Post Vasectomy Pain Forum

2019 study of 2 million men over a 38 year period finds a 10%-20% higher risk of prostate cancer after vasectomy. Researchers adjusted for number of doctor visits and socioeconomic factors

BACKGROUND:

A man’s risk of prostate cancer has been linked to his prior reproductive history, with low sperm quality, low ejaculation frequency, and a low number of offspring being associated with increased prostate cancer risk. It is however highly controversial whether vasectomy, a common sterilization procedure for men, influences prostate cancer risk.

METHODS:

We established a cohort of all Danish men (born from 1937) and linked information on vasectomy, doctor visits, socioeconomic factors and cancer from nationwide registries using unique personal identification numbers. Incidence risk ratios for prostate cancer by time since vasectomy and age at vasectomy during the follow-up were estimated using log-linear Poisson regression.

RESULTS:

Overall, 26,238 cases of prostate cancer occurred among 2,150,162 Danish men during 53.4 million person-years of follow-up. Overall, vasectomized men had an increased risk of prostate cancer compared with non-vasectomized men (relative risk 1.15; 95% CI, 1.10 to 1.20). The increased risk of prostate cancer following vasectomy persisted for at least 30 years after the procedure and was observed regardless of age at vasectomy and cancer stage at diagnosis. Adjustment for the number of visits to doctor and socioeconomic factors did not explain the association.

CONCLUSIONS:

Vasectomy is associated with a statistically significant increased long-term risk of prostate cancer. The absolute increased risk following vasectomy is nevertheless small, but our finding supports a relationship between reproductive factors and prostate cancer risk.

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Somebody check my algebra here, but if 10% of the males in the study had a vasectomy, that would be 215,016 men. If those men had chosen not to get a vasectomy, an estimated 2,585 would have gotten prostate cancer. Since they did get vasectomies, the rate was 10%-20% higher. So according to this study, if you focus in on just Danish men born in 1937, somewhere between 258 and 517 of them got prostate cancer as a result of their vasectomy.

Cheer up though guys. I have it on good authority that there is no physical way for a vasectomy to result in a reduced libido!

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Don’t forget about this study too…

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Yea, I have it in writing in my pre vasectomy informed consent paperwork too. It clearly states that there is no inherent risk of cancer, and there will be no change in hormones after the fact, among other rubbish. Doctors can lie to you, and it’s perfectly legal nowadays.

Several months ago, I was diagnosed with a testosterone level of 91, which jumped back up to over 200 several weeks later. My so called doctor (dictator) had the nerve to tell me that while my testosterone level was low, it was close to normal. I wanted to slap him.

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From what I hear, radical prostatectomy doesn’t boost the mojo either.

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Yea, it’s all good :confused:

T level of 200 is not normal. The guy is crazy. You should have slapped him hard so that may be his brain starts functioning.

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Thanks for sharing this. I’ve already put this on my FB page (without any reference to my own situation).

Just a recent thought, since I have had a swollen feeling prostate and trouble urinating ever since my vasectomy, and I understand that prostate trouble can also cause decreased orgasm sensation, which I also have.

The Danish study suggests that the relative risk of prostate cancer for vasectomized men is 1.15.

The overall chances of getting prostate cancer are 12.1% (Link)

If we assume that 5% of men had a vasectomy in the population that was measured to get the 12.1% PC incidence, then that works out to non-vasectomized men having a 12% chance of PC, and vasectomized men having a 13.8% chance of PC.

Those numbers are much higher than I realized. I thought prostate cancer was some kind of small risk, but in fact it’s a really common cancer. This is much higher than I realized in my May 2019 post above, because I did not get the correct number for the lifetime risk. I thought the “relative risk” value was showing the full lifetime risk, but it’s just showing the ratio between the vasectomy risk vs non-vasectomy risk.

So as I calculate it now, according to the Danish story, vasectomy is causing about 1,790 cases of prostate cancer for every 100,000 men who get a vasectomy. That’s a lot of men.

According to UpToDate, 43 million men got a vasectomy in 2004. So that’s 769,732 extra cases of prostate cancer. I mean holy moly.

Half a million men get a vasectomy in the USA each year. That’s 8,950 cases of prostate cancer added by vasectomy every year in the USA.

Am I doing this right? Somebody jump in here if I’m doing this wrong because this sounds like a lot.

And prostate cancer sucks. Even if it doesn’t kill you. You do not want to be buying tickets in the prostate cancer lottery.

So what about your chances of dying from prostate cancer? Looks like it’s 1:41 (Link)

1:41 is 2.439% That works out to 2.42% for non-vasectomized and 2.78 for vasectomized. The difference is 0.363% or 363 per 100,000. Or in other words, out of the 43,000,000 men who got a vasectomy in 2004, 156,000 of them will die from prostate cancer that they would not have gotten if they had not had a vasectomy. That’s for one year.

All I ever hear is that there have been zero deaths attributed to vasectomy. That’s definitely false, since there have been a handful of deaths due to infections that were acute complications of vasectomy. But with the prostate cancer thing… If my math is right that means that vasectomy providers should be advertising that vasectomy only kills 156,000 men per year.

The question I want to know the answer to, is whether those prostate cancers hit men without PVPS and men with PVPS-with-prostate-problems equally.

In other words, should I consider getting a reversal because the prostate symptoms I am having indicate a massive increase in the risk that I will develop prostate cancer?

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That’s a boatload of additional cancer cases. Perhaps others will disagree, but I believe that is a violation of the Hippocratic Oath to knowingly cause more cancer (especially when they falsely claim no connection).

Also with everything slanted pro-vas, I doubt that any studies will be conducted in the near future to determine the incidence rate of cancer in PVPS vs. non-PVPS patients.

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Don’t forget about the ginormous lobby that keeps this info tucked quietly away. If you took vasectomy from urology it severely impact the number of docs that go into it. It’s a cash cow for sure.

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Another study, out this month. This one is a meta-analysis done by researchers in China.

Abstract

Epidemiologic cohort studies investigating the association between vasectomy and prostate cancer risk have yielded inconsistent results. The aim of the present meta-analysis is to update the evidence on the association between vasectomy and prostate cancer. A comprehensively literature search of relevant studies was performed in December 2019 using PubMed. A DerSimonian and Laird random-effects model was used to calculate the summary relative risk (RR) and its 95% confidence interval (CI). A total of 15 eligible cohort studies (16 datasets) with more than four million of participants were eventually included in this meta-analysis. There was a statistically significant higher risk of prostate cancer among men who underwent vasectomy (RR 1.09, 95 % CI 1.04-1.13) with obvious heterogeneity among included studies (P < 0.001, I2 = 64.2%). Vasectomy was also associated with the risk of advanced prostate cancer (RR 1.07, 95 % CI 1.02-1.13), which is less likely to be affected from detection bias. In conclusion, findings from this meta-analysis of prospective studies indicate that vasectomy may be positively associated with the risk of prostate cancer. Further large prospective studies with long follow-up are warranted to verify the findings from this meta-analysis. In addition, the potential underlying molecular mechanism needed further exploration with in vitro and animal studies.

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Thank you for the info Ethan.

I read once that orchiectomy can lengthen a mans life, it’s interesting to know how the body can change with regards to vasectomy vs epididymectomy vs orchiectomy?

In prostate cancer cases a simple orchiectomy is preformed to help treat the condition, so I guess a vasectomy is basically causing a congestion which is bad for the prostrate, but why?

I guess a vasectomy is basically causing a congestion which is bad for the prostrate, but why?

Who knows. Could be as simple as that men with a vasectomy do not masturbate as often. Could be some ingredient in seminal fluid that was protective against cancer. Scientists seem like they have an open mind about this stuff. When they get a result that they cannot explain they seem to be able to say “I cannot explain this phenomenon, therefore perhaps something is missing from my mental model.” Doctors seem less willing to accept that there is something they are missing. They seem more prone to reason like this: “I cannot explain this phenomenon, therefore perhaps it not happening.” Maybe it’s something in the education process that tends to cause humble people to go into science and arrogant people to go into medicine. Would not surprise me.

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The idea that a vasectomy or any procedure that creates an obstruction type scenerio within the vas deferens has zero or next to nill effect on the prostate is just plain silly :yum:

Thanks for sharing all the links to the above studies @Ethan_Scruples. I’ve been pretty sick and tired of listening to people continue to support the idea that vasectomies have no impact on the prostate, no elevated risk of prostate cancer, and so on - for over a decade.

2+2 doesn’t equal 5

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Here’s another one from 2014 that examined 50,000 men and got the same result. Vasectomy raises your chance of prostate cancer – including the lethal variety – by about 10%

This may have been one of the studies the Chinese meta-analysis looked at, I haven’t read the full text yet.

Results like this destroy the argument that vasectomy is safer than tubal ligation. Official figures are that tubal ligation kills 4 out of 100,000 women. According to my calculations, vasectomy kills 244 out of 100,000 men – so it is 60 times more deadly.

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Yeah, I have seen that one before. Seems it’s been linked at least once elsewhere on this site already. I can think of at least a ~half dozen legitimate studies that completely contradict the idea that there is no link between vasectomies and prostate complications at minimum.

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I started reading around this similarly a few year ago myself, the products of the testicles have some interesting immune peoperties.

I did not go any further than the below however:

The fact infertile men in general have a higher prostate cancer risk would somewhat corelate with a higher vasectomy cancer risk

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Summing up some studies for reference for @stk

1993 USA study tracked 47,855 men and calculated a relative risk of 1.66 (95% CI 1.25 - 2.21). The longer you had the vasectomy the worse the risk – men with vasectomy at least 22 years prior had 1.85 (1.26 - 2.72) risk. (Link)

2014 USA study tracked 49,405 men and calculate a RR of 1.1 (1.04 - 1.17). Lethal disease RR 1.19 (1.00 - 1.43) “The results do not appear to be due to detection bias, and confounding by infections or cancer treatment is unlikely.” (Link)

2019 Denmark study tracked 2,150,162 men and calculated a RR of 1.15 (1.10 - 1.20). “Adjustment for the number of visits to the doctor and socioeconomic factors did not explain the association.” (Link)

2020 China study meta analysis covering more than 4,000,000 men calculated a RR of 1.09 (1.04 - 1.13). Advanced prostate cancer risk was 1.07 (1.02 - 1.13). “Vasectomy was also associated with the risk of advanced prostate cancer, which is less likely to be affected from detection bias.” (Link)

2020 Finland study tracked 38,124 men and calculated RR 1.15 (1.04 - 1.27). But only 19 men died from prostate cancer instead of the 20.5 men that would be expected in an un-vasectomized population, so no big deal. (Link)

To me, this seems to be as conclusive a result as you can hope for in medical science.

And yet…

AUA Expert Opinion We do not feel like vasectomy causes prostate cancer. More study would be good of course.

Based on a careful review of vasectomy literature from 1949 to 2011 (including the 1992 and 1993 papers by Giovannucci and co-author Stampfer [who are co-authors of the 2014 JCO article] et al .), the AUA Vasectomy Guideline Committee concluded in 2012 that there is no association between vasectomy and prostate cancer or other significant health risks. The 2012 AUA vasectomy guideline goes further by stating that there is no need for physicians to routinely discuss prostate cancer in their preoperative counseling of vasectomy patients. (Link)

I love that they not only say they don’t think there is any association between prostate cancer and vasectomy, but explicitly advise doctors that they do not need to warn patients about the possibility.

That’s here in the official guidelines as well from 2015:

Clinicians do not need to routinely discuss prostate cancer, coronary heart disease, stroke, hypertension, dementia or testicular cancer in pre-vasectomy counseling of patients because vasectomy is not a risk factor for these conditions.

https://www.auanet.org/guidelines/vasectomy-guideline

We do not speak of such things!

A man seeking a vasectomy assumes that if a urologist doesn’t warn him about an issue, then the issue must not be that bad. Few would consider the possibility that the urologist doesn’t tell you because the truth is so bad that you might cancel your appointment.

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Comparison with oral birth control:

  • Breast cancer RR = 1.07, 1.2
  • Cervical cancer RR = 1.1, 1.6, 2.0
  • Endometrial cancer risk is reduced by 30%
  • Ovarian cancer risk is reduced by 30-50%
  • Colorectal cancer risk is reduced by 15-20%

(Link)

And salpingectomy reduces ovarian cancer risk by 30 - 64% (Link)

I need to convert this to absolute numbers, but prostate cancer is a very common disease so I don’t expect that to change the overall picture.

Again:

Oral birth control causes cancer --> Horrible

Vasectomy causes cancer --> Nothing to see here

Oral birth control prevents cancer --> Nothing to see here

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