The risk of myocardial infarction 10 or more years after vasectomy in men under 55 years of age

To evaluate whether vasectomy is associated with a subsequent increase in the incidence of myocardial infarction 10 or more years after surgery and whether an effect is more pronounced in those already predisposed to a myocardial infarction, a hospital-based case-control study was carried out in men aged less than 55 years. The men were interviewed during 1980-1983 in 78 hospitals in Massachusetts, Rhode Island, Connecticut, and New York. Among 2,238 men with first episodes of myocardial infarction, 332 (15%) had undergone vasectomy, compared with 572 (16%) of 3,361 controls. Vasectomy greater than or equal to 10 years earlier was reported by 150 cases and 180 controls, to yield a multivariate relative risk estimate of 1.0 after allowance for potential confounding factors (95% confidence interval (Cl) = 0.8-1.3); for vasectomy greater than or equal to 15 years before, based on 34 cases and 33 controls, the estimate was 1.1 (95% Cl = 0.7-2.0). In men predisposed to myocardial infarction because of more advanced age, cigarette smoking, elevated cholesterol level, hypertension, angina pectoris, or other risk factors, vasectomy did not appear to increase the risk further, even after intervals of greater than or equal to 10 years. The results provide evidence against an increased risk of myocardial infarction greater than or equal to 10 years after vasectomy overall and in those known to be predisposed because of other risk factors.

Effect of vasectomy on high density lipoproteins

Primate research has associated vasectomy with accelerated rates of atherogenesis. We have evaluated the effect of vasectomy on serum lipoprotein profiles in healthy men. There was a decrease in high density lipoprotein levels, which was greatest in men with a family history of atherosclerotic disease. With the great number of variables known to affect high density lipoprotein levels further studies are needed to determine if this change can be attributed to the vasectomy.

A review of 357 bilateral vasectomies for male sterilization

A series of 357 bilateral vasectomies for male sterilization performed over a period of 18 months was reviewed to assess the safety of the surgical procedure, the onset of sterility, and the acceptability of the procedure. The surgical procedure proved to be safe with few complications, the patients became sterile after approximately 82 days, and the acceptability was very good. A group of 34 patients (10.8%) had a delay in the onset of aspermia. This is discussed in relation to the findings of other investigators.

Effect of vasectomy on the steroid profile of human seminal plasma

The effect of vasectomy on the steroid profile of seminal plasma was studied in 19 healthy men at 4-monthly intervals during a 2-year post-vasectomy period. The steroids analyzed by radioimmunoassays were: androstenedione (A), testosterone (T), dihydrotestosterone (DHT), oestradiol (E2) and the sulphoconjugated forms of pregnenolone (delta 5P-S), dehydroepiandrosterone (DHEA-S), testosterone (T-S), dihydrotestosterone (DHT-S), oestrone (E1-S) and oestradiol (E2-S). The quantitatively most important steroids present in the seminal plasma were DHEA-S, delta 5P-S and DHT-S. Vasectomy resulted in a significant but non-progressive reduction in DHT (40%) and T (23%) levels. The levels of E2, delta 5P-S and DHT-S also exhibited a smaller reduction following vasectomy. No significant changes were observed in the levels of the other steroids studied. The results are interpreted as suggesting that under normal conditions the bulk of the steroids present in the ejaculate is contributed by the accessory reproductive organs. In addition, a significant part of the DHT and T reach the ejaculate together with the sperm directly from the testis and/or epididymis. It is suggested that the normal steroid levels in seminal plasma established in this investigation could serve as reference values in the hormonal evaluation of male infertility.

Vasectomy and psychosexual damage

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