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Daniel W. Cramer, MD, ScD
Brigham and Women's Hospital Boston, Mass

JAMA. 1993;270(6):707.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Concern about recent studies linking vasectomy and prostate cancer has been tempered by the absence of any clear biologic rationale for the association. In dismissing as unlikely a role for hormonal mechanisms, Giovannucci et al¹ have overlooked evidence that may be linked to prostate cancer by disrupting gametogenesis and increasing gonadotropins. This mechanism is similar to that proposed for ovarian cancer,² which may share other epidemiologic features with prostate cancer. Experimental studies show that ligation of the vas causes Sertoli cell damage and Leydig cell hypertrophy. Seventy years ago, Steinach³ recognized this effect in men and proposed vasoligation to rejuvenate aging men after observing that it produced "a cycle of growth... of the male generative gland" by causing "the expansion of the interstitial tissue at the expense of the generative tissue." Sertoli cell damage may decrease inhibins with a consequent increase in follicle-stimulating hormone. . . . [Full Text PDF of this Article]

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