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Health Status of American Men--a study of post-vasectomy sequelae.

This paper summarizes the methodological approach and results of an historical cohort study of 10590 paris of men one group vasectomized and one not followed from the date of vasectomy to interview or death. This overview is conducted with the aim of identifying aspects of the design and conduct of the study which may require further comment or examination and potentially to identify areas in which the study could be extended or analyses of the existing data expanded. The matched control males were selected according to a carefully documented protocol so that vasectomized and nonvasectomized cohorts within cities were as similar as possible. 538 deaths occurred among the 21180 men in the study; 212 among vasectomized men and 326 among control matches. A consistent 20% rate of excess mortality was observed among the controls in all cities except for Minneapolis where there was an excess of 115%. Further age-adjusted mortality rates for both groups are somewhat lower than the 1970 rates for US males of the same ages. Study results for the period of follow-up ultimately do not support the suggestions of immunopathologic consequences of vasectomy. Except for epididymitis/orchitis the incidence of diseases is similar for vasectomized men and their paired controls or higher for the controls. This was true not only for individual diseases but also for broader categories of diseases and conditions in which a particular immunopathologic mechanism might conceivably operate. While these findings may hold for mortality and morbidity over the short to medium term one may not exclude on the basis of this study the potential that vasectomy is a risk factor for diseases which occur primarily in older men such as stroke and some cancers of which have an induction period longer than 8-10 years.