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Vasectomy: the nonreproductive effects.


 This paper discusses the incidence of adverse nonreproductive effects of vasectomy. The consequences of the operation can be considered under 3 headings: the immediate or short-term complications; sterility; long-term effects, especially the development of antibodies to sperm and changes in the hormonal status. The latter set of consequences is reviewed. Data show it is generally accepted that approximately 60% of men will have elevated sperm agglutination titers 6 to 12 months post vasectomy and that these will persist in most cases. About 30% of men, examined 1 year after vasectomy, will be found to have sperm immobilizing antibodies and the titer of these will have declined significantly 6 months later. The important question is whether the illness experience of vasectomized men will be different from that of healthy nonvasectomized males. Various studies show no evidence of excess endocrine or autoimmune disease, no meaningful increase in the rate of nonfatal myocardial infarction. Testicular volume remains unchanged in the early post vasectomy period and decreases slightly 3 years after. Investigations of the effect of ductus deferens occlusion on the accessory sex glands suggest that the seminal vesicles continue to function normally after vasectomy. The serum uric acid level appears to be unaffected up to a year after the operation. Psychological effects are equally reviewed and it is concluded that there are no physiological bases for any adverse psychological response to vasectomy. Finally, a recent study finds that the relative risk of cervical cancer in women is 4.29 times higher for women with unvasectomized partners. This may support previous suggestions that sperm proteins may have a role in the etiology of squamous cervical cancer.
