Does vasectomy accelerate testicular tumour? Importance of testicular examinations before and after vasectomy.

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.