Vasectomy: AUA Guideline

Sharlip, Ira D.; Belker, Arnold M.; Honig, Stanton C.; Labrecque, Michel; Marmar, Joel L.; Ross, Lawrence S.; Sandlow, Jay; Sokal, David C.

doi:10.1016/j.juro.2012.09.080

Cited by 195 publications

(274 citation statements)

References 44 publications

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“…Furthermore, concerns have been raised about bias, unmeasured confounding, and chance in relation to the small increased risk found by others 2554 Recently published meta-analyses of these studies found that vasectomy was not associated with risk of prostate cancer,6 7 and guidelines from the American Urological Association in 2012 recommended that clinicians do not need to routinely discuss prostate cancer during preoperative counselling of men considering vasectomy 55…”

Section: Discussionmentioning

confidence: 99%

Vasectomy and risk of prostate cancer: population based matched cohort study

Nayan

Hamilton

Macdonald

et al. 2016

BMJ

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Objective To determine the association between vasectomy and prostate cancer, adjusting for measures of health seeking behaviour.Design Population based matched cohort study.Setting Multiple validated healthcare databases in Ontario, Canada, 1994-2012.Participants 326 607 men aged 20 to 65 who had undergone vasectomy were identified through physician billing codes and matched 1:1 on age (within two years), year of cohort entry, comorbidity score, and geographical region to men who did not undergo a vasectomy.Main outcomes measures The primary outcome was incident prostate cancer. Secondary outcomes were prostate cancer related grade, stage, and mortality.Results 3462 incident cases of prostate cancer were identified after a median follow-up of 10.9 years: 1843 (53.2%) in the vasectomy group and 1619 (46.8%) in the non-vasectomy group. In unadjusted analysis, vasectomy was associated with a slightly increased risk of incident prostate cancer (hazard ratio 1.13, 95% confidence interval 1.05 to 1.20). After adjustment for measures of health seeking behaviour, however, no association remained (adjusted hazard ratio 1.02, 95% confidence interval 0.95 to 1.09). Moreover, no association was found between vasectomy and high grade prostate cancer (adjusted odds ratio 1.05, 95% confidence interval 0.67 to 1.66), advanced stage prostate cancer (adjusted odds ratio 1.04, 0.81 to 1.34), or mortality (adjusted hazard ratio 1.06, 0.60 to 1.85).Conclusion The findings do not support an independent association between vasectomy and prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Vasectomy and risk of prostate cancer: population based matched cohort study

Nayan

Hamilton

Macdonald

et al. 2016

BMJ

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“…In 2012, the American Urological Association (AUA) guidelines were amended to include 100,000 nonmotile sperm per mL in an uncentrifuged specimen as a measure of postvasectomy success. 7 These guidelines have reportedly improved patient compliance and have decreased repeat vasectomies, the number of semen analyses, and the time and use of alternate contraception while awaiting sterility results. 8 Despite equal access to health care in the military system, service members are frequently relocated and often deployed to austere combat environments, hampering follow-up.…”

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confidence: 99%

Impact of the 2012 American Urological Association Vasectomy Guidelines on Postvasectomy Outcomes in a Military Population

DeRosa

Lustik

Stackhouse

et al. 2015

Urology

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“…One meta-analysis reported an elevated risk of prostate cancer after vasectomy (RR 1.37, 95%CI 1.15-1.62), with a linear trend suggesting a 10% increase for each additional 10 years since vasectomy up to 30 years (RR 1.32, 95%CI 1.17-1.50) (17). Nevertheless, the results of two other meta-analyses showed no difference in the risk of prostate cancer between subjects with and without a history of vasectomy, regardless of the time since surgery (18,19). Our study demonstrated an inverse relation between vasectomy and prostate cancer (non-adjusted RR 0.26, 95%CI 0.06-1.04, p < 0.05).…”

Section: Discussionmentioning

confidence: 98%

The significance of biological, environmental, and social risk factors for prostate cancer in a cohort study in Brazil

Romero¹,

Romero²,

Almeida³

et al. 2012

Int. braz j urol.

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Purpose: To evaluate the signifi cance of several risk factors for prostate cancer in a cohort of Brazilian men. Subjects and methods: Men  40 years-old participating in a prostate cancer screening program between December 2006 and April 2011 in the city of Curitiba, Brazil, were evaluated to determine the prevalence, relative risk (RR) and 95% CI of prostate cancer according to age, race, ethnicity, family history of prostate cancer, educational level, and history of vasectomy, increased blood pressure, diabetes mellitus, and urethritis. Results: In 2121 men included in this study, prostate cancer prevalence was 0.6% for men between 40-49 years versus 2.0% (adjusted RR = 2.58), 7.7% (adjusted RR = 5.76), and 8.4% (adjusted RR = 4.88) for men 50-59 years, 60-69 years, and  70 years, respectively (p < 0.05 to all). The prevalence of cancer was 5.1% in blacks versus 3.3% in whites (adjusted RR = 1.56, p > 0.05); 6.1% in African descendants, in comparison to 3.0% in non-African descendants (adjusted RR = 3.17, p < 0.05); 5.1% in men with a positive family history, compared to 2.5% in those with no family history (adjusted RR = 1.55, p > 0.05); and 4.8% in participants with incomplete elementary school level or lower, compared to 2.2% in men with complete elementary school level or higher education (adjusted RR = 1.85, p > 0.05). Men with/without history of vasectomy, increased blood pressure, diabetes, and urethritis had a prostate cancer prevalence of 0.8%/3.0% (adjusted RR = 0.23, p > 0.05), 3.8%/2.2% (adjusted RR = 1.16, p > 0.05), 3.7%/2.6% (adjusted RR = 1.39, p > 0.05), and 2.6%/2.6% (adjusted RR = 0.99, p > 0.05), respectively. Conclusions: Risk factors associated with an increased prevalence of prostate cancer in this cohort included increasing age and African ethnicity.

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Vasectomy: AUA Guideline

Abstract: Vasectomy should be considered for permanent contraception much more frequently than is the current practice in the U.S. and many other nations. The full text of this guideline is available to the public at http://www.auanet.org/content/media/vasectomy.pdf.

Cited by 195 publications

References 44 publications

Vasectomy and risk of prostate cancer: population based matched cohort study

Vasectomy and risk of prostate cancer: population based matched cohort study

Impact of the 2012 American Urological Association Vasectomy Guidelines on Postvasectomy Outcomes in a Military Population

The significance of biological, environmental, and social risk factors for prostate cancer in a cohort study in Brazil

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