Edell: "A few years ago, we thought vasectomies could not be reversed after five years or more had passed. There were concerns that when you block the tube, well, the sperm on this side back up and the body loses its ability to produce more sperm. "But now we're learning that the human body is much more resilient than we first thought. Because, with varying degrees of success, it appears vasectomies can be reversed - even many years later."

Ira Sharlip, MD/Urologist: "I have patients whose wives got pregnant and had babies more than 20 years after a vasectomy."

Dean Edell: "Of course, those are the lucky ones. But research is getting better at predicting who will win this numbers game. Within three years of a vasectomy, the reversal success rate was 75 percent. Up to nine years later, more than 50 percent of reversals resulted in babies. Up to fourteen years after the initial vasectomy, reversal success rates were 44 percent. And even after fifteen years or more, men had a one in three chance of fathering a child.

"Often, couples starting a second family will undergo costly in vitro procedures using sperm extraction - rather than chance a vasectomy reversal."

Ira Sharlip: "My recommendation to patients is that they should have a vasectomy reversal rather than a sperm extraction procedure, if the number of years between the vasectomy and reversal is less than 15."

David: "She's just real precious - I call her my love child."

Dean Edell: "The success of David's reversal is daughter Lexie, who just turned one year old."

David: "I never would have dreamed, looking back ten years ago, that I would have this child. Looking back 5 years ago, it would have been hard to imagine. She's a dream come true."

End Note: Not only is a vasectomy reversal much cheaper than an in vitro procedure, it has another added benefit. You can have as many children as you want, but only need to pay for the surgery once.

Lawsuit Burdens For Botched Vasectomies

Introduction: The United States leads the world in outrageous or burdensome lawsuits. So a new German Supreme Court ruling has some Americans concerned. If this type of lawsuit catches on, it could have a chilling effect on all of medicine.

Dean Edell, MD "Every time you get behind the wheel, you're taking a very real risk of dying. In fact, depending on where you live, the odds are about one in 3,000 that you will die, not just get injured, but die, in a auto accident this year. Yet we're all willing to take the risk.

"But when it comes to other aspects of our lives, we want it risk-free. For instance, have a bad result from surgery, you sue the doctor, even if the complications are expected or the problem is nature's fault, not your surgeon's.

"Now this sue-happy state is spreading to Germany, where the Supreme Court has just set a chilling legal precedent. They found that if a doctor performs a sterilization procedure, either a tubal or a vasectomy, and it fails, the doctor could be liable for the resulting child's upkeep.

"But we know the human body can outsmart even the best sterilization technique, so if this ruling triggers similar lawsuits on this side of the Atlantic no doctor's going to do these operations - because no operation is foolproof.

"Studies have shown the failure rate of vasectomies may be as high as one in a few hundred to one in several thousand. Even when the ends of a man's tubes are cauterized or a portion is removed, the ends can regrow or sperm may find a way to create new pathways.

"And the same is true for tubal surgeries in women. In both cases, unexpected 'surprises' may result. But is it the doctor's fault if mother nature decides to interfere? Since nothing in life is absolutely risk-free, perhaps we need to face that fact when heading into surgery."

End Note: Another ruling from the same court said a doctor could be ordered to pay lifetime maintenance for a child born disabled if he gave it's parents so-called "misleading" genetic advice.

Vasectomies Not As Foolproof As We Though

Introduction: Medicine is not foolproof - we all know that - but most couples feel that a vasectomy is. More and more studies show sometimes even they can fail. Even leftover sperm can cause trouble.

Dean Edell, MD "This is a picture of the vast wasteland of dead or dying sperm. In a normal man undergoing a fertility work-up, a sperm sample like this would be cause for concern. But what if you'd had a vasectomy? The ends were clipped and cauterized and you leave feeling sure that you're not producing sperm of any kind.

"Well new research finds that even 3 months after a vasectomy, doctors found sperm like this - so-called non-motile sperm in one-third of men. One-third! One theory is that these sperm may be leftover after surgery. While most of these sperm aren't viable, out of nearly four hundred couples studied, three had viable sperm and one got pregnant. Not great odds!

"We used to think vasectomies were foolproof, but now we know they aren't. Studies show on average, about one in 2000 couples may get pregnant after a vasectomy. Remember that, before you assume your wife is cheating on you. Experts say, sometimes the ends of the tubes can actually grow together again.

"In this study, eventually all of these men produced zero sperm, but for some it took almost two years. So after surgery, it's essential for men to return to their doctors for follow-up tests unless they want a 'surprise' about nine months later."

End Note: This knowledge is so new. Researchers say every couple should be warned of this small possibility of failure. And perhaps every doctor should have couples acknowledge these warnings in writing to protect themselves against future lawsuits.

Source: Fertility & Sterility 1997;67:332-335.

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