About 15% of men have varicoceles, which are enlarged veins in the scrotum. Varicoceles can cause pain and fertility problems, but varicocelectomy is a safe and effective treatment option.
Vasectomy is a readily performed outpatient or in-office minor surgical procedure that offers a permanent method for male birth control. The “newer” no scalpel technique has been available from urologists in the US for over forty years. This option for family planning has gained increasing acceptance from all walks of US society over the past few decades and globally it is estimated to have been performed on tens of millions of men. However, certain publications have raised the question as to whether there is increased risk from prostate cancer among men who undergo vasectomy. A recent publication in the Journal of Clinical Oncology addresses this concern and concludes no increased risk of death from prostate cancer for vasectomized males.
The study appears in the March issue of the Journal of clinical oncology and is first authored by Karl Smith Byrnes. The Study was a prospective study following 84,753 men with an average follow up of 15 years. These were men from Denmark, Germany, Spain, and the United Kingdom who provided information on vasectomy status at recruitment.
Findings showed that Vasectomy was NOT associated with prostate cancer risk overall and that there was NO evidence of association of vasectomy death due to prostate cancer.
It also demonstrated that vasectomy was associated with increased use of the PSA blood test, a test used for prostate cancer detection. This finding was offered as a possible explanation for other investigations which suggested a possible minor increase in prostate cancer incidence. In other words, if you look for cancer more aggressively in a population, you will find more.
This study also serves to confirm the findings of a 2016 JCO study by Eric Jacobs et al which was a retrospective review of data from 363,726 men in the (US) Cancer Prevention Study II (CPS-II) cohort examining the association of vasectomy and prostate cancer mortality. In addition, in the same study a subset of 66,542 men in the CPS-II Nutrition Cohort were examined for the association of vasectomy and prostate cancer incidence. Results showed that in the larger cohort, vasectomy was not associated with prostate cancer mortality and that in the subset cohort vasectomy was not associated with overall prostate cancer incidence. Again the conclusion of the study was that “results from these large prospective cohorts do not support associations of vasectomy with either prostate cancer incidence or prostate cancer mortality.”
In addition to these findings, most physicians acknowledge that there is no accepted biologic explanation for why there would be a cause effect of increased risk between the two. It is hoped that the findings of these studies will serve to decrease any related anxiety or misgivings on the part of men considering the procedure.
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