Rose,

I don't know whether there is a correlation between vasectomy
and prostate cancer.  Even if there is, there is no way of knowing
whether it was a factor in your husband's case.

Sometimes bad things happen to us.  Sometimes it seems like
we do the right things and bad things still happen.  I never had
a vasectomy.  I always ate lots of vegetables, and other foods
like green tea that are supposed to prevent cancer.  I always
exercised a lot.  I had no cancer in my family.  Yet I got cancer.

sh.t happens.  You don't need a vasectomy to have it happen to
you.  He may very well have gotten cancer without having a
vasectomy.  I certainly did, and so did the vast majority of men
who have had it.

Your husband is feeling sorry for himself.  Who wouldn't
when he's had cancer, had to go through this nasty treatment
and had these nasty after effects.

I felt sorry for myself too.  All of us did.  But now is the time
for the two of you to pull together.  However bad he feels, he'll
feel worse if he allows himself to turn against the most important
person in his life.  However bad you feel, you'll feel worse if you
turn against him.

I strongly urge your husband to forget his recriminations.  They
are pointless and self-destructive.  I strongly urge you to forget
them too.  They are coming from your husband's depression over
the hard things that have happened to him.  I urge both of you to
offer each other love and support, and I promise that everything
you give to each other will come back to you as well.

Marital counseling may help you to make this happen.

Best of luck to both of you.

   Alan

here's an article on the subject.  hope this helps ~ curtis

Vasectomy & Prostate Cancer

           Many studies have looked for possible
long-term health problems associated with vasectomy. Almost without
fail, concerns that have arisen in one study have been disproved in
others. The one question that has remained throughout many years is
whether prostate cancer risk increases after vasectomy. In the space
below, I'll give you the representative data, and let you see why nobody
is sure. If there is an increased risk, it is very small.
           Until 1993, there were about an equal
number of studies that claimed vasectomy was not associated with
increase risk for prostate cancer as said it was. At least one study
even found it protective against prostate cancer. Then, two large
studies by the same principal author were published in the February 1993
issue of the Journal of the American Medical Association (JAMA).
          The first was a 'prospective' study, meaning
that the data was collected as the study was done, with this specific
question in mind. Approximately 10,000 men who had had vasectomies, and
about 38,000 who did not (but appeared to have the same characteristics
in every other regard), were sent questionnaires every six months. These
questionnaires collected data on any significant change in health over
the preceding six months. Over the four-year course of the study,
approximately 300 new prostate cancers were detected. The men who had
had vasectomy were just over 1.5 times as likely as those that did not
have vasectomy to develop prostate cancer.
          The second study was 'retrospective',
meaning the study pulled data from medical charts that already existed
(these are generally considered slightly less reliable than prospective
studies). This study had approximately 15,000 men who had had vasectomy
compared with 15,000 men that had not. The results were virtually the
same as in the first study. If these large studies are accurate, it
means the risk of developing prostate cancer after vasectomy goes from 7
per 1000 men per year to 11 per 1000 men per year, or just over a 60%
increase. But there are reasons to question numbers even from these
large studies, which I'll go into later.
          Other researchers have turned the question
around - If a man already has prostate cancer, what are the odds he has
had a vasectomy sometime before? The reasoning is that if there were an
association between the two, certainly more people with prostate cancer
would have had a vasectomy than those in the general population.
          One such study was published in June of
1999, and overall demonstrated no difference. Sixteen percent of men
with prostate cancer had had a vasectomy, while fifteen percent who were
healthy had had a vasectomy. In this study, though, men who had prostate
cancer under the age of 55 were almost twice as likely to have had a
vasectomy. Another such study was published in October of 1999. Enrolled
were 753 men with prostate cancer and 703 who were healthy. The odds of
having had a vasectomy were almost identical - 39% of the prostate
cancer group compared with 37% of the healthy control group.
Interestingly, the tumours in the group with vasectomy tended to be less
aggressive. The difference between the two studies in the percent of men
having vasectomy at all is a quirk of the Unites States - it has been
previously demonstrated that men in the East (the first study) are much
less likely to get a vasectomy than men in the West (the second study)!
          Why don't people accept these numbers at
face value? Because every study has biases, or unseen influences that
are hard to account for. What if the men who had vasectomies on average
had more unprotected sex with more partners (not everyone, but just a
few of them!)? Theories have been put forward that prostate cancer may
have a link with previous venereal disease. That would mean it wasn't
the vasectomy that caused the problem, but rather what the man did with
it. We have no data on this.
          What if some of the men who had vasectomies
said to their doctors, "While you are down there can you check something
else for me - I haven't been urinating as well as I used to"? These men
would be more likely to have an earlier pick-up of a prostate cancer.
Already, in separate studies, it has been demonstrated that men who have
vasectomies are more health conscious than others, so would on average
have more routine health checks, and so have more chance of picking up
an early prostate cancer. These factors are called detection biases, in
this case potentially making it look like vasectomy was associated with
prostate cancer, when in fact it was not.
          Finally, there is one factor that cannot be
overlooked. There is a small but measurable increase in serum
testosterone after a vasectomy. Testosterone is known as a promoter of
already established prostate cancers. This may be the missing link as to
why there is seen to be a small increase in prostate cancer after
vasectomy in some studies. But again there is missing information. Would
men who have not had a vasectomy have developed the same tumours but at
a later date? Are the tumours that arise in vasectomized men
qualitatively different, e.g. less aggressive as suggested in one study,
than those in men without a vasectomy are? We do not have answers to
these questions yet.
          So, the final answer is not in. The worst
case scenario is a very weak link. You have to decide if that
uncertainty is acceptable to you. Remember though, even if this reported
weak link is accurate, vasectomy still has the lowest risk of causing
illness or death compared with the birth control pill, tubal ligation,
or having another baby. Women have accepted those risks for a long time!
 

knowledge is power - growing old is mandatory - growing wise is optional

Rose

In 1972 at the age of 32 I had a vasectomy. Not long after, I read a study
that said all men who had had a vasectomy was at greater risk of a heart
attack. Seeing that the operation was past history and I have a philosophy
of "Don't worry about things I can't control", I put the study out of my
mind and forgot about it until I read your post today.

I had RRP in December 2000.

Between 1972 and 2000 (and now) I have had no heart problems, so at least
for me, that blew the heart attack report out of the water. Apart from a
cardiac arrest while having the op (hypersensitivity to the aneasthetic) I
had no problems. I had the op on Tuesday, took 2 days off work and on
Saturday played in an all-day lawn bowls competition. For me, the physical
and emotional effects of the vasectomy were minimal. However, I know many
who reacted in a similar way to your husband.

From 1972 until the RRP I had never had a problem with ED. Erections were
strong, lasted at least as long as they needed to, and appeared as and when
required. Therefore, I'm happy to declare that in this regard, the vasectomy
had no effect -- again with the proviso that this relate only to me.

After the RRP with no nerve sparing total and complete ED. I was expecting
it but it still came as a bit of a shock. I went to an impotence clinic for
a consultation. When I told the doc my history, plus being a diabetic, plus
having high blood pressure and being on medication for it, plus being 61
when I saw him, he just smiled and suggested that any solution was wishful
thinking.

When I commented that I'd had absolutely no problem prior to the RRP he just
smiled condescendingly and gave the impression he thought I was deluding
myself. Anyway, he gave me an injection of the magic potion and told me to
wait for 20 minutes. On his return he asked how things were. I replied that
things were pretty good, and again he replied with a dismissive smile and
said "don't tell me, show me." I did. His eyes opened wider and he just
commented "I'm impressed!"

I've related this in detail because in my case, I think this gives some
evidence that the vasectomy had no effect on ED. What it does for others I
couldn't say.

Unfortunately the injections were too successful. They were not painful or
unpleasant but I seemed to be hypersensitive to the ingredients. No matter
how diluted thay made the prescription, I always ended with an erection that
lasted for at least 4 hours and was very, very painful. So my wife and I
just found alternative ways of maintaining that aspect of our relationship.

Rose,
I also had a Vasectomy 25 years ago and I ask my URO the same
question.  He said from the studies they have not been able to make
the connection.  I think like Alan said, sh.t happens.
My Robitic RP was 12/15/2003 and I have been optimestic looking for
the erection to return but am also being a realist to not expect it
until atleast 8 months out if not further.  I am looking forward to
the celebration for when it does, and I am sure my wife is too.  But
until then, just wrap your arms around each other and consider it many
months of renewing your courtship or foreplay.  It can be nice
focusing on each other instead of satisfying "Mr. Long John".  And
this is coming from a 48 year old that could still be considered in my
prime.

Bill
PSA 1.4
Gleason 6 (3+3)
T2a
age 48

Rose,

Four months is still early days for return of erections.  I don't know
if the Vasectomy increased the risk of prostate cancer,  but it seems
higly unlikely that it had any effect on post surgical impotence.   Your
husband is clearly having a hard time adusting to his situation.  Your
best strategy is to be as supportive as possible. trying not to take it
personally.

Note also that even if the risk of prostate cancer is increased by
vasectomy, it is not by a large amount.  Biostatisticians don't get too
excited by a 50 percent increase, particularly if there could be
confounders, i.e. other factors explaining both the increased risk of pc
and the decision to have a vasectomy in the first place.

 If he insists on making you feel guilty and miserable, I say trade him in!
LOL.... As for ED probs... it's only a few months for him. Give the nerves
and system a chance to heal up and reconnect. I'm sexually active and at 18
months post RP, and still feel like it's improving.

Rose,

I'm sorry you are having these thoughts.  I suggest you discuss them with
him.  At the very least, he can tell you whether he honestly believes the
Big V caused his PCa and, more importantly, if he believes you are
responsible for his PCa.  I suspect it is more in your mind than in his.

As to vasectomy-caused PCa, I'm sure in every bit of research you saw not
one 'finding' that it causes PCa.  There are so many things that might cause
or could cause or maybe is associated with PCa and yet nothing has been
shown to actually cause it or be associated with it except that 100% of the
patients are male and if your father had it at an early age (mid-40s) you
have a slightly increased chance of getting it.

As to vasectomy and ED, that's just so much nonsense.  You need to study
anatomy.  All they do is cut the vas to stop the microscopic sperm from
getting to the rest of the glands and organs.  The prostate is literally the
second last stop for sperm and by then it is surrounded by so much fluid it
is hardly noticed by the prostate.  That's why when we get a prostatectomy,
our 'ejaculant' is bone-dry, or very nearly so.

Sorry you have to be here. My husband's vasectomy saved his life. He had one
Oct '02 at age 42 and ended up with an infection. The doc decided to do a
psa which was elevated. Three more psas and one biopsy later my hubby had an
RRP June '03 at 43. He has had no incontinence or ED. His 45 year old
brother was diagnosed and had an RRP Aug '03 and is still having ED,
although he need a nerve graft due to loss of one of the nerve bundles. He
never had a vasectomy.

There is no blame in prostate cancer. It's the luck of the draw. Trust me. I
never thought I'd be faced with these issues at only 35 with two small kids
in tow. I hope life improves for both of you. Don't look back, just live for
now.