Delayed thrombophlebitis and systemic complications after vasectomy: possible role of diabetogenic hyperinsulinism.

Abstract

Abstract:The development of unexplained thrombophlebitis and puzzling systemic disorders within one to several years after elective vasectomy is reported. The systemic features included prolonged fever, generalized lymph node enlargement, various skin eruptions, arthropathy, recurrent infections, glomerulonephritis, interstitial pulmonary fibrosis, neuropsychiatric features, increased BSP retention, an elevated level of circulating globulins, and a biologic false‐positive serologic reaction. The frequency of concomitant severe reactive hypoglycemia due to diabetogenic hyperinsulinism in these patients also was noteworthy. The possible pathogenetic mechanisms are discussed, including induced hormonal imbalances, autosensitization to testicular nucleoproteins, and altered blood coagulation in the hyperinsulinized‐diabetic state.These observations challenge the presumed innocuousness of elective vasectomy. The challenge assumes even greater significance in view of the current wholesale performance of vasectomy in an affluent society that is increasingly stigmatized by the hyperinsulinized‐diabetic state. If catastrophic iatrogenic damage is to be averted, it appears mandatory to ascertain the true incidence of delayed systemic complications in the large numbers of vasectomized American men who have chosen this procedure for the purpose of family limitation.