Vasectomy and Long-Term Health

A vasectomy is a medical procedure that prevents males from having children. Men who have had a vasectomy will continue to ejaculate semen, but it won’t contain sperm.

Some scrotal pain and swelling can occur after having a vasectomy. These side effects usually subside within a week. Over-the-counter pain relievers such as ibuprofen can help reduce discomfort.

Risk of Heart Disease

The long-term health consequences of vasectomy have been studied in a number of epidemiologic studies.

However, the results of these studies have been difficult to interpret. This is mainly because most of the studies have short periods of follow-up and because of selection bias, which may hide an increase in heart disease risk among men who undergo vasectomy.

Several possible explanations for the unfavorable outcomes have been suggested, but no convincing biological mechanism has been found.

In a large cohort study, Men under 40 years old who had a vasectomy had a lower risk of death from cardiovascular disease than men who did not have a vasectomy, but the effect disappeared after 15 years. In contrast, deaths from cancer were not reduced by vasectomy.

A meta-analysis of 30 epidemiologic studies examining cardiovascular disease and vasectomy concluded that men who had vasectomy had a slightly lower risk of developing coronary heart disease than men who did not have vasectomies, but the reduction was not statistically significant.

The studies had a wide range of limitations, including small sample sizes and uncontrolled potential confounders such as cigarette smoking, alcohol consumption, and educational level.

Another problem is the risk of long-term complications associated with vasectomy, such as chronic scrotal pain.

This condition occurs in about 2% of patients. In addition, long-term vasectomy can lead to recanalization of the vas deferens, an abnormality in which the vas deferens grow back and reconnect with the testicles.

Although the risk of recanalization is low, discussing this possibility with your doctor before vasectomy is important. Other possible complications include urinary tract infections and epididymitis, which are relatively common.

Before the procedure, you should avoid taking aspirin or other NSAIDs such as ibuprofen (brand names: Advil, Motrin, Nuprin) and naproxen (brand name Aleve), as these medications can thin your blood and increase bleeding during surgery.

Instead, you should take acetaminophen (brand name: Tylenol). After the surgery, you should avoid alcoholic beverages and vigorous activity. You should also not smoke a cigarette for at least two weeks.

The scrotal wound can be sore for a week or more after the procedure, and you may experience a loss of sensation in the scrotum.

Risk of Cancer

A vasectomy is a surgical procedure in which the man’s vas deferens are severed. The cut ends are folded back and tied off to prevent the release of sperm from the testicles through the urethra and out of the penis.

The procedure is almost 100% effective in preventing pregnancy and leaves sexual functions fully intact. However, the surgery has been linked to an increased risk of prostate cancer, the most common form of male malignancy.

This concern has led some men to seek alternative forms of birth control.

The vast majority of long-term side effects from having a vasectomy are minor. There is some risk that the testicles or penis could be permanently damaged, although this is very rare.

The scrotum may swell or appear bruised for some time following the procedure, but this usually resolves on its own. In very rare cases, an injury to the blood supply during surgery could lead to the loss of a testicle or part of the penis, but this is extremely unlikely if the surgeon is skilled.

Some front-page articles have claimed that vasectomy increases the risk of prostate cancer, but this is unfounded. A Journal of the National Cancer Institute study looked at data from over 500,000 Danish men who had a vasectomy between 1937 and 1996.

After adjusting for other variables, the researchers found that men who had a vasectomy had about a 15% increased risk of prostate cancer compared to men who did not have a vasectomy.

Other studies have analyzed data from several other populations. The investigators searched PubMed and Medline for studies that reported a relationship between vasectomy and prostate cancer.

The authors of the studies were asked to provide information about their methodology, including a list of the first author’s last name, year of publication, data source, study period, demographic characteristics for the study population, number of cases and participants, length of follow-up, and effect estimates with 95% confidence intervals.

It is important to note that a small fraction of men who have had vasectomies will experience recanalization.

This happens when the reversal of the vasectomy fails, and sperm is able to pass from the testicles again. Recanalization occurs in less than 1 percent of men who have had vasectomies, and it is usually not necessary to return to the doctor for another operation.

Risk of Diabetes

Having a vasectomy is an option for men who do not wish to have more children, especially if they are at an age where it would be difficult for them to conceive again.

It can help to reduce anxiety about unintentionally getting a partner pregnant, and some people report improvements in their sex life as a result. The procedure is not foolproof, though; some people become fertile again.

Vasectomy cannot be reversed, so a person who becomes fertile again should use another method of birth control.

Some bruising and swelling of the scrotum are expected after vasectomy, but it should resolve quickly. Over-the-counter pain relievers, such as ibuprofen, can help with discomfort. Supportive underwear that lifts the testicles can also be helpful.

A person can shower as usual after vasectomy but should change the sterile dressing if it gets dirty or soiled.

A man may develop epididymitis or orchitis after vasectomy, which is a painful inflammation of the testicles. A man should see his doctor if the pain becomes persistent and interferes with daily activities.

If a person has diabetes, a vasectomy can increase the risk of diabetes complications. This is because inflammation of the testicles can lead to increased insulin resistance and blood sugar levels. A person who has a vasectomy should talk to his doctor about managing diabetes symptoms and making lifestyle changes.

Several studies have looked at the relationship between vasectomy and metabolic disorders.

One study compared 23,908 men who had undergone vasectomy to 13,155 age- and race-matched non-vasectomized men. It found that the relative risk of death from heart disease decreased over the years since vasectomy but that the rate did not return to that of non-vasectomized men.

Another study examined physiologic data from 4385 vasectomized and 13155 age-matched non-vasectomized men.

The results showed that men who had a vasectomy had lower diastolic blood pressure and less severe high cholesterol and triglyceride levels than those who did not have a vasectomy.

Other physiologic measures, including total and white blood cell count, creatine, blood urea nitrogen, glucose, lipids, sodium, potassium, and calcium, were not related to the vasectomy.

Risk of Infection

Vasectomy is an effective, permanent male birth control procedure that blocks the flow of sperm from the testicles to the penis. It is a relatively safe procedure and is widely used.

In the surgery, 2 tubes called the vas deferens are cut and sealed so that sperm can’t reach the urethra or out of the body. The testicles still make sperm, but the body reabsorbs most of them, and they don’t get into semen.

Vasectomy is very effective at preventing pregnancy and is 99.9% effective at preventing sex. The only other medical procedure that is more effective at preventing pregnancy is female sterilization (tubal ligation).

Men with vasectomies should continue using condoms to protect themselves from sexually transmitted infections such as chlamydia and HIV/AIDS. If a man decides that he wants children in the future, it may be possible to reverse a vasectomy by re-joining the tube that was cut, but this is not guaranteed and can be expensive.

A very small number of men develop a painful condition in the scrotum, known as epididymitis, after a vasectomy.

This is caused by the build-up of sperm in a structure inside the scrotum called sperm granuloma. Most granulomas are asymptomatic and can be diagnosed by ultrasound. If a symptom is present, treatment is with warm compresses and pain medication.

The risk of complications from a vasectomy is very low, especially if the surgeon uses a no-needle, no-scalpel method. Some men experience temporary pain or swelling of the scrotum after the procedure, but these symptoms typically disappear within a few days.

Before having the operation, it is important to avoid taking aspirin or other drugs that thin the blood, such as ibuprofen (brand names: Advil, Motrin) and naproxen (brand name Aleve), for one week. Acetaminophen (brand name Tylenol) can be taken instead.

A complication that is more likely to occur in older men who have had a vasectomy is recanalization. This is a rare long-term complication that occurs when the tubes that were cut form a new pathway through which sperm can travel. This can lead to pregnancy.