Does vasectomy increase the risk of torsion of the testicle

Question by a patient: Does Vasectomy increase the risk of torsion of the testicle?

Image of testicular torsion

Dr Kittels response to the patient asking about increasing risk of testicular torsion after vasectomy.

Thank you for your feedback and your interesting question about testicular rotation, which has not been asked before, so I thought it is worth dropping you a line. I can see the logic of your argument. But while there was one study possibly confirming increased rotational mobility of the testicle after vasectomy there has been so far no evidence to show increased torsion.

Torsion means that the arterial blood supply stops and the testicle gets “ischaemic” i.e. under-supplied with Oxygen.

It is even more interesting and complex than that as I sometimes see patients with extremely tortuous vas deferens in vasectomy, who must have twisted their testicles multiple times without any ill effect.

Equally some patients with previous torsion attending my vasectomy clinic have completely straigth and smooth vas deferens.

So, the answer is, despite of 12,000 vasectomies, I cannot answer your question. The body is a conundrum and for the time being and according to my current knowledge we are no closer to the understanding of what causes a torsion of the testicle.

Dr M Kittel, February 2023