Long-Term Effects of Vasectomy
Trevor
Company
Long-Term Effects of Vasectomy
Long-term effects of vasectomy in humans include vasitis nodosa,
chronic testicular or epididymal pain, alterations in testicular
function, chronic epididymal obstruction, postulated systemic effects
of vasectomy, and possibly, an increased incidence of prostate cancer.
Although vasitis nodosa has been reported in up to 66% of vasectomy
specimens in men undergoing vasectomy reversal (Freund et al, 1989),
this entity does not appear to be associated with pain or significant
medical sequelae.
In humans, micropuncture studies have revealed that the markedly
increased pressures that occur on the testicular side of the vas as
well as the epididymis after vasectomy are not transmitted to the
seminiferous tubules (Johnson and Howards, 1975). Therefore, little
disruption of spermatogenesis is expected in humans. Biopsies up to 15
years after vasectomy show the testes to be essentially normal on light
microscopy. Electron microscopic studies, however, have revealed
thickening of the basal lamina and scattered areas of disrupted
spermatogenesis in portions of the biopsy specimens (Jarow et al,
1985). Chronic orchialgia or epididymal pain, or both, after vasectomy
occurs in approximately 1 in 2000 patients. In some cases, vasectomy
reversal might be considered or, alternatively, an open-ended vasectomy
may be used, as described previously. The brunt of pressure-induced
damage after vasectomy falls on the epididymis and efferent ductules.
These structures become markedly distended and then adapt to reabsorb
large volumes of testicular fluid and sperm products. When pain and
tenderness are localized in the epididymis, total epididymovasectomy,
including removal of the testicular vasal remnant, relieves pain in 95%
of men (Selikowitz and Schned, 1985)
and some more:
Complications of Vasectomy
Hematoma and Infection
Hematoma is the most common complication of vasectomy, with an average
incidence of 2% but a range of 0.09% to 29% (Kendrick et al, 1987).
Infection is surprisingly common, with an average rate of 3.4%, but
several series report rates from 12% to 38% (Appell and Evans, 1980;
Randall et al, 1983; Randall et al, 1985). The experience of the
vasectomist is the single most important factor relating to
complications (Kendrick et al, 1987). The hematoma rate was
significantly higher among physicians performing 1 to 10 vasectomies
(4.6%) than among those performing 11 to 50 vasectomies (2.4%) or
greater than 50 vasectomies per year (1.6%). A similar relationship was
seen for the hospitalization rate.
Sperm Granuloma
Sperm granulomas form when sperm leak from the testicular end of the
vas. Sperm are highly antigenic, and an intense inflammatory reaction
occurs when sperm escape outside the reproductive epithelium. Sperm
granuloma are rarely symptomatic. The presence or absence of a sperm
granuloma at the vasectomy site seems to be of importance in modulating
the local effects of chronic obstruction on the male reproductive
tract. The sperm granuloma's complex network of epithelialized channels
provides an additional absorptive surface that helps vent the high
intraluminal pressure in the obstructed excurrent ducts. Numerous
animal studies have correlated the presence or absence of sperm
granuloma at the vasectomy site with the degree of epididymal and
testicular damage. Species that always develop granulomas after
vasectomy have minimal damage to the seminiferous tubules. Some studies
of men undergoing vasectomy reversal have revealed somewhat higher
success rates in men who have a sperm granuloma at the vasectomy site
(Silber, 1977), whereas another large study has not (Belker et al,
1991).
Although sperm granulomas at the vasectomy site are present
microscopically in 10% to 30% of men undergoing reversal, it is likely
that, given enough time, virtually all men develop sperm granulomas at
the vasectomy site, the epididymis, or the rete testis.
When chronic postvasectomy pain is localized to the granuloma, excision
and occlusion of the vasa with intraluminal cautery usually relieve the
pain and prevent recurrence (Schmidt, 1979). On the other hand, men
with postvasectomy congestive epididymitis may be relieved of their
pain by open-ended vasectomy designed to purposefully produce a
pressure-relieving sperm granuloma.
and, 2) just for fun, on why you believe
> studies like those you mention have not been done (it seems there have
> been lots of studies on vasectomy's possible relation to other
> conditions).
======One phrase only: lack of financial support for such studies.
Mike Cronis
lower abdominal pain accompanied with mild testicular pain. According to
symptoms, I have something else?
Mike
"Trevor" <trev...@ntlworld.com> wrote in message
news:Rk7X7.51929$US4.9...@news2-win.server.ntlworld.com...
> Campbell's Urology, 7th ed., Copyright Š 1998 W. B. Saunders
Steve Law
Get to a doctor. Sounds like an infection and if so, should be treated
asap. Don't know of any reason why you should have burning sensation
during urination due to vasectomy. The other symptoms could be
vasectomy related independent of an infection.
First see what the doc says then give us an update.
Steve L
Jason G
Could also be gonorrhea or herpes. Esp. the groin/lymph pain sounds like
herpes.
--
Jason G
And I don't give a damn 'bout my bad reputation.
Never said I wanted to improve my station.
And I'm only doin' good
When I'm havin' fun
And I don't have to please no one.
--Joan Jett
David
related as Steve says.
Due to my daughter having certain problems I know rather more about female
urinary tract infections than I really wanted to. Men get urinary tract
infections too, and they cause a burning sensation as they do with ladies.
If it is an infection it's easily treated so getting yourself to a doctor is
the best thing you can do. It may be one of several things causing it, but
whatever the cause it needs medical attention.
Jason is correct that some of the symptoms are the same as those of certain
STD's but there is no suggestion that this is what may be the case.
Regarding the comment that the other symptoms may be vasectomy related -
I'll digress for a moment if that's OK.
In a previous incarnation I was a field based engineer, and the complaint
when I arrived at the house to fix the video (yes it WAS me in those corny
porn films with a video repair man) was "It worked fine until the last man
fixed it a year ago - must be something he did". When you get inside the
machine the breakdown is more often than not due to the owners kids posting
pennies/chocolate/teletubby dolls ect through the front and jamming the
machine as opposed to what the last engineer did - unless it was ALSO to
remove the kids last postings of course.
Same analogy for vasectomy. If you have a pain in the nether regions after
vasectomy, blaming the vasectomy without proper investigation is foolish.
Many of the symptoms associated with genuine pvp are identical to those
caused by other non-related conditions. EG congestive epididymitus - it's
caused by an STD (chlamydya) in many many cases, and other infections such
as brucellosis. It can also be caused by vasectomy, but although you may
have had a vasectomy the cause of congestive epididymitis in your case may
be cause by an infection, or other problems. Therefore when a doctor
investigates all other possibilities, he's not "covering up" anything, but
doing a proper investigation of all possible causes.
So in short, as the guys say get youreslf to a doctor to get it sorted.
Happy new year to all
David
trifold
comments: The text from which it is taken was published in 1998.
Since then the American Urological Association has discontinued its
earlier recommendation that vasec tomised men should be screened for
prostate cancer more regularly than non-vasectomised men. It changed
its recommendation due to more research that established there is no
increased risk due to vasectomy. Another point I would make is that
the piece you have posted suggests vasectomy does not substantially
alter testicular structure, even 15 years after vasectomy. Also, that
changes that do occur result only in "scattered areas of disruption of
spermatogenisis." This, I suggest, is an outcome that should not
concern men who got vasectomies in order to be sterile. Finally, the
piece does make clear that 1) pvp due to epi backpressure is extremely
rare (1 in 2000); and 2) that it can be treated through epi removal in
95% of cases.
"Trevor" <trev...@ntlworld.com> wrote in message news:<Rk7X7.51929$US4.9...@news2-win.server.ntlworld.com>...