A survey of personal habits, symptoms of illness, and histories of disease in man with and without vasectomies.

Abstract

Using questionnaire information provided by 4,385 vasectomized and 13,155 matched, non-vasectomized men, we found no significant differences between them for a large number of symptoms and diseases, including those of the cardiovascular system. After taking into account differences in their marital status, past smoking habits, and physical activity at work, significant statistical associations of vasectomy with joint pain or swelling, back trouble, and a history of kidney or bladder infection persisted. Our data are inconsistent with the occurrence of large increases in the risks of many important diseases in vasectomized humans. (Am J Public Health 1982; 72:476-480.) Reports that vasectomized monkeys have more severe atherosclerosis than non-vasectomized monkeys has caused concern about the possibility that vasectomy may have unanticipated health effects in humans' 2. We investigated this possibility using computer-stored information from health questionnaires completed during the period from 1977 through 1980 by members of a large Northern California prepaid medical care program who had multiphasic health check-ups. Materials and MethodsMedical Care Program taking multiphasic health check-ups in Oakland or in San Francisco has been computer stored. The information provided on these questionnaires about vasectomies, personal habits, symptoms of illness, and the histories of certain diseases constitute the basic data for this study.In the period from 1977 through 1980, 4,392 male examinees indicated on the health questionnaires that they had had vasectomies. We matched each vasectomized man with three men who did not indicate on the questionnaires that they had had vasectomies. The matching variables were age, race, and date of the health check-up. For 98 per cent of the vasectomized men, we found three "exact" matches (birth year was plus or minus one year, date of check-up was plus or minus one month, and race was same). To find matches for the remaining two per cent of vasectomized men, we relaxed the matching criteria by stages. For seven vasectomized men, three matches could not be found. These men were excluded, leaving 4,385 vasectomized and 13,155 matched, non-vasectomized men for the analyses.We used x2 tests for independent samples to assess statistical significance. As a measure of strength of association, we present here the ratio of the prevalence rates of the symptoms and illnesses in men with and without vasectomies. We used the test-based method to calculated 95 per cent confidence intervals for the rate ratios. We used stratification to handle confounding.

Effects of vasectomy on the epididymis

“…Vasectomized monkeys were reported to have a greater than normal incidence of atherosclerosis (Clarkson and Alexander, 19801, possibly due to immunologic changes. However, epidemiologic studies have not revealed an increased incidence of atherosclerosis or other serious diseases in men (Lepow and Crozier, 1979;Massey et al, 1984;Petitti et al, 1982;Walker et al, 1981), and a subsequent study in monkeys showed no effect of vasectomy on atherosclerosis (Clarkson et al, 1988). Neverthe-less, vasectomy-induced elevations in antisperm antibodies may affect the reproductive organs and/or fertility after vasovasostomy.…”

Early testicular changes after vasectomy and vasovasostomy in Lewis rats

“…Such widespread application has stimulated interest in the effects of the operation and in its potential reversibility. Studies in animals raised concern about possible systemic vascular effects of the antisperm antibodies that are induced by vasectomy (Bigazzi et al, 1976;Anderson et al, 1983;Alexander and Clarkson, 1978;Clarkson and Alexander, 19801, but these reports were balanced by controlled epidemiological studies which found no increased incidence of serious diseases in vasectomized men (Goldacre et al, 1979;Walker et al, 1981;Petitti et al, 1982;Massey et al, 1984). In addition, a more recent study in monkeys showed no effect of vasectomy on development of atherosclerosis (Clarkson et al, 1988).…”

Vasectomy and cardiovascular disease risk

“…Table 1 displays the basic characteristics of the 12 included studies. Moreover, 2 were cross-sectional, [ 19 , 25 ] 4 were case–control, [ 17 , 18 , 21 , 26 ] and 6 were retrospective cohort studies. [ 20 , 22 – 24 , 27 , 28 ] The publication years of the included studies ranged from 1981 to 2005.…”

“…[ 17 , 18 ] Furthermore, 6 studies were performed among the middle-aged and elderly populations, [ 17 – 24 , 26 – 28 ] but one study did not report this. [ 25 ] The follow-up length was from 1 to 36 years. In the included clinical trials, the sample sizes varied between 413 and 184,253 participants.…”

“…In addition, 9 studies were considered to have high methodological quality, [ 17 , 18 , 20 , 22 – 24 , 26 – 28 ] and 3 studies [ 19 , 21 , 25 ] were regarded to be of poor quality in accordance with the NOS. The main deficiency was selection bias related to insufficient adjustment of core factors among the included studies.…”