Akanksha Mehta, MD, on pre-operative counseling for vasectomy

In the following video, Akanksha Mehta, MD, MS, outlines key points about pre-vasectomy counseling that are forefront in the American Urological Association’s 2026 Vasectomy Guideline.^1,2 Mehta is a professor of urology at Emory School of Medicine in Atlanta, Georgia.

Mehta began by emphasizing the importance of tailoring preoperative counseling to the individual patient. While vasectomy has traditionally been pursued by men who have completed their families, clinicians are increasingly encountering younger men, single individuals, and those who have not yet begun family building but are certain they do not want children. Others may be motivated by genetic or medical concerns. As a result, counseling must shift to focus more directly on the patient’s own reproductive goals and autonomy, rather than external factors such as partner preferences or social expectations. Mehta stressed that these conversations should include a clear understanding of the permanence of vasectomy and its implications for the patient’s future.

A second key component of counseling involves addressing common concerns about potential associations between vasectomy and long-term health conditions, including prostate cancer, testosterone deficiency, sexual dysfunction, cardiovascular disease, and kidney stones. According to Mehta, the guideline committee conducted a comprehensive review of the available literature, carefully evaluating study quality and distinguishing between correlation and causation. Although some large studies have suggested possible associations, these findings are often influenced by selection and surveillance biases, such as increased health care engagement among men who undergo vasectomy.

Ultimately, Mehta underscored that the evidence does not support a causal relationship between vasectomy and these comorbid conditions. Patients should be reassured that undergoing vasectomy does not increase their risk of developing conditions such as prostate cancer, cardiovascular disease, or kidney stones. While individuals may still develop these conditions over time based on their underlying risk factors, vasectomy itself is not a contributing cause. This clarity, she noted, is essential for both clinicians and patients to support informed, confident decision-making.

REFERENCES

1. Schlegel PN, Clark JY, Coward , RM, et al. Vasectomy: AUA Guideline Part I. J Urol. 0(0). doi:10.1097/JU.0000000000004861. https://www.auajournals.org/doi/10.1097/JU.0000000000004861

2. Schlegel PN, Clark JY, Coward , RM, et al. Fertility Restoration After Vasectomy: AUA Guideline Part II. J Urol. 0(0). doi:10.1097/JU.0000000000004862. https://www.auajournals.org/doi/10.1097/JU.0000000000004862