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  • Title: Does vasectomy accelerate testicular tumour? Importance of testicular examinations before and after vasectomy.
    Author: Cale AR, Farouk M, Prescott RJ, Wallace IW.
    Journal: BMJ; 1990 Feb 10; 300(6721):370. PubMed ID: 2106990.
    Abstract:
    An association between vasectomy and the development of testicular tumors, and the importance of testicular examinations both before and after a vasectomy is discussed. Patients diagnosed with testicular tumors within the last ten years were examined at Bangour General Hospital in Scotland. From 1977-87, 37 patients under age 60 were detected with testicular tumors. 3079 men underwent a vasectomy during this time. 8 were diagnosed with the tumors. Average time between the vasectomy and the diagnosis of the tumors was 1-9 years. The number of cases in men aged 20-59, and the age specific incidence were calculated from population on figures. Incidences of tumors, combined with the number of patient years of risk contained in the group who underwent a vasectomy, were used to ascertain the expected number of tumors in the 1-9 year group. Observed number was 8. As result, the ratio for patients with a vasectomy was 4.2 (95% confidence interval 1.8 to 8.2) with absolute annual incidence of testicular tumor in men who had had a vasectomy at 53/100000 men. Further suggested is that vasectomy accelerates the incidence of a palpable tumor from a carcinoma in situ, or possibly that tumors are often overlooked during a vasectomy. An examination before a vasectomy should detect palpable tumors, with carcinomas being detected by cytological examination of semen. Men should be screened by examination 12-18 months after a vasectomy. In light of the growing popularity of vasectomy as a more accepted means of contraception, how vasectomy affects the etiology of testicular malignancy is an important issue.
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