Question- Does vasectomy cause prostate cancer? Northeast Georgia Urology

a-madajet-2

This is probably one of the most common questions asked at a vasectomy consultation.

The second most common? “What is the success rate of a vasectomy?” (I’ll address that next time.) J.M.

Vasectomy Not Associated With Prostate Cancer

Urology – February 28, 2009 – Vol. 25 – No. 04

There is no association between prostate cancer and age at vasectomy or years since vasectomy.

Article Reviewed: Vasectomy and the Risk of Prostate Cancer. Holt SK, Salinas CA, Stanford JL: J Urol; 2008;180 (December): 2565-2568.

Background: The majority of the literature now has shown no association between vasectomy and prostate cancer. The effect of vasectomy on men with a family history of prostate cancer or on those who underwent a vasectomy at a young age or had an extended period of time since the procedure has been poorly studied due to small sample sizes and short study follow-up.

Objective: To assess the risk of prostate cancer in men by age and length of time to exposure from vasectomy to disease.

Design: Population-based, prostate cancer case-controlled study.

Participants: 1327 men aged 35 to 74 years residing in King County, Washington, with a diagnosis of prostate cancer.

Methods: Cases of prostate cancer were identified from the SEER database for this population. Structured in-person interviews were conducted. Eligible controls were identified by random digit telephone dialing. Analysis based on prostate cancer Gleason score and stage was performed. Analysis was also performed based on demographics, age, prostate cancer screening history (within the last 5 years), family history of prostate cancer, and vasectomy parameters.

Results: 1327 men were eligible for study from the SEER database; 1001 completed the personal questionnaire. In total, 1340 controls were identified, of which 942 were interviewed. The control population showed that men who had undergone vasectomy were older, white, married, non-smokers with higher income and education, and had undergone PSA screening. Of men with prostate cancer and controls, 36% had undergone a vasectomy. Mean number of years since vasectomy in cases and controls was 21.1 years. No significant association was seen between prostate cancer and vasectomy status, age at vasectomy, years since vasectomy, or year of vasectomy. There was no evidence of risk estimates across vasectomy parameters. Risk did not change if men with prostate cancer within 2 years of vasectomy and controls with no PSA screening within 5 years (n=136) were excluded.

Conclusions:

No association was found between prostate cancer and vasectomy, even in men who had a vasectomy performed at a young age or had an extended period of time since vasectomy.

Reviewer’s Comments: This paper is a well-conducted, large case-control study that answers the concern about possible limitations of previous work that reported the lack of association between prostate cancer and vasectomy. This criticism often indicated inadequate follow-up since vasectomy to make this claim. In this study, average time since vasectomy in cases of prostate cancer and controls was 21 years. Multiple variables were looked at including vasectomy in the face of prostate cancer family history and screening. This large study should end the criticism on previous work that did not answer the question of prostate cancer and time from vasectomy. (Reviewer–Ajay K. Nangia, MBBS).

Question: What is this lump after my vasectomy?

From Vasectomy.com

I had a vasectomy a year ago and now I have a small pea size lump on my vas deferns and it feels as if the two ends have connected. Is this possible?

This is a common finding following a vasectomy. It can be nothing more than the normal healing process that would occur with any procedure as the body attempts to heal the trauma of the transected vas deferens.

A sperm granuloma again is a natural body response to the leakage of sperm that may have occurred at the vasectomy site.  These areas are sometimes tender to the touch or in certain sitting positions. Uncommonly if the pain is significant enough, a course of antibiotics or anti-inflammatories are necessary. Rarely the discomfort is often enough and bad enough that a patient will request that the can be removed surgically.

I did a vasectomy on a friend of mine who developed a sperm granuloma and it was painful to him about every six months or two years and responded to antibiotics, although there is no real scientific reason for this. The after a few years, it stopped bothering him.  He would call and say, “John, my sperm “granola” is back.” J.M.

ANSWERS FROM DOCTORS (3)


2 months ago by Steven K. Sterzer, MD

Yes, you may have had a sperm leak early on post-vasectomy that the ever magnificent body healing process took care of. The pea-sized lump is probably what is called a granuloma. This is of no clinical significance, unless you wish to get a reversal of the vasectomy. In that case, the reversal success rate will be higher than if this did not occur. Best wishes!


2 months ago by Mark J. Saslawsky, MD – Memphis Office

It’s typical for the vas ends to “approximate”, but they rarely reconnect. The knot could be scar tissue or a cyst from back pressure.


2 months ago by Randy Brett Ackerman, MD

If the semen analysis shows no sperm, then you should not be able to father a child. Small pea-sized lumps following a vasectomy can happen, but there is no indication from them that the procedure has failed.