Vasectomy--a note of concern: reprise.

The title of my comments derives from Harold Lear's editorial, published inThe Journalalmost a decade ago. 1 Since Lear wrote, additional signs of concern have appeared, including the article in this issue by Walker and his colleagues (p 2315). In a carefully controlled study, Walker et al report causes for hospitalization of vasectomized men, compared with hospitalization for the same ailments in men who had not undergone vasectomy. Disorders of the genitourinary system constituted the only category in which hospitalization incidences were significantly greater in the vasectomized men than in the control population. However, the disorders included epididymitis and orchitis (well known though infrequent postvasectomy complications) and benign prostatic hypertrophy, redundant prepuce, phimosis, and other diseases of the male genitals. The authors wisely observe that the latter four conditions probably had been discovered when clients applied for vasectomy and that these conditions were not attributable to the operation