Science.gov

Sample records for vasectomy

  1. Vasectomy

    MedlinePlus

    ... on the left. ​ Common Name Vasectomy Medical or Scientific Name Vasectomy Last Reviewed: 06/03/2013 NICHD News and Spotlights June Wrap-Up: Promoting Men’s Health New Research on Male Contraceptive Methods Men’s Health is the Focus in June All ...

  2. [Vasectomy].

    PubMed

    Iversen, H G

    1994-04-18

    The first vasectomy operation was carried out 100 years ago in patients with prostate hyperplasia with symptoms. Then it became extensively used for hereditary hygiene purposes/eugenics, especially after the passing of the sterilization law in Denmark in 1935. In Nazi Germany, vasectomies and castrations were also used for forced sterilization of undesired races. Vasectomy has become a popular method of fertility control, especially in the US. In Denmark it is also popular, and since the 1973 sterilization law, approximately 100,000 procedures have been performed with a 95% rate of satisfaction. Vasectomy seems not to be as harmless as previously thought. The blockage of the transport route from the testes does not stop spermatogenesis. Spermatozoa are a certain kind of foreign matter which are first produced in puberty and act as antigens vis-a-vis other organisms. Certain immune complexes are formed that can have implication for a number of autoimmune diseases. Later in life vasectomy can be a potentiating factor in arteriosclerosis according to rhesus monkey experiments. Men with hypertension, hyperlipidemia, or heavy smokers should not undergo vasectomy. On the other hand, a 1990 epidemiological study showed no increased risk of cardiovascular diseases in vasectomized men. Yet the immune complexes could have other, more serious biological consequences. In large cohort studies the connection to testicular cancer has not been proven with certainty, but there may be an increased risk of prostate cancer among the vasectomized. The American Urological Association (AUA) has recently recommended that men over 40 who had been vasectomized should undergo examination and tests for prostate-specific antigen every year for early detection of cancer. There has been no indication of an increased mortality from prostate cancer among vasectomized men in the above epidemiological studies, but the AUA advises counseling patients about the possible connection. PMID:8009696

  3. Vasectomy reversal.

    PubMed

    Young, M R; Logan, C J

    1989-10-01

    A small personal series of vasovasostomies and a review of the literature on this subject are presented. The importance is stressed of good counselling before vasectomy is undertaken in the first place. PMID:2603266

  4. Vasectomy - series (image)

    MedlinePlus

    Vasectomy is the surgical division of the vas deferens. Vasectomy prevents sperm from being released into semen during ejaculation, thus preventing pregnancy. Vasectomy may be recommended for adult men who are ...

  5. Vasectomy reversal.

    PubMed

    Belker, A M

    1987-02-01

    A vasovasostomy may be performed on an outpatient basis with local anesthesia, but also may be performed on an outpatient basis with epidural or general anesthesia. Local anesthesia is preferred by most of my patients, the majority of whom choose this technique. With proper preoperative and intraoperative sedation, patients sleep lightly through most of the procedure. Because of the length of time often required for bilateral microsurgical vasoepididymostomy, epidural or general anesthesia and overnight hospitalization are usually necessary. Factors influencing the preoperative choice for vasovasostomy or vasoepididymostomy in patients undergoing vasectomy reversal are considered. The preoperative planned choice of vasovasostomy or vasoepididymostomy for patients having vasectomy reversal described herein does not have the support of all urologists who regularly perform these procedures. My present approach has evolved as the data reported in Tables 1 and 2 have become available, but it may change as new information is evaluated. However, it offers a logical method for planning choices of anesthesia and inpatient or outpatient status for patients undergoing vasectomy reversal procedures. PMID:3811050

  6. Vasectomy and vasectomy reversal: An update

    PubMed Central

    Ramasamy, Ranjith; Schlegel, Peter N.

    2011-01-01

    Vasectomy is an elective surgical sterilization procedure for men that is intended to obstruct or remove a portion of both vas deferens, thereby preventing sperm from moving from the testes to the ejaculatory ducts. Although intended for permanent sterilization, vasectomy can be reversed in most men seeking to restore their fertility due to a change in marital status or reproductive goals. The purpose of this document is to provided a synopsis of the latest techniques used in vasectomy and reversal. PMID:21716894

  7. Making vasectomy attractive.

    PubMed

    Herndon, N

    1992-08-01

    In 1989, Pro-Pater, a private, nonprofit family planning organization in Brazil, used attractive ads with the message Vasectomy, An Act of Love to promote vasectomy. The number of vasectomies performed/day at Pro-Pater clinics increased from 11 to 20 during the publicity campaign and fell after the ads stopped but continued at higher levels. Word of mouth communication among friends, neighbors, and relatives who had vasectomies maintained these high levels. This type of communication reduced the fear that often involves vasectomies because men hear from men they know and trust that vasectomies are harmless and do not deprive them of potency. In Sao Paulo, the percentage of men familiar with vasectomies and how they are performed increased after the campaign, but in Salvador, knowledge did not increase even though the number of vasectomies in Pro-Pater clinics increased. Organizations in Colombia and Guatemala have also been effective in educating men about vasectomies. These successes were especially relevant in Latin American where machismo has been an obstacle of family planning programs. The no-scalpel technique 1st introduced in China in 1974 reduces the fear of vasectomy and has fewer complications than the conventional technique. Further trained physicians can perform the no-scalpel technique in about 10 minutes compared with 15 minutes for the conventional technique. In 1987 during a 1-day festival in Thailand, physicians averaged 57 no-scalpel vasectomies/day compared with only 33 for conventional vasectomies. This technique has not spread to Guatemala, Brazil, Colombia, the US, and some countries in Asia and Africa. Extensive research does not indicate that vasectomy has an increased risk of testicular cancer, prostate cancer, and myocardial infarction. Physicians are working on ways to improve vasectomy. PMID:12317726

  8. Attitudes to vasectomy.

    PubMed

    Howard, G

    1981-08-01

    4 surveys were conducted in the United Kingdom in an attempt to determine the personal and social factors influencing the decision to have a vasectomy. The surveys differed from other vasectomy studies in that they represented couples requesting a vasectomy and not only those who obtained a vasectomy. They include, therefore, individuals who were refused and those who changed their minds, as well as those individuals on whom the operation was performed. The surveys showed that by 1978 the majority of requests came from couples who had 2 children or less (70%), who came from social class 3 (64%), and where the wife was under age 35. There was a relative absence of high-parity couples, of the least skilled, and of those of African or Asian origin. The husbands viewed vasectomy as a final act of male contraceptive responsibility. The reasons for choosing vasectomy were to prevent further pregnancies and to protect the wife from the health risks of the oral contraceptive or the IUD and from the dangers of childbearing or the fear of pregnancy. The findings of the first 3 surveys were similar. All surveys suggested that men of low parity preferred vasectomy and that men of high parity and those of African or Asian origin were often reluctant to undergo a vasectomy. All the marriages described as successful remained so after vasectomy. Minor degrees of impotence, frigidity or lack of libido appeared to improve. 11% of the couples withdrew from the operation following the counseling session. The 476 couples requesting vasectomy in the first 3 surveys produced a wide range of anxieties over health, life problems, sexual enjoyment, contraception, children, marriage, and the change of life. There appeared to be marked differences between couples who undergo vasectomy and those choosing tubal ligation. PMID:12310974

  9. Attracting men to vasectomy.

    PubMed

    Finger, W R

    1998-01-01

    There is far less information available for men about vasectomy than there is available for women about comparable contraceptive services. Also, men do not have medical check-ups on a regular basis, and therefore have less contact with medical practitioners during which vasectomy could otherwise be discussed. Vasectomy needs to be promoted in order for men to learn about and accept it as their contraceptive method of choice. To that end, Marie Stopes International (MSI) launches a vasectomy promotion campaign annually which includes advertising in local newspapers and upon billboards at football stadiums. The campaigns use light-hearted and bold ideas, with some shock value. This approach helps to relax men who otherwise tend to be wary of both the surgical procedure and subsequent consequences of vasectomy. Prevailing social norms should, however, guide the content of promotional campaigns. The UK is one of only a few countries in the world where about the same proportions of men and women use sterilization; 16% of men and 15% of women have been sterilized. A MSI campaign in the UK which began during fall 1997 prompted an increase in the number of inquiries about vasectomy at the Marie Stopes Vasectomy Clinic. Promotional campaigns in developing countries have also been successful. It is also important that campaigns be put in the larger context of promoting all contraceptive methods. PMID:12293534

  10. Vasectomy - series (image)

    MedlinePlus

    ... vas deferens are thin muscular tubes that carry sperm from each testicle to the urethra. ... surgical division of the vas deferens. Vasectomy prevents sperm from being released into semen during ejaculation, thus ...

  11. Immediate Sterility after Vasectomy

    PubMed Central

    Hay, D. Urquhart

    1973-01-01

    A 2·5-ml injection of 1/1,000 solution of euflavine given down each vas during vasectomy for sterilization will destroy all sperms within the semen and eliminate the necessity for examining two consecutive specimens of semen for azoospermia after the operation. No local inflammatory response has been observed in the seminal vesicles or prostate of 81 consecutive patients in whom the method has been used. PMID:4730187

  12. Noninvasive laser vasectomy

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher Michael

    Development of a noninvasive vasectomy technique may eliminate male fear of complications (incision, bleeding, infection, and scrotal pain) and result in a more popular procedure. These studies build off previous studies that report the ability to thermally target tissue substructures with near infrared laser radiation while maintaining a healthy superficial layer of tissue through active surface cooling. Initial studies showed the ability to increase the working depth compared to that of common dermatological procedures and the translation into an ex vivo canine model targeting the vas deferens in a noninvasive laser vasectomy. Laser and cooling parameter optimization was required to determine the best possible wavelength for a safe transition to an in vivo canine model. Optical clearing agents were investigated as a mechanism to decrease tissue scattering during in vivo procedures to increase optical penetration depth and reduce the overall power required. Optical and thermal computer models were developed to determine the efficacy for a successful transition into a human model. Common clinical imaging modalities (ultrasound, high frequency ultrasound, and optical coherence tomography) were tested as possible candidates for real-time imaging feedback to determine surgical success. Finally, a noninvasive laser vasectomy prototype clamp incorporating laser, cooling, and control in a single package was designed and tested in vivo. Occlusion of the canine vas deferens able to withstand physiological burst pressures measured postoperative was shown during acute and chronic studies. This procedure is ready for azoospermia and recanalization studies in a clinical setting.

  13. The evolution of vasectomy reversal.

    PubMed

    Dickey, Ryan M; Pastuszak, Alexander W; Hakky, Tariq S; Chandrashekar, Aravind; Ramasamy, Ranjith; Lipshultz, Larry I

    2015-06-01

    In the USA, about 500,000 vasectomies are performed each year, with up to 6% of men requesting reversal. The technique of vasectomy reversal has evolved from macrosurgical to the implementation of both microscopic and robotic technologies. The very earliest attempts at vasectomy reversal, the vasoepididymostomy and vasovasostomy, have remained central in the treatment of male infertility and will continue to be so for years to come. As seen throughout its history, urological microsurgery has consistently implemented advanced techniques and state-of-the art technology in its craft, and its continued refinement will allow for even more favorable outcomes in the lives of patients seeking restoration of fertility following vasectomy. Here, we review the evolution of vasectomy reversal and its current techniques. PMID:25980804

  14. Pulmonary Embolism Following Outpatient Vasectomy

    PubMed Central

    Mott, Frank E.; Farooqi, Bilal; Moore, Harry

    2016-01-01

    Venous thromboembolic events have several known major risk factors such as prolonged immobilization or major surgery. Pulmonary embolism has rarely been reported after an outpatient vasectomy was completed. We present the rare case of a healthy 32-year-old Caucasian male with no known risk factors who presented with pleuritic chest pain 26 days after his outpatient vasectomy was performed. Subsequently, he was found to have a pulmonary embolism as per radiological imaging. We explore the association between outpatient vasectomies and venous thromboembolic events. A review of the literature is also included. PMID:26989373

  15. Pulmonary Embolism Following Outpatient Vasectomy.

    PubMed

    Mott, Frank E; Farooqi, Bilal; Moore, Harry

    2016-02-01

    Venous thromboembolic events have several known major risk factors such as prolonged immobilization or major surgery. Pulmonary embolism has rarely been reported after an outpatient vasectomy was completed. We present the rare case of a healthy 32-year-old Caucasian male with no known risk factors who presented with pleuritic chest pain 26 days after his outpatient vasectomy was performed. Subsequently, he was found to have a pulmonary embolism as per radiological imaging. We explore the association between outpatient vasectomies and venous thromboembolic events. A review of the literature is also included. PMID:26989373

  16. Vasectomy reversal: a clinical update.

    PubMed

    Patel, Abhishek P; Smith, Ryan P

    2016-01-01

    Vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery. PMID:26975488

  17. Vasectomy reversal: a clinical update

    PubMed Central

    Patel, Abhishek P; Smith, Ryan P

    2016-01-01

    Vasectomy is a safe and effective method of contraception used by 42–60 million men worldwide. Approximately 3%–6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery. PMID:26975488

  18. Experiences of Vasectomy: A Phenomenological Study

    PubMed Central

    Hosseini, Habibollah; Abdi, Fatemeh

    2012-01-01

    Background: Irregular growth of population is considered as a serious threat to the international community. It is a major obstacle for socioeconomic development. One of the methods to control the population is by providing effective methods of contraception. Vasectomy, as a simple and effective contraceptive method, has been approved by the World Health Organization (WHO). It is very important to involve men in the control of population and the promotion of reproductive health. Aims: This study was conducted with the aim of describing the experiences of the men who underwent vasectomy. Materials and Methods: This qualitative study was performed by using a phenomenological research design. The sample consisted of 14 vasectomized men selected through purposive sampling method. In-depth and open interviews with participants were conducted to collect the data. Results: The results were transcribed and recorded in comprehensive field notes. Colaizzi's method was used to analyze the data. Four themes emerged from the obtained results of the present study, which described the structure of the experiences of men as follows: Opinions about vasectomy, own perceptions about vasectomy, experiences with the procedure, and recommendation of vasectomy to others. Conclusion: Vasectomy can influence achievement of family planning goals and participation of men in this regard. The results of this study can help the planners and health-care providers for appropriate interventions, and training and counseling programmers to increase the acceptability and uptake of vasectomy in the society. PMID:23272302

  19. Semen characteristics after vasectomy in the ram.

    PubMed

    Janett, F; Hüssy, D; Lischer, C; Hässig, M; Thun, R

    2001-08-01

    The objective of this study was to monitor the changes in semen characteristics in vasectomized rams and to determine if infertility was present 14 days after vasectomy. Experiments were performed using five cross-breed rams, aged between 18 and 30 months. Semen was collected weekly by artificial vagina from 2 months before to 5 months after vasectomy. After sexual rest for 10 days, vasectomy was performed by the cranial midscrotal approach. In all ejaculates the volume, concentration, total sperm number, motility and morphology (normal spermatozoa, loose heads) were determined and sperm viability (SYBR-14/PI) was evaluated in all semen samples collected after vasectomy. In the first ejaculate obtained 14 days post vasectomy all rams showed a significant (P < 0.05) drop in mean volume (from 1.2 to 0.5 mL), total sperm count (from 5176.8 to 51.1 x 10(6)) and morphologically normal sperm (from 84.1 to 15.7%), when compared to the last prevasectomy collection. We could also demonstrate a positive correlation (r = 0.89) between the individual cumulative total number of spermatozoa after vasectomy and the scrotal circumference measured before vasectomy. Sperm motility and viability could never be demonstrated after vasectomy and normal spermatozoa continuously decreased concomitant with an increase in loose heads. On post mortem examination 5 months after surgery, spermatocele formation and multiple sperm granulomas were present in all five rams. Our results show that in the first ejaculate collected by artificial vagina 14 days after vasectomy, no motile and viable spermatozoa could be detected. Despite weekly collections during a 5-month period after sterilization, azoospermia could never be achieved. PMID:11516127

  20. The need for epididymovasostomy at vasectomy reversal plateaus in older vasectomies: a study of 1229 cases.

    PubMed

    Mui, P; Perkins, A; Burrows, P J; Marks, S F; Turek, P J

    2014-01-01

    Vasectomy reversal involves either vasovasostomy (VV) or epididymovasostomy (EV), and rates of epididymal obstruction and EV increase with time after vasectomy. However, as older vasectomies may not require EV for successful reversal, we hypothesized that sperm production falls after vasectomy and can protect the system from epididymal blowout. Our objective was to define how the need for EV at reversal changes with time after vasectomy through a retrospective review of consecutive reversals performed by three surgeons over a 10-year period. Vasovasotomy was performed with Silber score 1-3 vasal fluid. EVs were performed with Silber score 4 (sperm fragments; creamy fluid) or 5 (sperm absence) fluid. Reversal procedure type was correlated with vasectomy and patient age. Post-operative patency rates, total spermatozoa and motile sperm counts in younger (<15 years) and older (>15 years) vasectomies were assessed. Simple descriptive statistics determined outcome relevance. Among 1229 patients, 406 had either unilateral (n = 252) or bilateral EV's (n = 154) constituting 33% (406/1229) of reversals. Mean patient age was 41.4±7 years (range 22-72). Median vasectomy interval was 10 years (range 1-38). Overall sperm patency rate after reversal was 84%. The rate of unilateral (EV/VV) or bilateral EV increased linearly in vasectomy intervals of 1-22 years at 3% per year, but plateaued at 72% in vasectomy intervals of 24-38 years. Sperm counts were maintained with increasing time after vasectomy, but motile sperm counts decreased significantly (p < 0.001). Pregnancy, secondary azoospermia, varicocoele and sperm granuloma were not assessed. In conclusion, and contrary to conventional thinking, the need for EV at reversal increases with time after vasectomy, but this relationship is not linear. EV rates plateau 22 years after vasectomy, suggesting that protective mechanisms ameliorate epididymal 'blowout'. Upon reversal, sperm output is maintained with time after

  1. Vasectomy

    MedlinePlus

    ... Pa: Saunders Elsevier; 2011:chap 37. Read More Birth control and family planning Scrotum Testes Update Date 3/26/2014 Updated by: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, Albert Einstein College of Medicine, New York, NY. Review provided ...

  2. Vasectomy

    MedlinePlus

    ... back together again. If this happens, sperm can mix with semen. This would make it possible for ... have sexual intercourse as soon as you feel ready, most often about a week after the surgery. ...

  3. Vasectomy

    MedlinePlus Videos and Cool Tools

    ... in a man by preventing the transport of sperm out of the testes. A small incision is ... deferens is tied off and cut apart preventing sperm from being released within the ejaculate. The small ...

  4. Computer simulation of vasectomy for wolf control

    USGS Publications Warehouse

    Haight, R.G.; Mech, L.D.

    1997-01-01

    Recovering gray wolf (Canis lupus) populations in the Lake Superior region of the United States are prompting state management agencies to consider strategies to control population growth. In addition to wolf removal, vasectomy has been proposed. To predict the population effects of different sterilization and removal strategies, we developed a simulation model of wolf dynamics using simple rules for demography and dispersal. Simulations suggested that the effects of vasectomy and removal in a disjunct population depend largely on the degree of annual immigration. With low immigration, periodic sterilization reduced pup production and resulted in lower rates of territory recolonization. Consequently, average pack size, number of packs, and population size were significantly less than those for an untreated population. Periodically removing a proportion of the population produced roughly the same trends as did sterilization; however, more than twice as many wolves had to be removed than sterilized. With high immigration, periodic sterilization reduced pup production but not territory recolonization and produced only moderate reductions in population size relative to an untreated population. Similar reductions in population size were obtained by periodically removing large numbers of wolves. Our analysis does not address the possible effects of vasectomy on larger wolf populations, but it suggests that the subject should be considered through modeling or field testing.

  5. The psychological effects of vasectomy for American men

    ERIC Educational Resources Information Center

    Bloom, Larry J.; Houston, B. Kent

    1976-01-01

    Reviewed evidence concerning the psychological effects of vasectomy for American men. Surveys of postoperative sexual behavior and satisfaction and/or happiness were cited, as were data from studies employing clinical interviews and/or psychological tests. (Author/SB)

  6. Vasectomy: potential links to an increased risk of aggressive prostate cancer?

    PubMed

    Gaines, Alexis R; Vidal, Adriana C; Freedland, Stephen J

    2015-01-01

    Several studies have found associations between aggressive prostate cancer (PC) and having a vasectomy. However, findings from two very recent meta-analyses have found that this is not the case. Therefore, the data are mixed. Herein, we detail the controversy between vasectomy and PC risk, particularly aggressive PC, by shedding some light on the molecular pathways, potential risk factors and suggested links for those considering vasectomy and medical professionals who perform it. We conclude by supporting the American Urological Association's position that there is no need to discuss potential prostate cancer risks with patients considering vasectomy given reasonably strong data finding no link between vasectomy and prostate cancer risk. PMID:26402245

  7. Post-Vasectomy Depression: A Case Report and Literature Review

    PubMed Central

    Shaik, Subahani

    2014-01-01

    Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure – a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient’s current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined. PMID:25553234

  8. Post-vasectomy depression: a case report and literature review.

    PubMed

    Shaik, Subahani; Rajkumar, Ravi Philip

    2014-09-01

    Vasectomy is a commonly performed and relatively safe procedure, with low reported rates of psychological morbidity, though there is some variability across studies. Depression following a vasectomy is relatively infrequent. A married man aged 30 developed a chronic depressive episode, lasting four years and resistant to an adequate trial of fluoxetine, following a vasectomy. His depression was heralded by a post-operative panic attack, and was accompanied by medically unexplained symptoms and the attribution of all his symptoms to the procedure - a belief that was shared by his family. Psychological complications of vasectomy have generally been studied under four heads: sexual dysfunction, effects on marital relationships, chronic post-operative pain, and other complications including anxiety and depression. These complications have generally been reported at higher rates in developing countries, and are linked to poor knowledge about the procedure and inadequate pre-operative counseling. The implications of the existing literature for the patient's current complaints, and the mechanisms and risk factors involved, are discussed in the light of existing research. Suggestions for the prevention and treatment of post-vasectomy depression are also outlined. PMID:25553234

  9. Validation of robot-assisted vasectomy reversal.

    PubMed

    Kavoussi, Parviz K

    2015-01-01

    Vasectomy reversal (VR) has traditionally been performed with the operative microscope. Recently, robot assistance has been applied to VR. Retrospective chart review from a single VR center included men who underwent either robot-assisted VR (RAVR) or microsurgical VR (MVR) by a single fellowship trained microsurgeon between 2011 and 2013 and had a 6 weeks postoperative semen analysis. Fifty-two men who were interested in VR were counseled and given the option of RAVR versus MVR. Twenty-seven men elected to have MVR while 25 men elected RAVR. These included vasovasostomies and vasoepididymostomies in both groups, as well as redo VRs in men who had failed previous VR attempts by other surgeons. There was no statistically significant difference between the microsurgical group and the robot-assisted group, respectively, in overall patency rates (89% vs 92%), 6 weeks post-VR mean sperm concentrations (28 million ml-1 vs 26 million ml-1 ) or total motile counts (29 million vs 30 million), or mean operative times (141 min vs 150 min). There was a statistically significant difference in anastomosis time (64 min vs 74 min), however, clinically this only represented a 10 min longer anastomosis time in the early robotic experience, which was found to be decreasing as the case series continued. Transitioning from MVR to RAVR is feasible with comparable outcomes. PMID:25475663

  10. Trends in vasectomy. Analysis of one teaching practice.

    PubMed Central

    Reynolds, J. L.

    1998-01-01

    PROBLEM BEING ADDRESSED: How can a teaching practice develop a referral service and incorporate educational opportunities for family medicine residents, clinical clerks, and community family physicians? OBJECTIVE OF PROGRAM: To develop a high-quality vasectomy service within a teaching practice to change the surgical procedure to the no-scalpel vasectomy (NSV) technique; to educate family medicine residents, clinical clerks, and community family physicians about vasectomy and the NSV technique; and to monitor outcomes and compare them with published results. MAIN COMPONENTS OF PROGRAM: The program took place in an urban family medicine residency program. Data on number of procedures, types of patients choosing vasectomy, and outcomes are presented, along with information on number of learners who viewed, assisted with, or became competent to perform NSV. CONCLUSIONS: A few family medicine residents and some interested community physicians could be trained to perform NSV competently. Involving learners in the procedure does not seem to change the rate of complications. Images Figure 1 PMID:9559195

  11. Immunologic effects of vasectomy in men and experimental animals.

    PubMed

    Bigazzi, P

    1981-01-01

    Vasectomy is a widely accepted surgical procedure for male sterilization, with the unique characteristic of eliciting immune responses to self-antigens. Persistent humoral autoimmune responses to spermatozoa and transient responses to other antigens have been demonstrated in vasectomized men. Little information is available on delayed hypersensitivity reactions to spermatozoa, as well as histopathology and immunohistopathology of the testes and other organs in vasectomized individuals. Overall, the data obtained in men do not point to any immediate cause for concern and seem to justify the optimistic view that vasectomy is a safe procedure. A review of the studies performed in experimental animals similarly shows that vasectomy is followed by humoral and/or cell-mediated immune responses to spermatozoal antigens. In some species, such as rabbits and guinea pigs, it is also followed by testicular lesions, mediated by in situ immune complexes and/or delayed hypersensitivity reactions. Other sequelae may be glomerulonephritis and an increased severity of atherosclerotic lesions. Therefore, the rather encouraging picture emerging from the human studies is to a certain extent offset by the findings in experimental animals. Additional research on the effects of vasectomy is obviously necessary, as well as caution in advising this procedure to individuals who may be genetically predisposed to autoimmune disease. PMID:7031702

  12. Prooxidant-antioxidant balance and malondialdehyde over time in adult rats after tubal sterilization and vasectomy

    PubMed Central

    Faramarzi, Azita; Seifi, Behjat; Shabanzadeh, Alireza; Ebrahimpoor, Mitra

    2012-01-01

    Objective Sterilization (tubal sterilization and vasectomy) is a widely applied contraceptive method worldwide. Although most studies have described sterilization as a safe method, there are reports of tubal ligation (TL) and vasectomy complications. The aim of this study was to evaluate the effects of TL and vasectomy on the serum oxidative stress, specifically prooxidant-antioxidant balance (PAB) and malondialdehyde (MDA) levels, over time. Methods Male and female rats were classified into vasectomy, sham-vasectomy, TL, and sham-TL groups, respectively. The PAB and MDA levels were measured on days 15 and 45 and months 3 and 6 after the intervention. For female rats, blood sampling was performed during the diestrous phase and estradiol and progesterone were also measured. Results Serum PAB and MDA increased after TL (p<0.05). Vasectomy increased serum MDA remarkably after 45 days, 3 months, and 6 months (p<0.05). After vasectomy, serum PAB also increased although not significantly. Serum estradiol and progesterone decreased remarkably in the TL group compared to the sham group (p<0.05). Conclusion Bilateral TL and vasectomy both increase the serum oxidative stress; however the imbalance after TL was very noticeable. As for the TL, the reduction of serum estrogen levels can be involved in this imbalance. Complications followed by TL or vasectomy could be due to increased levels of oxidants. Thus, prescribing antioxidants during and or after surgery may be a solution. PMID:22816074

  13. Pre-operative risk factors associated with need for vasoepididymostomy at the time of vasectomy reversal.

    PubMed

    Fuchs, M E; Anderson, R E; Ostrowski, K A; Brant, W O; Fuchs, E F

    2016-01-01

    The absence of sperm in the ejaculate after vasectomy reversal is commonly caused by failure to recognize and subsequently bypass epididymal or proximal vasal obstruction at the time of vasectomy reversal. If intra-operative proximal obstruction is suspected, vasoepididymostomy (VE) is recommended rather than vasovasostomy (VV). We sought to calculate the associated risk of needing VE, rather than VV with time from original vasectomy (obstructive interval) using a large cohort of vasectomy reversal patients. We reviewed the electronic and paper vasectomy reversal database by a single surgeon from 1978 through 2012. We performed univariate analysis to identify variables that predicted the need for VE rather than VV, and then combined only significant univariates into our multi-variable analysis. 2697 total men underwent vasectomy reversal, and 239 were repeat procedures. Of the 5296 individual testes operated on, 1029 were VE. Significant variables that predicted the need for VE on univariate analysis included: age, obstructive time interval, vasectomy reversal after previous VV (repeat vasectomy reversal), and year the procedure was performed. On multi-variable analysis significant risk factors for VE were age above 50 (OR 1.36), repeat vasectomy reversal (OR 5.78), and greater obstructive time interval (OR 1.56). For every 3 years since original vasectomy, the risk of needing VE increases by 56%. There is a linear relationship between obstructive interval and need for VE. Men undergoing repeat vasectomy reversal have five times greater risk of requiring VE and men greater than 50 years of age are also at higher risk. Using these pre-operative predictors is helpful in identifying patients who will benefit from referral to an experienced surgeon who can perform VE. PMID:26663812

  14. Role of no scalpel vasectomy in male sterilization.

    PubMed

    Bhuyan, K; Ali, Ilias; Barua, S J

    2012-08-01

    No Scalpel Vasectomy (NSV) is a modern method of delivery, ligation and excision of vas deference without use of a knife. It provides a permanent sterilization option for male. It is a safe, effective method of vasectomy with low complication and greater patient compliance. To evaluate effectiveness and its acceptance of the procedure data were collected on men who accepted NSV between Jan'2008 to Mar'09. Demographic information, motivating factors, educational status and surgical complications were recorded. The cases were done in rural hospitals & Primary health centers as camp procedure. A total of 649 vasectomies performed using NSV method from Jan'08 to Mar'09. The mean age of the acceptors was 35 years with 4 numbers of children on average. Complications included bleeding during surgery in 4 cases (0.6%), haematoma in one case (0.2%), and superficial wound infection occurred in two cases (0.3%) and scrotal pain in 4 cases (0.6%). NSV is an effective, minimal access method of vas delivery, ligation and excision. It provides safe and effective contraceptive option to male population with minimal complications. Doctors, health workers along with the simplicity of procedure and early return to work are great motivating factors. It is easily performed as camp procedure in a simple medical setup. Doctors can be effectively trained hands on during the camp procedure. PMID:23904714

  15. Prospective comparison of ligation and bipolar cautery technique in non-scalpel vasectomy

    PubMed Central

    Altok, Muammer; Şahin, Ali Feyzullah; Divrik, Rauf Taner; Yildirim, Ümit; Zorlu, Ferruh

    2015-01-01

    ABSTRACT Objectives: There is no trial comparing bipolar cautery and ligation for occlusion of vas in non-scalpel vasectomy. This study aimed to compare the effectiveness of these vasectomy occlusion techniques. Materials and Methods: Between January 2002-June 2009, patients were allocated in alternate order. We recruited 100 cases in cautery group and 100 cases in ligation group. Non-scalpel approach was performed during vasectomy and fascial interposition was performed in all cases. First semen analysis was done 3 months after vasectomy. Vasectomy success was defined as azoospermia or non-motile sperm lower than 100.000/mL. Results: Four patients from the cautery group were switched to the ligation group due to technical problem of cautery device. Thus, data of 96 patients as cautery group and 104 patients as ligation group were evaluated. After vasectomy, semen analyses were obtained from 59 of 96 (61.5%) patients in cautery group and to 66 of 104 (63.5%) patients in ligation group. There was no statistical significant difference between the two groups in terms of the success of vasectomy (p=0.863). Conclusion: Although bipolar cautery technique is safe, effective and feasible in non-scalpel vasectomy, it has no superiority to ligation. There was no statistically significant difference in terms of the success and complications between the two groups. PMID:26742977

  16. Vasectomy and prostate cancer risk: a historical synopsis of undulating false causality.

    PubMed

    Nutt, Max; Reed, Zachary; Köhler, Tobias S

    2016-01-01

    The potential influence of vasectomy being a risk factor for the development of prostate cancer is not a new concept, with more than 30 publications addressing the topic. Given the global frequency of vasectomy and the prevalence of prostate cancer, this subject justifiably deserves scrutiny. Several articles have claimed that vasectomy puts men at risk for future development of prostate cancer. We explore articles that have shown the contrary (no link), explore the studies' strengths and weaknesses, describe possible prostate cancer pathophysiologic mechanisms, and apply Bradford Hill criteria to help discern correlation with causation. The risk and interest of association of prostate cancer with vasectomy has waxed and waned over the last three decades. Based on our review, vasectomy remains a safe form of sterilization and does not increase prostate cancer risk. PMID:27486569

  17. Vasectomy and prostate cancer risk: a historical synopsis of undulating false causality

    PubMed Central

    Nutt, Max; Reed, Zachary; Köhler, Tobias S

    2016-01-01

    The potential influence of vasectomy being a risk factor for the development of prostate cancer is not a new concept, with more than 30 publications addressing the topic. Given the global frequency of vasectomy and the prevalence of prostate cancer, this subject justifiably deserves scrutiny. Several articles have claimed that vasectomy puts men at risk for future development of prostate cancer. We explore articles that have shown the contrary (no link), explore the studies’ strengths and weaknesses, describe possible prostate cancer pathophysiologic mechanisms, and apply Bradford Hill criteria to help discern correlation with causation. The risk and interest of association of prostate cancer with vasectomy has waxed and waned over the last three decades. Based on our review, vasectomy remains a safe form of sterilization and does not increase prostate cancer risk. PMID:27486569

  18. An overview of the management of post-vasectomy pain syndrome.

    PubMed

    Tan, Wei Phin; Levine, Laurence A

    2016-01-01

    Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well-recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of post-vasectomy pain syndrome is not clearly delineated. Postulations include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, nerve impingement, or perineural fibrosis. Post-vasectomy pain syndrome is defined as at least 3 months of chronic or intermittent scrotal content pain. This article reviews the current understanding of post-vasectomy pain syndrome, theories behind its pathophysiology, evaluation pathways, and treatment options. PMID:26952956

  19. An overview of the management of post-vasectomy pain syndrome

    PubMed Central

    Tan, Wei Phin; Levine, Laurence A

    2016-01-01

    Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well-recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of post-vasectomy pain syndrome is not clearly delineated. Postulations include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, nerve impingement, or perineural fibrosis. Post-vasectomy pain syndrome is defined as at least 3 months of chronic or intermittent scrotal content pain. This article reviews the current understanding of post-vasectomy pain syndrome, theories behind its pathophysiology, evaluation pathways, and treatment options. PMID:26952956

  20. Thousands of men in four Latin countries choose to have vasectomies; machismo is no barrier.

    PubMed

    1975-12-01

    The acceptability of vasectomy in 4 Latin American countries is repo rted. The unenthusiastic reception of vasectomy in Latin America is apparently due to a paucity of male sterilization programs and not to machismo. The 1st vasectomy program in Latin America was established in Bogota, Colombia, in 1970. This was followed by programs in Costa Rica (1971), El Salvador (1972), and Guatemala (1973). Upon expansion of the Colombian program from 1 city to 9 cities, the number of voluntary vasectomies increased from 100 to 560. 235 vasectomies were performed in the 1st 6 months of the Costa Rican program, and 278 were performed in the 1st 9 months of the Guatemalan program. During the 1st 2 years of the program in El Salvador, the monthly average of operations performed rose from 3 to 19. In El Salvador at least, vasectomy was acceptable to men aged 22-69 years, with 2-20 living children, and from all types of occupations. PMID:12277254

  1. Vasectomy and prostate cancer risk: a meta-analysis of cohort studies.

    PubMed

    Shang, Yonggang; Han, Guangwei; Li, Jia; Zhao, Jiang; Cui, Dong; Liu, Chengcheng; Yi, Shanhong

    2015-01-01

    Some studies have suggested that vasectomy is associated with the increased risk of prostate cancer, however, this conclusion is not supported by all the published studies. In order to examine the relationship between vasectomy and prostate cancer risk, we conducted a meta-analysis of cohort studies to clarify this controversial association. PubMed and Medline were used to identify the cohort studies that reported the association of vasectomy with prostate cancer risk from 1980 to January 2015. Based on a random effects model, the RR and 95% CI were used to assess the combined risk. In total, 10 cohort studies involving more than 7027 cases and 429914 participants were included. There was no significant relationship between vasectomy and prostate cancer risk, the pooled RR (95%CI) was 1.11[0.98, 1.27] (P = 0.109). In subgroup-analysis, the relationship between vasectomy and prostate cancer risk was not significantly modified by the length of follow-up and population distribution except Americans. Omission of any single study had little effect on the pooled risk estimate. Little evidence of publication bias was found. In conclusion, our meta-analysis suggests that vasectomy is not associated with the increased risk of prostate cancer. More studies based on other populations including the Chinese are needed. PMID:25927401

  2. Effects of vasectomy on seminal plasma alkaline phosphatase in male alpacas (Vicugña pacos).

    PubMed

    Pearson, L K; Campbell, A J; Sandoval, S; Tibary, A

    2013-12-01

    Azoospermia is a common finding in male alpacas which present for infertility. The challenge is to differentiate azoospermia of testicular origin from non-testicular origin. In several species, alkaline phosphatase (AP) concentrations in seminal plasma have been used as a diagnostic marker of contributions of the testis and epididymis to the ejaculate. The purpose of this study was to determine whether AP assay could differentiate testicular from non-testicular azoospermia in male alpacas. An experimental model of bilateral outflow obstruction (pre-scrotal vasectomy) was used in 22 male alpacas, aged 2-9 years. No reproductive history was available. Animals were submitted for electroejaculation (EE) under general anaesthesia and vasectomy performed. Five weeks later, animals were submitted for EE. Vasectomy was not successful in one animal, which was removed from analysis. AP levels were compared in seminal plasma in the pre- and post-vasectomy samples. The mean ± SEM concentration of AP in pre-vasectomy seminal plasma was 504.29 ± 166.45 U/l (range 10-2910); the post-vasectomy levels were 252.48 ± 81.77 U/l (range 0-1640; p = 0.06). In 71.4% of animals, AP levels decreased, varying from 18% to 100% reduction. Results of this study suggest that AP is not produced exclusively by the testis and epididymis in alpacas and that AP assay is not a valid diagnostic test for determination of origin of azoospermia; the gold standard for diagnosis of origin of azoospermia remains testicular biopsy. PMID:23790090

  3. Embolic Stroke Caused by Staphylococcus lugdunensis Endocarditis Complicating Vasectomy in a 36-Year-Old Man

    PubMed Central

    Loftsgaarden, Megan; Chukwudelunzu, Felix

    2015-01-01

    Staphylococcus lugdunensis is part of the native flora in the inguinal region of the body. Inguinal surgeries, such as vasectomy, place carriers of this aggressive pathogen at risk for contamination. Native-valve endocarditis caused by coagulase-negative S. lugdunensis has a rapid and complicated clinical course. The pathogenicity of this organism is not limited to cardiac valvular destruction. We report the case of a 36-year-old man who presented with S. lugdunensis endocarditis, dysarthria, and hemiparesis 5 weeks after a vasectomy. To our knowledge, this is the first report of embolic stroke caused by S. lugdunensis endocarditis. In addition, we discuss the relevant medical literature. PMID:26664319

  4. Embolic Stroke Caused by Staphylococcus lugdunensis Endocarditis Complicating Vasectomy in a 36-Year-Old Man.

    PubMed

    David, Manova; Loftsgaarden, Megan; Chukwudelunzu, Felix

    2015-12-01

    Staphylococcus lugdunensis is part of the native flora in the inguinal region of the body. Inguinal surgeries, such as vasectomy, place carriers of this aggressive pathogen at risk for contamination. Native-valve endocarditis caused by coagulase-negative S. lugdunensis has a rapid and complicated clinical course. The pathogenicity of this organism is not limited to cardiac valvular destruction. We report the case of a 36-year-old man who presented with S. lugdunensis endocarditis, dysarthria, and hemiparesis 5 weeks after a vasectomy. To our knowledge, this is the first report of embolic stroke caused by S. lugdunensis endocarditis. In addition, we discuss the relevant medical literature. PMID:26664319

  5. Perceived Interest in Vasectomy among Latina Women and their Partners in a Community with Limited Access to Female Sterilization.

    PubMed

    Hubert, Celia; White, Kari; Hopkins, Kristine; Grossman, Daniel; Potter, Joseph E

    2016-01-01

    The low prevalence of vasectomy among Latino men in the United States is often attributed to cultural characteristics despite limited evidence supporting this hypothesis. We assessed male partners' perceived willingness to undergo vasectomy through surveys with 470 Mexican-origin women who did not want more children in El Paso, Texas. Overall, 32% of women reported that their partner would be interested in getting a vasectomy. In multivariable analysis, completing high school (OR=2.03 [1.05, 3.95]), having some college education (OR=2.97 [1.36, 6.48]) or receiving US government assistance (OR=1.95 [1.1, 3.45]) was associated with partners' perceived interest. Additionally, we conducted two focus groups on men's knowledge and attitudes about vasectomy with partners of a subsample of these women. Despite some misperceptions, male partners were willing to get a vasectomy, but were concerned about cost and taking time off work to recover. Health education and affordable vasectomy services could increase vasectomy use among Mexican-origin men. PMID:27180707

  6. Vasectomy and risk of prostate cancer: a systematic review and meta-analysis of cohort studies.

    PubMed

    Liu, L H; Kang, R; He, J; Zhao, S K; Li, F T; Wan, S P; Zhao, Z G

    2015-07-01

    The results of published literature focusing on the association between vasectomy and the incidence of prostate cancer are often inconsistent. We conducted a meta-analysis to provide a quantitative assessment of the association between vasectomy and the risk of prostate cancer. We identified all cohort studies by searching the PubMed, Embase, and Cochrane Library before August 2014. The quality of the studies was evaluated using the Newcastle-Ottawa Scale checklist. Summary effect estimates with 95% confidence intervals (CI) were derived using a fixed or random effects model, depending on the heterogeneity of the included studies. Nine cohort studies that spanned across two continents involving 1 127 096 participants (ages 20-75) with 7539 cases of prostate cancer cases were included in the meta-analysis. The overall combined relative risks for men with the reference group were 1.08 (95% CI: 0.87-1.34) in a random effects, however, the association was not statistically significant (p = 0.48). Estimates of total effects were generally consistent in the sensitivity and subgroup analyses. No evidence of publication bias was observed. This meta-analysis indicated that vasectomy may not contribute to the risk of prostate cancer. The conclusion might have a far-reaching significance for the public health, especially in countries with high prevalence rates of vasectomy. PMID:26041315

  7. Robotic intra-abdominal vasectomy reversal: A new approach to a difficult problem

    PubMed Central

    Barazani, Yagil; Kaouk, Jihad; Sabanegh, Edmund S.

    2014-01-01

    The management of obstructive azoospermia resulting from intra-abdominal vasal obstruction poses a formidable surgical challenge. A number of surgical methods have been described to address this problem, including both open and laparoscopic approaches to mobilize and sometimes even re-route the abdominal vas deferens prior to performing a re-anastamosis. We present the first report, to our knowledge, of robotic intra-abdominal vasectomy reversal used to repair obstructive azoospermia resulting from prior laparoscopic vasectomy. In doing so, we summarize the techniques described previously in the literature and build upon this body of surgical experience by combining robotic-assisted laparoscopic mobilization of the vas with robotic vasovasostomy. We believe this novel approach for repairing intra-abdominal vasal defects minimizes morbidity, while at the same time obviating the need for the operating microscope, and thus represents a practical alternative to existing techniques. PMID:25024801

  8. Optimizing outcomes in vasectomy: how to ensure sterility and prevent complications.

    PubMed

    Lowe, Gregory

    2016-04-01

    Vasectomy provides a long-term effective sterilization for men and is performed on nearly 500,000 men annually in the United States. Improvements in technique have led to a decreased failure rate and fewer complications, although significant variations in technique exist. Use of cautery occlusion with or without fascial interposition appears to have the least failures. A no-scalpel approach lowers risk of hematoma formation, infection and bleeding post-operatively. A patient can be considered sterile when azoospermia is achieved or the semen analysis shows less than 100,000 non-motile sperm per milliliter. Incorporating these principles may allow the physician to optimize outcomes in vasectomy. PMID:27141443

  9. Optimizing outcomes in vasectomy: how to ensure sterility and prevent complications

    PubMed Central

    2016-01-01

    Vasectomy provides a long-term effective sterilization for men and is performed on nearly 500,000 men annually in the United States. Improvements in technique have led to a decreased failure rate and fewer complications, although significant variations in technique exist. Use of cautery occlusion with or without fascial interposition appears to have the least failures. A no-scalpel approach lowers risk of hematoma formation, infection and bleeding post-operatively. A patient can be considered sterile when azoospermia is achieved or the semen analysis shows less than 100,000 non-motile sperm per milliliter. Incorporating these principles may allow the physician to optimize outcomes in vasectomy. PMID:27141443

  10. Vasectomy with rivanol injection and fertility control by vital staining with eosin.

    PubMed

    Lauritsen, N P; Kløve-Mogensen, M; Glavind, K

    1987-01-01

    A material is presented of 66 males who were treated with Rivanol injection during vasectomy in order to obtain immediate sterility. The fertility control was established using vital eosin staining on seminal fluid at home. One case of recanalization occurred. All patients had infertile spermatozoa or aspermia 10 days after surgery. Increased frequency of complications was not observed. Vital staining with eosin is found to be practical and easily used. PMID:2448262

  11. Morphometric study of the testis and reproductive tract (including sperm granuloma) after vasectomy in mature rats.

    PubMed

    Ma, Li; Guo, Yang; Yuan, Yong; Li, Yu-Gen; Deng, Xian-Zhong; Yang, Zheng-Wei

    2016-01-01

    By utilizing the rabbit model, previous studies have found good evidence indicating that vasectomy-induced spermatogenic damage is pressure-mediated: the damage occurs when the occluded reproductive tract is unable to accommodate additional spermatozoa produced by the testis. More studies with the more commonly used rat model have shown, however, controversial results on whether and why the damage occurs. In this study, 12 mature male Sprague-Dawley rats were subjected to unilateral vasectomy: double ligation (without severing) of the vas deferens exposed via a small inguinal incision; 37 days after the operation, the testes, epididymides, vasa deferentia (juxta-epididymal segments), and sperm granulomas (at the vasectomy site) were removed to obtain methacrylate resin-embedded sections and morphometric studies carried out with light microscopy. Marked spermatogenic damage with spermatids and spermatocytes depleted in the seminiferous epithelium in 43% of the seminiferous tubule profiles was demonstrated in 5 of the 12 testes on the vasectomized side, and the damage was associated with smaller or absent sperm granulomas; in the other 7 testes with essentially normal spermatogenesis, there was an increase (by 111% on average) in the volume of the tubule lumen, associated with larger granulomas or granulomas containing more spermatozoa. There was an overall increase (by 66%) in the thickness of the rete testis in the 12 testes; the epididymis or vas deferens showed no distension. It seems therefore that the spermatogenic damage induced by vasectomy in rats is pressure-mediated as well, and that variation in the damage depends mainly on the postoperative development of the sperm granuloma. PMID:25791731

  12. Laparoscopic vasectomy in African savannah elephant (Loxodonta africana); surgical technique and results.

    PubMed

    Marais, Hendrik J; Hendrickson, Dean A; Stetter, Mark; Zuba, Jeffery R; Penning, Mark; Siegal-Willott, Jess; Hardy, Christine

    2013-12-01

    Several small, enclosed reserves in southern Africa are experiencing significant elephant population growth, which has resulted in associated environmental damage and changes in biodiversity. Although several techniques exist to control elephant populations, e.g., culling, relocation, and immunocontraception, the technique of laparoscopic vasectomy of free-ranging bull elephants was investigated. Bilateral vasectomies were performed in 45 elephants. Of these elephants, one died within 24 hr of recovery and two had complications during surgery but recovered uneventfully. Histologic examination confirmed the resected tissue as ductus deferens in all the bulls. Most animals recovered uneventfully and showed no abnormal behavior after surgery. Complications recorded included incisional dehiscence, 1 full-thickness and 2 partial-thickness lacerations of the large intestine, and initial sling-associated complications, for example, deep radial nerve paresis. One bull was found dead 6 weeks after surgery without showing any prior abnormal signs. Vasectomy in free-ranging African bull elephants may be effectively performed in their normal environment. The surgical procedure can be used as a realistic population management tool in free-ranging elephants without major anesthetic, surgical, or postoperative complications. PMID:24437080

  13. The use of URYX for reversible vasectomy in a rabbit model.

    PubMed

    Naughton, Cathy K; Myles, Jonathan; Thomas, Anthony J

    2004-01-01

    URYX is a biocompatible polymer of ethylene vinyl alcohol dissolved in a dimethyl sulfoxide (DMSO) carrier to allow injection of a very low-viscosity fluid into tissue. Once the material comes into contact with body tissue or fluid, the DMSO rapidly dissipates from the polymer, which results in a precipitate of a coherent solid mass. The purpose of the present study was to determine whether URYX can effectively occlude the vas deferens and whether patency can be restored by redissolving the URYX in vivo using the solvent DMSO. Eight male New Zealand White rabbits (age range, 25-41 weeks; mean age, 33.9 +/- 7.5 weeks; mean weight, 4.0 +/- 0.2 kg) were used in 2 experiments (E1 and E2). In E1, 3 rabbits underwent unilateral vasectomy, and the contralateral vas was injected with either 0.05 or 0.10 mL of URYX, to determine the amount of URYX required to cause obstruction. Two animals underwent bilateral vasectomy, to serve as controls. In E2, 3 animals underwent bilateral URYX injection and were compared with the bilateral vasectomy control rabbits used in E1. After 1 month of initial bilateral URYX treatment, all animals in E2 underwent attempted unilateral reversal with 1.5 mL of DMSO injected into 1 occluded vas deferens. Two end points were evaluated-a clinical end point assessed by semen analyses and a pathological end point assessed by histological analysis of treated tissues, to assess for safety. A 1.5-cm infrapubic incision was made to expose both vasa in anesthetized rabbits. The vasal injection of URYX was performed with a 30-gauge needle. Vasectomy was performed by excision of a 1-cm segment of the vas deferens and subsequent ligation with a 6-0 prolene suture. Semen was collected using an artificial vagina 2-3 times/wk before and 1 month later, after injection treatments and vasectomy. Manual sperm counts were performed. All animals were sacrificed, and tissues (distal vas, injection site, proximal vas, cauda epididymis, caput epididymis, and testis) were

  14. Awareness, diffusion of information and reasons for adoption of vasectomy: a study of family planning in Bihar.

    PubMed

    Sinha, R P

    1973-03-01

    A survey carried out to study problems related to Indian vasectomy camps organized at Patna and Jamue towns had the following major purposes: 1) to determine to what extent vasectomy adopters were aware of the family planning program; 2) to determine advantages perceived of adopting vasectomy; 3) to determine how the adopters became aware of the vasectomy camps; and 4) to determine why adopters chose permanent conception control. 200 adopters from Patna and an equal number from Jamue were selected, based on an accidental sampling technique whereby each adopter was contacted and persuaded to be interviewed. It was found that a majority of the adopters were illiterates. Among advantages listed by adopters, the importance of family planning seemed to be subdued by propensity to better their economic condition. It was seen that the literate adopters have a much higher proportion of awareness of the need for family planning and population control. Concerning diffusion of information, the informal and interpersonal sources were equally effective and conducive for the adopters. More than l/2 of the adopters relied upon information provided by friends. In general, higher levels of education correlate with less influence of friends as communicators. The official sources turned out to be effective for the more highly educated adopters. The following advantages were called out as reasons for vasectomy adoption by adopter : 1) permanence; 2) economical reasons; 3) no reason; or 4) many reasons. Whatever the reasons, it is obvious that vasectomy is gaining momentum gradually and people are becoming aware of the underlying advantages of permanent conception control. PMID:12277430

  15. No-scalpel vasectomy by electrocauterization in free range rhesus macaques (Macaca mulatta)

    PubMed Central

    Kumar, V.; Raj, A.

    2012-01-01

    The objective of the study was to standardize a new method of vasectomy in male rhesus macaques (Macaca mulatta). A total of 208 free range male rhesus macaques captured from different locations in Shivalik Hills in a population control programme of the rhesus macaques in India. General anaesthesia was achieved by using a combination of ketamine hydrochloride at 8 mg/kg body weight and xylazine hydrochloride at 2mg/kg body weight intramuscularly in squeeze cage. Surgical procedure of vasectomy was carried out by single-hole no-scalpel technique using a single pre-scrotal skin incision above the median raphae. Spermatic cord was grasped with ringed forceps and was pulled out through the single-hole incision. Vas deferens was separated from the artery-vein complexus and about 3-4 cm portion of vas deferens was resected. Cauterization of both ends of the vas deferens was achieved with electrocautery. The induction time for anaesthesia was 1.40±0.18 min while surgical time for vasectomy was found to be 5.09±0.22 min. Recovery from general anaesthesia was without side-effects after a mean duration of 36.07±1.22 min, whereas the duration of anaesthesia was observed to be 82.27±4.96 min. There were no major complications following the surgery and recovery of animals was smooth. Animals were kept in postoperative care for five days and released at the same capturing site. PMID:26623283

  16. COMPARISON OF CHEMICAL AND SURGICAL VASECTOMY ON TESTICULAR ACTIVITY IN FREE-ROAMING HORSES (EQUUS CABALLUS).

    PubMed

    Scully, Clare M; Lee, Rebecca L; Pielstick, Leon; Medlock, Jan; Patton, Kristin M; Collins, Gail H; Kutzler, Michelle A

    2015-12-01

    Free-roaming horse (Equus caballus) management is a complex issue incorporating social, economic, emotional, political, and environmental factors. Currently, few proven field techniques exist for managing free-roaming horse population growth, which can reach 20-25% annually. Although there are several strategies available for sterilizing mares when managing free-roaming horse populations, surgical vasectomy is the only method used in the field for stallions. Some managers believe that surgically vasectomizing dominant stallions would have significant effects on reducing horse populations. However, sterilizing only dominant harem stallions results in a relatively modest reduction in population growth as substantial reproduction may occur even when 100% of the dominant harem stallions are sterilized if other males perform as little as 10% of the breeding. The overall goal of the current project was to evaluate the efficacy of a novel nonsurgical method for sterilizing free-roaming horses (chemical vasectomy). In September of 2013, stallions that had been previously surgically vasectomized (SURG, n = 25), previously chemically vasectomized (CHEM, n = 16), or untreated (CONT, n = 32) were captured and surgically castrated in preparation for adoption. When comparing both sterilization methods to CONT, serum testosterone and estrone sulfate concentrations did not differ (P > 0.05), suggesting that these methods for sterilizing free-roaming stallions would not disrupt herd social hierarchy. However, similar to the CONT, all CHEM stallions had sperm present within the vas deferens seminal fluid samples. CHEM stallions had more morphologically abnormal sperm than did CONT stallions but it is not known if this affected the actual fertility. Additional research is needed using alternative sclerosing agents for chemical vasectomy in free-roaming horse populations. PMID:26667538

  17. Long-term reproductive consequences of no-scalpel vasectomy in beagles.

    PubMed

    Zhang, Yuanfeng; Wang, Xinggang; Chen, Zonglin; Huang, Xunbin

    2012-12-01

    The effects of vasectomy on the reproductive organs in various species are controversial. This study investigated the morphological change and apoptosis of the testis, epididymis, and vas deferens in beagle dogs 12 months after vasectomy. The male beagles were divided into two groups: vasectomized and sham-operated groups (n=5 in each). Histopathological, ultrastructural, and TUNEL evaluation of the changes in the testis, epididymis, and ductus deferens of each animal were conducted 12 months after surgery. The mean lumen diameter, cellular thickness, mean interstitial distance, and lumen area fraction of each seminiferous tubule and ductus epididymis were measured by stereological analysis. The results showed that, compared with the sham-operated group, the seminiferous tubular epithelial cells of the testes in the vasectomized group were disorderly arranged and scattered. Significant atrophy and apoptosis were found in the endothelial cells, and a range of ultrastructural variations were observed in the cells of testes, epididymis, and vas deferens in vasectomized group. It was concluded that complete obstruction of the vas deferens as a traditional contraception method is not absolutely safe in terms of the reversal of fertility in the long run. Techniques of relieving the inner pressure in the vas deferens while maintaining the efficacy of male contraception need to be explored. PMID:23271294

  18. Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy.

    PubMed

    Cilip, Christopher M; Allaf, Mohamad E; Fried, Nathaniel M

    2012-04-01

    A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in six dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy. PMID:22559684

  19. Endoscopic Vasectomy of Male Feral Pigeons (Columba livia) as a Possible Method of Population Control.

    PubMed

    Heiderich, Elisabeth; Schildger, Bernd; Lierz, Michael

    2015-03-01

    To evaluate whether single-entry endoscopic vasectomy of male feral pigeons (Columba livia) significantly reduced fertility and would potentially be valuable for control of feral pigeon populations, 252 male feral pigeons were caught in the city of Berne and endoscopically vasectomized. In this procedure, approximately 1 cm of the deferent duct was removed bilaterally. Rapid, uneventful recoveries occurred in 94% (237/252) of the pigeons, whereas 6% (15/252) died because of complications associated with the procedure, consisting of perforation of the ureter (9/15), major hemorrhage (5/15), and respiratory arrest (1/15). Mean anesthesia time was 23±6 minutes. The vasectomized males were habituated to 2 pigeon houses together with fertile females. Another pigeon house with fertile pairs acted as control. All eggs laid were candled weekly to assess fertility. In the 2 pigeon houses with vasectomized males, the mean fertilization rate was 0.9% (5/563), while in the control pigeon house, the rate was 100% (39/39). The results indicate that endoscopic vasectomy of male feral pigeons may be a promising tool for field control of feral pigeon populations, especially in combination with other methods such as pigeon houses. PMID:25867661

  20. Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy

    PubMed Central

    Cilip, Christopher M.; Allaf, Mohamad E.

    2012-01-01

    Abstract. A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in six dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy. PMID:22559684

  1. Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Allaf, Mohamad E.; Fried, Nathaniel M.

    2012-04-01

    A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in six dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy.

  2. No Scalpel Vasectomy (NSV) with Ligation and Excision: A Single Centre Experience.

    PubMed

    Bhuyan, K; Ali, I; Sarma, G; Das, U

    2015-12-01

    No scalpel vasectomy (NSV) has proved to be a safe and simple procedure for permanent sterilization for men. Ligation and excision of the vas deferens followed by fascial interposition is the procedure of choice. It is believed that vas excision without fascial interposition has a risk of failure. The objective of this study was to evaluate the technique of NSV with ligation and excision only. No scalpel vasectomy performed in an urban centre was taken for this prospective study. Only ligation and excision procedure was applied in its execution. It was demonstrated and performed under the supervision of an expert. Information regarding early and late complications including failure was gathered. A total number of 3,392 NSVs were performed in an urban training centre between Apr' 2009 to Mar' 2013. The procedure applied was only excision and ligation of the vas deferens. The fascial interposition was not included in the procedure. Haematoma (1), bleeding (3), foreign body granuloma (1), scrotal pain (3), epididymitis (1) and sinus formations (1) were encountered. There was only one failure in the whole group of acceptors. NSV with ligation and excision is a simple and easy procedure to learn and perform. Complications and failures are negligible. The additional fascial interposition needs more surgical skill and is time-consuming, hence can be avoided where a large number of acceptors need to undergo NSV in a rural camp. PMID:27011506

  3. Can we predict the chance of successful epididymal or testicular sperm aspiration following vasectomy?

    PubMed

    Datta, Adrija Kumar; Nayini, Krishnaveni; Eapen, Abey; Barlow, Su; Lockwood, Gillian

    2016-06-01

    Purpose of this retrospective study was to investigate if serum markers, men's age, interval since vasectomy, BMI, testicular size and smoking could predict the success of epididymal or testicular sperm aspiration (PESA/TESA) in vasectomized men. Forty-four consecutively performed PESA/TESA procedures were reviewed retrospectively. Motile sperm was retrieved from 77.3% of PESA/TESA procedures. Mean serum Inhibin-B (Inh-B) level tended to be higher in men who had motile sperm retrieved compared to those who had not (180.3 versus 126.2 pg/ml, p = 0.05). Univariate analysis identified serum Inh-B to be the only predictor of PESA/TESA success (r = 0.32, CI: 0.006-0.584, p = 0.046). Serum FSH, LH, T levels, age, BMI, smoking status and interval since vasectomy did not correlate with the PESA/TESA outcome. Inh-B could modestly discriminate between successful and unsuccessful PESA/TESA (AUC= 0.70) with high positive (89.5%) but low negative prediction (36.8%); 58.6% sensitivity and 77.7% specificity at the optimum cut-off level of 166 pg/ml. Positive outcome was only 50% when the Inh-B level was below 100 pg/ml. It is concluded that a high serum Inh-B might reliably predict successful PESA/TESA in vasectomized men. More invasive sperm retrieval procedures could be reserved for men with very low Inh-B or failed PESA/TESA. Future studies with adequate power may confirm our findings. PMID:27335274

  4. Vasectomy Reversal

    MedlinePlus

    ... vas. So this is a marker to prevent torsion of the vas. We're making sure that ... important that they're aligned appropriately to prevent torsion or undue tension on the anastomosis. and also ...

  5. Utero-tubal Embryo Transfer and Vasectomy in the Mouse Model

    PubMed Central

    Bermejo-Alvarez, Pablo; Park, Ki-Eun; Telugu, Bhanu P.

    2014-01-01

    The transfer of preimplantation embryos to a surrogate female is a required step for the production of genetically modified mice or to study the effects of epigenetic alterations originated during preimplantation development on subsequent fetal development and adult health. The use of an effective and consistent embryo transfer technique is crucial to enhance the generation of genetically modified animals and to determine the effect of different treatments on implantation rates and survival to term. Embryos at the blastocyst stage are usually transferred by uterine transfer, performing a puncture in the uterine wall to introduce the embryo manipulation pipette. The orifice performed in the uterus does not close after the pipette has been withdrawn, and the embryos can outflow to the abdominal cavity due to the positive pressure of the uterus. The puncture can also produce a hemorrhage that impairs implantation, blocks the transfer pipette and may affect embryo development, especially when embryos without zona are transferred. Consequently, this technique often results in very variable and overall low embryo survival rates. Avoiding these negative effects, utero-tubal embryo transfer take advantage of the utero-tubal junction as a natural barrier that impedes embryo outflow and avoid the puncture of the uterine wall. Vasectomized males are required for obtaining pseudopregnant recipients. A technique to perform vasectomy is described as a complement to the utero-tubal embryo transfer. PMID:24637845

  6. No-scalpel vasectomy: review of the first 1,000 cases in a family medicine unit.

    PubMed

    Arellano Lara, S; Gonzalez Barrera, J L; Hernandez Ono, A; Moreno Alcazar, O; Espinosa Perez, J

    1997-01-01

    In Mexico, the Mexican Institute of Social Security (IMSS) had adopted the no-scalpel vasectomy technique by the end of 1989. The technique was described by Dr. Li Shunquiang in 1974, and more than 60 million no-scalpel vasectomies have been performed in 26 countries. Among the advantages with no-scalpel vasectomy is that it has fewer complications (0.4%) compared to the traditional technique (3.1%). We studied 1,000 clinical charts of the subjects operated on between January, 1990 and January, 1993, with the objective of reporting our experiences as well as analyzing whether there existed a correlation between the subject's social and demographic characteristics and the number of control spermatic counts he attended postoperatively. In 97.9% of the cases, subjects had no postoperative hemorrhage or hematoma. None of the subjects had a surgical wound infection. In addition, 54.4% of the subjects came to the first control spermatic count, 39.7% came to the second, and only 18.4% came to all three controls. In an attempt to find a characteristic which defined the subject who attends his postoperative control spermatic counts, we found an association using chi2 between the attendance at two controls with the subjects who had been married from 6 - 10 years (p = 0.059), and with the subjects who had an income of three minimum wages. Regarding the attendance at all three controls, we found an association with subjects who had an income of two minimum wages (p = 0.037). We also found a weak correlation between the attendance at all three controls and the reason reported for not having more children (the couple did not want more children) (r = 0.07; p = 0.025) and with the manner in which the subjects were referred to the clinic (came on their own initiative) (r = 0.09; p = 0.006). Finally, we consider that no-scalpel vasectomy can be implemented as an adequate family planning method in Mexico's primary care centers. The lack of adequate attendance at postoperative control

  7. Vasectomy as a proxy: extrapolating health system lessons to male circumcision as an HIV prevention strategy in Papua New Guinea

    PubMed Central

    2012-01-01

    Background Male circumcision (MC) has been shown to reduce the risk of HIV acquisition among heterosexual men, with WHO recommending MC as an essential component of comprehensive HIV prevention programs in high prevalence settings since 2007. While Papua New Guinea (PNG) has a current prevalence of only 1%, the high rates of sexually transmissible diseases and the extensive, but unregulated, practice of penile cutting in PNG have led the National Department of Health (NDoH) to consider introducing a MC program. Given public interest in circumcision even without active promotion by the NDoH, examining the potential health systems implications for MC without raising unrealistic expectations presents a number of methodological issues. In this study we examined health systems lessons learned from a national no-scalpel vasectomy (NSV) program, and their implications for a future MC program in PNG. Methods Fourteen in-depth interviews were conducted with frontline health workers and key government officials involved in NSV programs in PNG over a 3-week period in February and March 2011. Documentary, organizational and policy analysis of HIV and vasectomy services was conducted and triangulated with the interviews. All interviews were digitally recorded and later transcribed. Application of the WHO six building blocks of a health system was applied and further thematic analysis was conducted on the data with assistance from the analysis software MAXQDA. Results Obstacles in funding pathways, inconsistent support by government departments, difficulties with staff retention and erratic delivery of training programs have resulted in mixed success of the national NSV program. Conclusions In an already vulnerable health system significant investment in training, resources and negotiation of clinical space will be required for an effective MC program. Focused leadership and open communication between provincial and national government, NGOs and community is necessary to assist

  8. Long-term effect of vasectomy on the biochemical composition of testes and sex accessory organs of the Indian desert gerbil, Meriones hurrianae Jerdon.

    PubMed

    Lohiya, N K; Dixit, V P

    1975-02-01

    A long-term vasoligation operation in gerbils, Meriones hurrianae Jerdon did not reveal any consistent change in the weights of androgen dependent organs such as seminal vesicles, ventral prostate, epididymes and perineal complex (levator ani muscle and penis). Histological structure of the testis and caput epididymis remains normal after vasectomy. There was no effect of bilateral vasectomy on androgen production of the testes as reflected by fructose content of coagulating gland. No compensatory hypertrophy of the contralateral testis was observed in unilaterally vasectomized gerbils. The RNA content of the testis and epididymis and ascorbic acid content of adrenal gland did not show appreciable change. No change in protein content of the testis was found but a significant increase was observed in the protein content of epididymis after the operation. PMID:1175529

  9. Intraluminal occlusion of the seminal duct by laser and Histoacryl: Two non-invasive alternatives for vasectomy

    NASA Astrophysics Data System (ADS)

    Freitag, B.; Sroka, R.; Koelle, S.; Becker, A. J.; Khoder, W.; Pongratz, T.; Stief, C. G.; Trottmann, M.

    2014-03-01

    Introduction and objective: Vasectomy is a well-established method in family control. Even though it is a safe and low risk operation, this surgery is invasive and difficult to reverse. Therefore the aim of this study was to investigate new non-invasive methods for occlusion of the seminal duct. Material and Methods: Seminal duct tissue was obtained from patients (n=30) suffering from prostate cancer and therefore undergoing prostatectomy. In a first set of experiments, the seminal duct was occluded by intraluminal application of Histoacryl® (Braun Aesculap AG, Tuttlingen, Germany). In a 2nd set of experiments, endoluminal laser induced occlusion was performed. Four different laser wavelengths (1940nm, 1470nm, 1064nm, 940nm) and different sets of laser parameters (e.g. power, exposure duration, fibre diameter, energy applied) were compared. Effectiveness of occlusion of the seminal duct was proven by post-treatment irrigation flow measurement, as well as by morphological analyses. To evaluate a potential damage of the surrounding tissue, external temperature was measured using a thermometer during laser application. Results: Intraluminal application of Histoacryl® induced an immediate and complete occlusion of the seminal duct. The underlying connective tissue maintained its functional integrity after this treatment. By laser light application to a Histoacryl® block, a hole could be created into the block thus indicating the possibility of recanalization. Treatment with laser energy resulted in shrinkage of the ductal lumen. The laser application generally caused necrosis in the epithelium and induced formation of vacuoles in the underlying connective tissue. As described for endoluminal varicose treatment, this distinct local reaction might result in an intense inflammation leading to a functional occlusion of the vas deferens. Conclusions: Both laser-induced occlusion and application of Histoacryl® are fast and simple techniques which may be able to achieve a

  10. How Is a Vasectomy Done?

    MedlinePlus

    ... with questions about grants, contracts & research areas Training, Education & Career Development Support for Training at Universities & Other Institutions Extramural training, fellowships & career development opportunities Training at ...

  11. What Are the Risks of Vasectomy?

    MedlinePlus

    ... with questions about grants, contracts & research areas Training, Education & Career Development Support for Training at Universities & Other Institutions Extramural training, fellowships & career development opportunities Training at ...

  12. Key Statistics from the National Survey of Family Growth: Vasectomy

    MedlinePlus

    ... Submit Button Related Sites NCHS Listservs Surveys and Data Collection Systems Vital Statistics: Birth Data NCHS Key Statistics ... Submit Button Related Sites NCHS Listservs Surveys and Data Collection Systems Vital Statistics: Birth Data File Formats Help: ...

  13. Staphylococcus lugdunensis endocarditis following vasectomy--report of a case history and review of the literature.

    PubMed

    Schandiz, Hossein; Olav Hermansen, Nils; Jørgensen, Trond; Roald, Borghild

    2015-08-01

    Staphylococcus lugdunensis is a coagulase-negative Staphylococcus (CoNS), and part of the normal skin flora. The bacterium is an emerging pathogen that, unlike other CoNS, resembles coagulase-positive Staphylococcus aureus infections in virulence, tissue destruction, and clinical course. We report a fatal case following minor surgery. The frequency of S. lugdunensis infections has probably been underestimated and under-reported in the past as few clinical laboratories routinely identify coagulase-negative Staphylococci. PMID:26058423

  14. Studies in Family Planning, Volume 3, Number 8.

    ERIC Educational Resources Information Center

    Population Council, New York, NY.

    "Kerala's Pioneering Experiment in Massive Vasectomy Camps," the principal article in this monthly publication of the Population Council, is a detailed research report on the success of a massive vasectomy camp conducted at Cochin, the capital city of the Ernakulam District of Kerala State, India. The second article, "The Gujarat State Massive…

  15. Birth control and family planning

    MedlinePlus

    ... to have children in the future. They include vasectomy and tubal ligation. These procedures can sometimes be reversed if a ... 26. Jensen JT, Mishell DR. Family planning: contraception, sterilization, and pregnancy termination. In: Lentz GM, Lobo RA, ...

  16. Field Experiments of Family Planning Incentives.

    ERIC Educational Resources Information Center

    Rogers, Everett M.

    A review of four quasi-experiments on family planning incentives in three Asian nations is presented, and a multi-national comparative field experiment on family planning incentives is proposed. Experiments include: (1) The Ernakulam vasectomy campaigns, (2) Indian Tea Estates retirement bond incentive program, (3) Taiwan educational bond…

  17. The Censorship of "Maude": A Case Study in the Social Construction of Reality.

    ERIC Educational Resources Information Center

    Mihevc, Nancy T.; And Others

    The concept of reality held by individuals and societies can be explored by examining reactions to the censorship of the two-part television show in the "Maude" series that dealt with abortion and vasectomy. The station managements of WMBD in Peoria, Illinois, and of WCIA in Champaign-Urbana, Illinois, chose not to broadcast the two "Maude"…

  18. Presterilization Interviewing: An Evaluation

    ERIC Educational Resources Information Center

    Carey, Raymond G.

    1976-01-01

    The role of interviewing in diffusing possible harmful side effects of sterilization operations was evaluated in an acute general hospital. Two simultaneous field experiments were conducted with 50 vasectomy couples and 50 tubal-ligation couples. There were no significant differences between the interview and control groups. (Author)

  19. Are Latin American and Caribbean men irresponsible with regard to family planning? A surprising male view.

    PubMed

    Santiso, R

    1988-04-01

    The viewpoint expressed in this article by the executive director of family planning in Guatemala is that Latin American men are interested in family planning. The "machismo" of the past is declining rapidly. Reference is made to studies since the 1970s that show that men are open to family planning and will permit their wives to use contraceptives. Men also, if properly informed and if their fears are dealt with, would accept vasectomy or other male methods. In fact, over 40 million Latin American men may be using condoms, and another 15 million practice periodic abstinence. The experiences of APROFAM in Guatemala have shown that males will accept vasectomy. The APROFAM program provides for presentations made to men in factories and in social groups. Announcements are made during football games. The program was successful in part because men's fears about the quality of services were removed. When services were provided in private by dedicated personnel, the acceptance of vasectomy increased. The program was also successful in bringing couples in together to discuss contraceptive services. The percentage of men who supported the use of contraceptives was greater than expected. It is argued that communication campaigns will continue to play an important role increasing male participation by increasing men's knowledge of methods, reducing men's fears about vasectomy, and reducing men's fears about female methods of contraception. PMID:12179851

  20. 32 CFR 732.15 - Unauthorized care.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....

  1. 32 CFR 732.15 - Unauthorized care.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....

  2. 32 CFR 732.15 - Unauthorized care.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....

  3. 32 CFR 732.15 - Unauthorized care.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....

  4. 32 CFR 732.15 - Unauthorized care.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 5 2010-07-01 2010-07-01 false Unauthorized care. 732.15 Section 732.15... DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.15 Unauthorized care. The following are not authorized by this part: (a) Chiropractic services. (b) Vasectomies. (c) Tubal ligations....

  5. Spaying and Neutering

    MedlinePlus

    ... hormones. This may not eliminate the dog or cat’s behaviors associated with the breeding instinct. • Vasectomy: only the ... hormones. This may not eliminate the dog or cat’s behaviors associated with the breeding instinct. Nonsurgical sterilization There ...

  6. Microsurgical vasovasostomy

    PubMed Central

    Herrel, Lindsey; Hsiao, Wayland

    2013-01-01

    Up to 6% of men who have undergone vasectomy will ultimately elect for reversal in the form of vasovasostomy or vasoepididymostomy for various reasons. Vasovasostomy performed to regain fertility is a technique that has undergone numerous advances during the last century, including the use of microsurgical equipment and principles to construct a meticulous anastomosis. It is important during vasovasostomy to ensure good blood supply to the anastomosis as well as to build as a tension-free anastomosis. Visual inspection to ensure healthy mucosa and inner muscularis as well as atraumatic handling of tissues is helpful. With vasovasostomy, it is essential to create a watertight anastomosis to prevent secondary scar formation. The microdot technique of vasovasostomy allows for markedly discrepant lumens to be brought together more precisely. Thereby, the planning is separated from suture placement, which prevents dog-ears and avoids subsequent leaks. In the age of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), it becomes even more important to clarify outcomes after vasectomy reversals, as patients now have a choice between surgical sperm retrieval coupled with IVF/ICSI versus vasectomy reversal. Little data on long-term outcomes for vasectomy reversals exist. Therefore, further research in this field needs to evaluate the rate of late failures and the predictors of late failures. PMID:23147468

  7. Applying clinically proven human techniques for contraception and fertility to endangered species and zoo animals: a review.

    PubMed

    Silber, Sherman J; Barbey, Natalie; Lenahan, Kathy; Silber, David Z

    2013-12-01

    Reversible contraception that does not alter natural behavior is a critical need for managing zoo populations. In addition to reversible contraception, other fertility techniques perfected in humans may be useful, such as in vitro fertilization (IVF) or oocyte and embryo banking for endangered species like amphibians and Mexican wolves (Canis lupus baileyi). Furthermore, the genetics of human fertility can give a better understanding of fertility in more exotic species. Collaborations were established to apply human fertility techniques to the captive population. Reversible vasectomy might be one solution for reversible contraception that does not alter behavior. Reversible approaches to vasectomy, avoiding secondary epididymal disruption, were attempted in South American bush dogs (Speothos venaticus), chimpanzees (Pan troglodytes), gorillas (Gorilla gorilla), Przewalski's horse (Equus przewalski poliakov), and Sika deer (Cervus nippon) in a variety of zoos around the world. These techniques were first perfected in > 4,000 humans before attempting them in zoo animals. In vitro fertilization with gestational surrogacy was used to attempt to break the vicious cycle of hand rearing of purebred orangutans, and egg and ovary vitrification in humans have led to successful gamete banking for Mexican wolves and disappearing amphibians. The study of the human Y chromosome has even explained a mechanism of extinction related to global climate change. The best results with vasectomy reversal (normal sperm counts, pregnancy, and live offspring) were obtained when the original vasectomy was performed "open-ended," so as to avoid pressure-induced epididymal disruption. The attempt at gestational surrogacy for orangutans failed because of severe male infertility and the lack of success with human ovarian hyperstimulation protocols. Vitrification of oocytes is already being employed for the Amphibian Ark Project and for Mexican wolves. Vasectomy can be a reversible contraception

  8. India: population: shocking results; monetary incentives.

    PubMed

    Addressing a conference of Parliament members on population and development in New Delhi, Prime Minister Indira Gandhi was reported to have informed the gathering that results of India's latest census "shocked us." The census counted a total national population of 683 million. It was 11 million more than officially anticipated. In her speech, Mrs. Gandhi was also reported to have reiterated that her government is totally committed to "voluntary family planning" and "firmly against compulsion." J.R.D. Tata, chairman of the Family Planning Foundation of India, proposed that the government raise monetary incentives for citizens voluntarily opting for vasectomy and tubectomy. He suggested that the present Rs. 200 for vasectomy and tubectomy be upped to Rs. 5000. He made the proposal in a call to the government to increase its outlay for the family planning program. PMID:12337557

  9. [Vasovasostomies performed in 60 cases from June 1990 to January 1994].

    PubMed

    Alvarado, A A; García de Paredes, R; Monterrey, J A

    1994-09-01

    60 vasovasostomies were performed between june 1990 and january 1994, following the modified one layer technique, under microscopic magnification. All the patients who requested the surgical procedure were included in the present study despite their age or time after vasectomy, in order to have a non selected group. Follow up was given with sperm counts processed under similar standards and performed at 2, 4 and 6 months after the surgical procedure. Our overall experience seems to confirm that strong correlation does not exist between the surgical technique used (one layer vs two layer), but the lapse of time passed between the vasectomy and the reversal is critical. In our series a pregnancy rate of 56.6% was achieved, with a patency rate of 86.7%. PMID:7746902

  10. Changing trends in conception control.

    PubMed

    El-tonsi, H; Gable, H; Arias, E; Behr, H Z

    1989-01-01

    Individual methods of conception control lend themselves to further description and detailed breakdown regarding their unique possibilities. Surgical contraception branches into tubal ligation and vasectomy. Tubal ligation methods involve a variety of means such as electro-coagulation, rings, or clips to terminate the oviducts. Vasectomy has various possibilities for its desired effects. Contraceptive barrier devices include such commonly known items as the cervical cap/diaphragm, and IUD. Consent from the user of these devices should be designed with the patient in mind, including detailed medical history and information regarding the possible hazards of the device itself. Various areas of conception control and population control have been explored and are continuing to be explored not only in the large hemispheres of the world, but in those smaller countries where population control has previously been ignored and has gotten out of control. PMID:12315699

  11. Petrunic and Anor. v. Barnes, 1 February 1988.

    PubMed

    1988-01-01

    The defendant physician was charged with negligence and breach of contract in the performance of a tubal ligation on the plaintiff. After the plaintiff became pregnant and gave birth to twins, she and her husband sought damages for pecuniary losses resulting from the birth of twins, claiming that the defendant should have warned them of the risk of failure of the operation or mentioned the alternative of performance of a vasectomy on the husband. The Supreme Court of Victoria, Australia, held that the defendant had no duty to inform the plaintiffs of the risk of failure or the alternative of a vasectomy since his actions accorded with accepted practice within the profession. It also concluded that, even if he had warned the plaintiffs, they would not have withheld their consent to the operation. PMID:12289437

  12. Blood epididymal barrier to (/sup 3/H)-inulin in intact and vasectomized hamsters

    SciTech Connect

    Turner, T.T.; D'Addario, D.A.; Howards, S.S.

    1981-09-01

    The net transport of (/sup 3/H)-inulin into the fluids of the hamster seminiferous and caput, corpus, and cauda epididymal tubules was examined in both intact animals and those vasectomized 10 months previously. Mean isotope concentrations in reproductive tract tubule fluids did not exceeded 10 per cent of blood plasma isotope concentrations during the experiment. There were no significant differences in net transport of (/sup 3/H)-inulin into any of the tubule fluids sampled. Ten months after vasectomy, the seminiferous tubule, and all regions of the epididymal tubule retain the capacity to exclude (/sup 3/H)-insulin. Thus in the hamster 10 months after vasectomy, the blood testis and blood epididymal barriers to inulin are intact.

  13. Noninvasive laser coagulation of the canine vas deferens, ex vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2009-02-01

    Male sterilization (vasectomy) is more successful, safer, less expensive, and easier to perform than female sterilization (tubal ligation). However, female sterilization is more popular, due to male fear of vasectomy complications (e.g. incision, bleeding, infection, and scrotal pain). The development of a completely noninvasive vasectomy technique may allay some of these concerns. Ytterbium fiber laser radiation with a wavelength of 1075 nm, average power of 11.7 W, 1-s pulse duration, 0.5 Hz pulse rate, and 3-mm-diameter spot was synchronized with cryogen cooling of the scrotal skin surface in canine tissue for a treatment time of 60 s. Vas thermal lesion dimensions measured 2.0 +/- 0.3 mm diameter by 3.0 +/- 0.9 mm length, without skin damage. The coagulated vas bursting pressure measured 295 +/- 72 mm Hg, significantly higher than typical vas ejaculation pressures of 136 + 29 mm Hg. Noninvasive thermal coagulation and occlusion of the vas is feasible.

  14. Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens.

    PubMed

    Cilip, Christopher M; Ross, Ashley E; Jarow, Jonathan P; Fried, Nathaniel M

    2010-01-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to scrotal skin to reduce laser power necessary for successful noninvasive laser vasectomy and eliminate scrotal skin burns. A mixture of dimethyl sulfoxide and glycerol was noninvasively delivered into scrotal skin using a pneumatic jet device. Near-infrared laser radiation was delivered in conjunction with cryogen spray cooling to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify strength of vas closure. A 30-min application of OCA improved skin transparency by 26+/-3%, reducing average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP=291+/-31 mmHg) to 7.0 W with OCA (BP=292+/-19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82+/-28 mmHg) significantly below typical ejaculation pressures (136+/-29 mmHg). Application of an OCA reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by approximately 25%. This technique may result in use of a less expensive laser and eliminate the formation of scrotal skin burns during the procedure. PMID:20799844

  15. Infertility, impotence, and emasculation – psychosocial contexts for abandoning reproduction

    PubMed Central

    Wibowo, Erik; Johnson, Thomas W; Wassersug, Richard J

    2016-01-01

    From a Darwinian perspective we live to reproduce, but in various situations genetic males elect not to reproduce by choosing medical treatments leading to infertility, impotence, and, in the extreme, emasculation. For many men, infertility can be psychologically distressing. However, for certain genetic males, being infertile may improve their quality of life. Examples include (1) men who seek vasectomy, (2) individuals with Gender Dysphoria (e.g., transwomen, and modern day voluntary eunuchs), (3) most gay men, and (4) men treated for testicular and prostate cancer. Men who desire vasectomy typically have a Darwinian fitness W >1 at the time of their vasectomies; i.e., after they have their desired number of offspring or consider themselves past an age for parenting newborns. In contrast, prostate and testicular cancer patients, along with individuals with extreme Gender Dysphoria, do not necessarily seek to be sterile, but accept it as an unavoidable consequence of the treatment for their condition undertaken for survival (in case of cancer patients) or to achieve a better quality of life (for those with Gender Dysphoria). Most gay men do not father children, but they may play an avuncular role, providing for their siblings’ offspring's welfare, thus improving their inclusive fitness through kin selection. In a strictly Darwinian model, the primary motivation for all individuals is to reproduce, but there are many situations for men to remove themselves from the breeding populations because they have achieved a fitness W ≥1, or have stronger medical or psychological needs that preclude remaining fertile. PMID:26924280

  16. Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-07-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to scrotal skin to reduce laser power necessary for successful noninvasive laser vasectomy and eliminate scrotal skin burns. A mixture of dimethyl sulfoxide and glycerol was noninvasively delivered into scrotal skin using a pneumatic jet device. Near-infrared laser radiation was delivered in conjunction with cryogen spray cooling to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify strength of vas closure. A 30-min application of OCA improved skin transparency by 26+/-3%, reducing average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP=291+/-31 mmHg) to 7.0 W with OCA (BP=292+/-19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82+/-28 mmHg) significantly below typical ejaculation pressures (136+/-29 mmHg). Application of an OCA reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by ~25%. This technique may result in use of a less expensive laser and eliminate the formation of scrotal skin burns during the procedure.

  17. Use of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens, ex vivo and in vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-02-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to the scrotal skin to reduce both the laser power necessary for successful noninvasive laser vasectomy and the probability of scrotal skin burns. A mixture of DMSO/glycerol was noninvasively delivered into the scrotal skin using a Madajet. Near-infrared laser radiation with a range of average powers (7.0-11.7 W) was delivered in conjunction with a range of cryogen spray cooling rates (0.20-0.33 Hz) to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify the strength of vas closure. A 30-min application of the OCA improved skin transparency by 26 +/- 5 %, reducing the average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP = 291 +/- 31 mmHg) to 7.0 W with OCA (BP = 292 +/- 19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82 +/- 28 mmHg) significantly below typical ejaculation pressures (136 +/- 29 mmHg). Application of an optical clearing agent reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by approximately 25%. This technique may result in the use of a less expensive laser system and eliminate the formation of scrotal skin burns during the procedure.

  18. Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

    PubMed Central

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-01-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent (OCA) to scrotal skin to reduce laser power necessary for successful noninvasive laser vasectomy and eliminate scrotal skin burns. A mixture of dimethyl sulfoxide and glycerol was noninvasively delivered into scrotal skin using a pneumatic jet device. Near-infrared laser radiation was delivered in conjunction with cryogen spray cooling to the skin surface in a canine model, ex vivo and in vivo. Burst pressure (BP) measurements were conducted to quantify strength of vas closure. A 30-min application of OCA improved skin transparency by 26±3%, reducing average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA (BP=291±31 mmHg) to 7.0 W with OCA (BP=292±19 mmHg). Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures (82±28 mmHg) significantly below typical ejaculation pressures (136±29 mmHg). Application of an OCA reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by ∼25%. This technique may result in use of a less expensive laser and eliminate the formation of scrotal skin burns during the procedure. PMID:20799844

  19. Postsurgical Food and Water Consumption, Fecal Corticosterone Metabolites, and Behavior Assessment as Noninvasive Measures of Pain in Vasectomized BALB/c Mice

    PubMed Central

    Jacobsen, Kirsten R; Kalliokoski, Otto; Teilmann, Anne C; Hau, Jann; Abelson, Klas SP

    2012-01-01

    Recognition of pain and stress is a common challenge when working with laboratory mice. The aim of the current study was to identify noninvasive parameters to assess the severity and duration of possible pain and stress after vasectomy in BALB/c mice. Mice underwent isoflurane anesthesia with or without vasectomy. Body weight, food and water intake, and fecal corticosterone metabolites (FCM) were measured 3 d before and 3 d after the procedure. Behavior was recorded 1, 2, 4, and 8 h after the procedure. Food and water consumption and defecation were reduced postoperatively in the vasectomized group compared with mice given anesthesia only. FCM were elevated the first day after anesthesia in the control mice but not in the vasectomized group. Vasectomy resulted in behavioral changes that were not seen in the group that was anesthetized only. In conclusion, food and water consumption and pain-related behaviors, but not FCM, may be useful as noninvasive parameters to assess postoperative pain and stress in vasectomized mice. PMID:22330871

  20. Why Bolivians are talking about gender roles.

    PubMed

    Eschen, A

    1998-01-01

    The first hospital to offer no-scalpel vasectomy services in La Paz, Bolivia, introduced its program in 1996. However, over the course of 2 years, only 1 vasectomy was performed. Vasectomy services in La Paz are underutilized due to inadequate counseling, outreach, and use of educational materials. While the national health and population policy mandates the provision of comprehensive reproductive health care for both men and women, Bolivian men rarely seek health care services of any kind because most services are designed mainly for women and children. The only services offered to men are urology related, which focus upon screening for STDs, and workplace-related services, such as for factory workers and miners. Nongovernmental organizations (NGO) are exploring how to increase men's involvement in health care and family planning services. Men need to be made aware of gender issues related to reproductive and sexual health. The Centro de Investigacion Social Tecnologia Apropriada y Capacitacion (CISTAC), a Bolivian NGO which focuses upon research and training in health and social issues, plans to use research, training, and information dissemination to broaden the male role and identity in Bolivia, which will also affect men's access to and receipt of health care services. Toward that end, CISTAC and AVSC co-sponsored a workshop to teach health care program managers about the relationship between gender issues and men's involvement in reproductive health care. PMID:12321882

  1. Infertility, impotence, and emasculation - psychosocial contexts for abandoning reproduction.

    PubMed

    Wibowo, Erik; Johnson, Thomas W; Wassersug, Richard J

    2016-01-01

    From a Darwinian perspective we live to reproduce, but in various situations genetic males elect not to reproduce by choosing medical treatments leading to infertility, impotence, and, in the extreme, emasculation. For many men, infertility can be psychologically distressing. However, for certain genetic males, being infertile may improve their quality of life. Examples include (1) men who seek vasectomy, (2) individuals with Gender Dysphoria (e.g., transwomen, and modern day voluntary eunuchs), (3) most gay men, and (4) men treated for testicular and prostate cancer. Men who desire vasectomy typically have a Darwinian fitness W >1 at the time of their vasectomies; i.e., after they have their desired number of offspring or consider themselves past an age for parenting newborns. In contrast, prostate and testicular cancer patients, along with individuals with extreme Gender Dysphoria, do not necessarily seek to be sterile, but accept it as an unavoidable consequence of the treatment for their condition undertaken for survival (in case of cancer patients) or to achieve a better quality of life (for those with Gender Dysphoria). Most gay men do not father children, but they may play an avuncular role, providing for their siblings' offspring's welfare, thus improving their inclusive fitness through kin selection. In a strictly Darwinian model, the primary motivation for all individuals is to reproduce, but there are many situations for men to remove themselves from the breeding populations because they have achieved a fitness W ≥1, or have stronger medical or psychological needs that preclude remaining fertile. PMID:26924280

  2. A randomized, controlled, multicenter contraceptive efficacy clinical trial of the intravas device, a nonocclusive surgical male sterilization

    PubMed Central

    Lu, Wen-Hong; Liang, Xiao-Wei; Gu, Yi-Qun; Wu, Wei-Xiong; Bo, Li-Wei; Zheng, Tian-Gui; Chen, Zhen-Wen

    2014-01-01

    Because of unavoidable complications of vasectomy, this study was undertaken to assess the efficacy and safety of male sterilization with a nonobstructive intravas device (IVD) implanted into the vas lumen by a mini-surgical method compared with no-scalpel vasectomy (NSV). IVDs were categorized into two types: IVD-B has a tail used for fixing to the vas deferens (fixed wing) whereas IVD-A does not. A multicenter prospective randomized controlled clinical trial was conducted in China. The study was comprised of 1459 male volunteers seeking vasectomy who were randomly assigned to the IVD-A (n = 487), IVD-B (n = 485) or NSV (n = 487) groups and underwent operation. Follow-up included visits at the 3rd–6th and 12th postoperative months. The assessments of the subjects involved regular physical examinations (including general and andrological examinations) and semen analysis. The subjects’ partners also underwent monitoring for pregnancy by monthly interviews regarding menstruation and if necessary, urine tests. There were no significant differences in pregnancy rates (0.65% for IVD-A, 0 for IVD-B and 0.21% for NSV) among the three groups (P > 0.05). The cumulative rates of complications at the 12th postoperative month were zero, 0.9% and 1.7% in the three groups, respectively. In conclusion, IVD male sterilization exhibits a low risk of long-term adverse events and was found to be effective as a male sterilization method, similar to the NSV technique. IVD male sterilization is expected to be a novel contraceptive method. PMID:24589454

  3. Myths and Fallacies about Male Contraceptive Methods: A Qualitative Study amongst Married Youth in Slums of Karachi, Pakistan

    PubMed Central

    Nishtar, Noureen; Sami, Neelofar; Faruqi, Anum; Khowaja, Shaneela; Farid-Ul-Hasnain

    2013-01-01

    Pakistan presently has one of the largest cohorts of young people in its history, with around 36 million people between the ages of 15 and 24 years. One of the main reasons for high population growth in Pakistan is almost stagnant contraceptive prevalence rate of 30% nationally and 17.4% amongst youth. The study was conducted to explore the perceptions regarding myths and fallacies related to male contraceptive methods among married youth aged 18-24 year in Karachi, Pakistan. Qualitative exploratory study design was adopted and a total of eight Focus Group Discussions (FGDs) were conducted. Study was conducted in two Union Councils of Korangi Town in the squatter settlement of Karachi, Pakistan from July to September 2010. Thematic analysis was done manually. General, physical, sexual, psychological, socio-cultural and religious were the common categories which lead to myths and fallacies related to condoms use and vasectomy among the married youth. The foremost myth amongst male and female youth was that use of both condoms and vasectomy cause impotence in males. Additionally, condoms were thought to cause infections, backache and headache in males. Some youth of the area think that vasectomy is meant for prisoners only. In conclusion our findings suggest that the potential reasons behind low use of male contraceptive methods among youth of squatter settlement of Karachi were myths and fallacies about male contraceptive methods. There are some important policy implications like counseling of the couple through peers and well trained family planning service providers to address these myths and misconceptions from the minds of youth. PMID:23445697

  4. 2016 Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons.

    PubMed

    Hancock, P; Woodward, B J; Muneer, A; Kirkman-Brown, J C

    2016-07-01

    Post-vasectomy semen analysis (PVSA) is the procedure used to establish whether sperm are present in the semen following a vasectomy. PVSA is presently carried out by a wide variety of individuals, ranging from doctors and nurses in general practitioner (GP) surgeries to specialist scientists in andrology laboratories, with highly variable results.Key recommendations are that: (1) PVSA should take place a minimum of 12 weeks after surgery and after a minimum of 20 ejaculations. (2) Laboratories should routinely examine samples within 4 h of production if assessing for the presence of sperm. If non-motile sperm are observed, further samples must be examined within 1 h of production. (3) Assessment of a single sample is acceptable to confirm vasectomy success if all recommendations and laboratory methodology are met and no sperm are observed. Clearance can then be given. (4) The level for special clearance should be <100 000/mL non-motile sperm. Special clearance cannot be provided if any motile sperm are observed and should only be given after assessment of two samples in full accordance with the methods contained within these guidelines. Surgeons are responsible both preoperatively and postoperatively for the counselling of patients and their partners regarding complications and the possibility of late recanalisation after clearance. These 2016 guidelines replace the 2002 British Andrology Society (BAS) laboratory guidelines and should be regarded as definitive for the UK in the provision of a quality PVSA service, accredited to ISO 15189:2012, as overseen by the United Kingdom Accreditation Service (UKAS). PMID:27083211

  5. The contraceptive effect of a novel filtering-type nano-copper complex/polymer composites intra-vas device on male animals.

    PubMed

    Chen, Z-L; Huang, X-B; Suo, J-P; Li, J; Sun, L

    2010-12-01

    Contraceptive techniques which target vas deferens have been paid great attention for their good efficacy, safety and reversibility. We have made a filtering-type intra-vas device (IVD) using nano-copper complex/polymer composites. Twenty male adult Beagle dogs and 40 male rabbits were randomly assigned to four groups (sham-operation, IVD, reversal and vasectomy groups). Dogs' semen parameters, concentration of α-glucosidase, copper and zinc ions were tested pre-operation and 1, 3, 6 and 12 months post-operation. The pregnancy rates of the rabbits were evaluated by mating trials after the IVDs were implanted. The histology of testis, epididymides and vas deferens of the animals was examined using an electron microscope. Apoptosis of the cells in the testes, epididymides and vas deferens was detected by TUNEL method. There was no sperm in the semen of dogs, which had been inserted IVD and vasectomized at 1, 3, 6 and 12 months post-operation. The concentration of α-glucosidase in the IVD group, reversal group and sham-operation group was not significantly different between pre- and post-operation. The pregnancy rates of the female rabbits in the vasectomy, IVD and reversal groups were all zero, but the pregnancy rate in the reversal group, after taking out IVD, and that of the sham-operation group was 60% and 80%, respectively. The ultrastructures of the testes, epididymides and vas deferens of the male animals in the IVD group and sham-operation group were in normal ranges compared with the vasectomy group. The apoptosis of the cells in the testes, epididymides and vas deferens in the vasectomy group of both dogs and rabbits was obvious compared with the other groups. No significant changes in the quantities of copper and zinc ions were found in semen of the male dogs both pre- and post-operation. Our studies demonstrated that the filtering-type nano-copper complex/polymer composites intra-vas device may be an efficacious, safe and reversible male contraceptive

  6. Avian Soft Tissue Surgery.

    PubMed

    Guzman, David Sanchez-Migallon

    2016-01-01

    Basic surgical instrumentation for avian soft tissue surgery includes soft tissue retractors, microsurgical instrumentation, surgical loupes, and head-mounted lights. Hemostasis is fundamental during the surgical procedures. The indications, approach, and complications associated with soft tissue surgeries of the integumentary (digit constriction repair, feather cyst excision, cranial wound repair, sternal wound repair, uropygial gland excision), gastrointestinal (ingluviotomy, crop biopsy, crop burn repair, celiotomy, coelomic hernia and pseudohernia repair, proventriculotomy, ventriculotomy, enterotomy, intestinal resection and anastomosis, cloacoplasty, cloacopexy), respiratory (rhinolith removal, sinusotomy, tracheotomy, tracheal resection and anastomosis, tracheostomy, pneumonectomy) and reproductive (ovocentesis, ovariectomy, salpingohysterectomy, cesarean section, orchidectomy, vasectomy, phallectomy) systems are reviewed. PMID:26611927

  7. Postpartum Care and Contraception in Obese Women.

    PubMed

    Maclean, Courtney C; Thompson, Ivana S

    2016-03-01

    Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women. PMID:26694498

  8. Human robotic assisted bilateral vasoepididymostomy and vasovasostomy procedures: initial safety and efficacy trial

    NASA Astrophysics Data System (ADS)

    Parekattil, Sijo J.; Cohen, Marc S.; Vieweg, Johannes W.

    2009-02-01

    Our goal was to develop a robotic approach for vasoepididymostomy (RAVE) and vasovasostomy (RAVV) using a 4 arm High Definition Platform (Intuitive Surgical, CA) and present our human in-vivo results. All 3 RAVV procedures were successful and one patient had 102 million motile sperm/ml of ejaculate at 1 month post-op. The RAVE procedure patient only had a few non-motile sperm at 6 month follow up in his ejaculate. The use of robotics seems to offer advantages in terms of ergonomics and suture control. Further evaluation is needed to assess the clinical potential of robotics in vasectomy reversal.

  9. Sterilization: A Review and Update.

    PubMed

    Moss, Chailee; Isley, Michelle M

    2015-12-01

    Sterilization is a frequently used method of contraception. Female sterilization is performed 3 times more frequently than male sterilization, and it can be performed immediately postpartum or as an interval procedure. Methods include mechanical occlusion, coagulation, or tubal excision. Female sterilization can be performed using an abdominal approach, or via laparoscopy or hysteroscopy. When an abdominal approach or laparoscopy is used, sterilization occurs immediately. When hysteroscopy is used, tubal occlusion occurs over time, and additional testing is needed to confirm tubal occlusion. Comprehensive counseling about sterilization should include discussion about male sterilization (vasectomy) and long-acting reversible contraceptive methods. PMID:26598311

  10. Sterility: an immunologic disorder?

    PubMed

    Rümke, P; Hekman, A

    1977-09-01

    Immunologic aspects of infertility are discussed. The autoantigenic and isoantigenic nature of spermatozoa is reviewed. Sperm antibodies may form in males by extravasation of spermatozoa following vasectomy and as a result of testicular lesions. Although little is known about the formation of isoantibidies to spermatozoa in females, they may arise as a result of epithelial lesions of the genital tract. Clinical findings of sperm agglutination and immobilizing antibodies in males and sperm antibodies in females in association with infertility are discussed along with some therapeutic approaches. A rare condition, allergy to seminal plasma, is noted. PMID:891061

  11. A feasible ambulatory mini-incision microsurgical vasovasostomy under local anaesthesia using a specially designed double-ringed clamp that simplifies surgery

    PubMed Central

    Moon, Hyun Joon

    2015-01-01

    INTRODUCTION In line with the effort to evaluate feasible surgical options for vasectomy reversal and to increase patients’ willingness to undergo the procedure, this study reported on a technique for ambulatory mini-incision microsurgical vasovasostomy using a double-ringed clamp (i.e. Moon’s clamp). This technique does not require the use of dilators, approximators and other accessory devices. METHODS Ambulatory mini-incision microsurgical vasovasostomy was conducted on 263 patients who satisfied the surgical eligibility requirements for vasovasostomy and the safety criteria for local anaesthesia. The operation time, details on postoperative recovery and results of the postoperative semen analysis were recorded and retrospectively analysed. RESULTS The mean time used to isolate the bilateral vas deferens was 25.5 minutes. All patients were discharged on the day of surgery and all patients returned to their normal activities within 24–48 hours after surgery. No haematoma or infection occurred except in one patient. Postoperative semen analysis showed that the surgery was successful in 182 (96.8%) of the 188 patients who complied with the postoperative patient instructions. CONCLUSION Ambulatory mini-incision microsurgical vasectomy reversal using Moon’s clamp and under local anaesthesia is a surgically feasible option that offers the advantages of a low-risk operation. It also achieves successful vasovasostomy without other accessory devices and allows patients to return to their daily activities quickly with minimal complications. PMID:25502335

  12. Optical coherence tomography vs. high-frequency ultrasound during noninvasive laser coagulation of the canine vas deferens

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Allaf, Mohamad E.; Fried, Nathaniel M.

    2012-02-01

    A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. In this study, optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in 6 dogs (n=12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy.

  13. Consequences of autoimmunity to sperm antigens in vasectomized men.

    PubMed

    Anderson, D J; Alexander, N J

    1979-12-01

    The development by a large percentage of vasectomized men of sperm autoantibodies is discussed in this monograph chapter. The production of anti-sperm antibodies is attributed to: 1) granuloma formation; 2) increased permeability of epithelial barriers in the rete testis and epididymis; and 3) transport of phagocytic cells to regional lymph nodes. Individual variation in type of antibodies and response to antibody production is documented and is thought to depend on such factors as rate of sperm production, the structure of the blood-testis barrier, surgical technique, and expression of immune response genes. Morphological changes in spermatozoa and testes occurring after vasectomy may be induced by immunological mechanisms. Tests of cell-mediated immunity to sperm antigens are described, and more accurate tests are needed. Animal studies provide evidence that chronic immune stimulation can result in formation of circulating immune complexes, resulting in deleterious systemic effects, including damage to kidneys, blood vessels, and cells of the immune system. Further studies of the autoimmune orchitis phenomenon may aid in avoidance of immunologically mediated side effects of vasectomy. PMID:92384

  14. Evaluation of Canada goose sterilization for population control.

    USGS Publications Warehouse

    Converse, Kathryn A.; Kennelly, James J.

    1994-01-01

    We evaluated the vasectomy of 72 male Canada geese as a method to control growing populations of nuisance geese in Westchester County, New York. Thirty-three of the vasectomized males paired with a female and were located during ≥1 breeding seasons; 7 treated males were not seen following surgery. The remaining 32 males were never observed paired with a female during the breeding season. Of 56 nesting attempts by the 33 pairs in ≥1 breeding seasons, 84% of the nests were unsuccessful. Fidelity to nest sites during the second and third breeding seasons occurred for 17 of the 18 vasectomized males and their females that were observed for ≥2 seasons. The results suggest that male sterilization may reduce productivity of nuisance Canada geese providing one carefully selects areas and flocks suitable for this type of control.

  15. Surgical sterilization of free-ranging wolves.

    PubMed Central

    Spence, C E; Kenyon, J E; Smith, D R; Hayes, R D; Baer, A M

    1999-01-01

    The objective of the study was to determine whether surgical sterilization of both males and females in wolf pairs alters basic wolf social and territorial behaviors. Wolves were located from the air by snow-tracking methods and were tranquilizer-darted from a helicopter. Surgeries were performed either in a tent at the capture site or in a heated building in a nearby village. Six vasectomies and seven uterine horn ligations were performed in January and February of 1996 and 1997. Two females died: one likely related to the capture procedure, the other of a peritonitis unrelated to the surgery. One wolf had a litter. None of the wolves have shown changes in behavioral patterns. Surgical sterilization can be effective, but other, less invasive, fertility control techniques should be investigated. PMID:10065320

  16. Achievements of the Iranian family planning programmes 1956-2006.

    PubMed

    Simbar, M

    2012-03-01

    Family planning programmes initiated in the Islamic Republic of Iran from 1966 met with limited success. Following the 1986 census family planning was considered a priority and was supported by the country's leaders. Appropriate strategies based on the principles of health promotion led to an increase in the contraceptive prevalence rate among married women from 49.0% in 1989 to 73.8% in 2006. This paper reviews the family planning programmes in the Islamic Republic of Iran and their achievements during the last 4 decades and discusses the principles of health promotion and theories of behaviour change which may explain these achievements. Successful strategies included: creation of a supportive environment, reorientation of family planning services, expanding of coverage of family planning services, training skilled personnel, providing free contraceptives as well as vasectomy and tubectomy services, involvement of volunteers and nongovernmental organizations and promotion of male participation. PMID:22574484

  17. Exploratory rigid laparoscopy in an African elephant (Loxodonta africana).

    PubMed

    Sweet, Julia; Hendrickson, Dean A; Stetter, Mark; Neiffer, Donald L

    2014-12-01

    In March 2009, a 25-yr-old captive female African elephant (Loxodonta africana) underwent an exploratory laparoscopy after several weeks of diarrhea, submandibular and ventral edema, and swelling on medial and lateral aspects of all feet. Although there have been recent advances in laparoscopic vasectomies in free-ranging African elephants in South Africa utilizing specially designed rigid laparoscopes and insufflation devices, this was the first attempt at using these same techniques for an exploratory purpose. The elephant was sedated in a static restraint chute and remained standing for the duration of the procedure. Laparoscopy provided visibility of the dorsal abdomen, enabled collection of reproductive tract biopsies and peritoneal fluid samples, and allowed for instillation of antibiotics and crystalloid fluids directly into the abdominal cavity. Abdominal exploration, collection of tissue samples, and local therapy is possible via standing laparoscopy in megavertebrates. PMID:25632688

  18. Cost-effectiveness of levonorgestrel subdermal implants. Comparison with other contraceptive methods available in the United States.

    PubMed

    Ashraf, T; Arnold, S B; Maxfield, M

    1994-10-01

    The objective of this analysis was to evaluate and compare the cost-effectiveness of eight contraceptive methods: condoms, diaphragms, oral contraceptives, intrauterine devices, medroxyprogesterone acetate suspension, levonorgestrel subdermal implants, tubal ligation and vasectomy. Based on a comprehensive review of the literature and various additional data sources, this analysis identified, measured and compared direct costs of the methods, physician visits, treatment of adverse effects and cost of failure (i.e., mean cost for all types of deliveries or first-trimester abortion). Medical benefits (if any) resulting from each contraceptive method were calculated and considered in the analysis as cost savings. The cost of method failure proved to be the greatest influence on cost-effectiveness. Sterilization was identified as the most cost-effective method overall. Of the reversible methods, the intrauterine device was found to be the most cost-effective, followed by levonorgestrel implants. PMID:7837126

  19. Social and Logistical Barriers to the Use of Reversible Contraception among Women in a Rural Indian Village

    PubMed Central

    Hall, Mary Ann Kirkconnell; Stephenson, Rob B.; Juvekar, Sanjay

    2008-01-01

    Women in a small coastal village in western India were asked to explain their preference for female sterili-zation over modern reversible contraceptive methods. Married women aged 19+ years were interviewed in six focus groups (n=60) and individually (n=15) regarding contraceptive methods and their use and side-effects. Women publicly denied contraceptive use but privately acknowledged limited use. They obtained contraceptive information from other village women and believed that modern reversible methods and vasectomy have high physical and social risks, and fertility goals could be achieved without their use. Women felt that reversible contraception is undesirable, socially unacceptable, and usually unnecessary, although the achievement of fertility goals is likely due to the use of female sterilization with abortion as a back-up method. Economic migration of village men may also play a role. Although women with high social capital can effectively disseminate correct knowledge, the impact on the uptake of reversible method is uncertain. PMID:18686557

  20. [Urological diseases most frequently involved in medical professional liability claims].

    PubMed

    Vargas-Blasco, César; Gómez-Durán, Esperanza L; Arimany-Manso, Josep; Pera-Bajo, Francisco

    2014-03-01

    Clinical safety and medical professional liability are international major concerns, especially in surgical specialties such as urology. This article analyzes the claims filed at the Council of Medical Colleges of Catalonia between 1990 and 2012, exploring urology procedures. The review of the 173 cases identified in the database highlighted the importance of surgical procedures (74%). Higher frequencies related to scrotal-testicular pathology (34%), especially testicular torsion (7.5%) and vasectomy (19.6%), and prostate pathology (26 %), more specifically the surgical treatment of benign prostatic hyperplasia (17.9%). Although urology is not among the specialties with the higher frequency of claims, there are special areas of litigation in which it is advisable to implement improvements in clinical safety. PMID:24913755

  1. Robotic instrumentation: Evolution and microsurgical applications

    PubMed Central

    Parekattil, Sijo J.; Moran, Michael E.

    2010-01-01

    This article presents a review of the history and evolution of robotic instrumentation and its applications in urology. A timeline for the evolution of robotic instrumentation is presented to better facilitate an understanding of our current-day applications. Some new directions including robotic microsurgical applications (robotic assisted denervation of the spermatic cord for chronic orchialgia and robotic assisted vasectomy reversal) are presented. There is a paucity of prospective comparative effectiveness studies for a number of robotic applications. However, right or wrong, human nature has always led to our infatuation with the concept of using tools to meet our needs. This chapter is a brief tribute to where we have come from and where we may be potentially heading in the field of robotic assisted urologic surgery. PMID:21116362

  2. AB031. Challenge of microsurgery for male infertility in China

    PubMed Central

    Yuan, Yiming; Xin, Zhongcheng

    2016-01-01

    There are more than 15% couples suffer from infertility within 1 year. One in eight couples encounters problems when attempting to conceive a first child and one in six when attempting to conceive a subsequent child. The causes of infertility both of male and female could share 50%. With the recent advances in assisted fertilization such as in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), the couples suffer from infertility would like to choose assisted fertilization and nearly 1 million cycles ICSI were carried out in China every year, even its pregnancy rate 40% and live birth rate 35%, with very costed and with risks of inherent and born defects. Among of male factors of infertility, varicoceles are highly relevant (38%) and can result in a myriad of deleterious effects on male reproduction. Varicocele repair may be effective in men with subnormal semen analysis, a clinical varicocele and otherwise unexplained infertility. Numerous therapeutic options are available for correcting varicoceles, including surgical varicocelectomy and radiographic venous embolization. However, recent studies demonstrated that microsurgery for varicocele correction, with the lowest recurrence rate and the highest pregnancy rate compared with other surgical approaches, is a more cost-effective therapeutic modality than both assisted fertility for in infertility couples and it is safe and effective compared to the others surgical approaches. Obstructive azoospermia (OA) are highly prevalent (13%) in male infertility results from obstruction of the excurrent ducts (due to many causes) at any location between the rete testis and the ejaculatory ducts. Recent advances in microsurgical approaches with reversal rate 63.8–79.2%, pregnancy rate 30.6–35.8%. According to the calculations of cost per delivery for vasectomy reversal vs. sperm retrieval/ICSI, under a wide variety of initial assumptions, it is clear that vasectomy reversal/epididymovasostomy is associated

  3. A dynamic family planning and health campaign.

    PubMed

    1986-11-01

    Any successful development program that combines family planning, nutrition, and parasite control such as the integrated project, must include effective information, education, and communication (IEC) components. The Population an Community Development Association (PDA), the largest nonprofit organization in Thailand provides a network of family planning service delivery composed of volunteer distributors including midwives, school techers and shopkeepers. Reliability and accessibility are the 2 important elements. A concerted media campaign which exposes people to condoms and other contraceptives helps desensitize an otherwise "too personal" issue. The problem which confronts family planning communication is how to counteract the sensuous messages form advetisers while focusing on mundane topics such as maternal and child health, responsible parenthood, and family budgets. The PDA has tried to use the same attractions to promote family planning. It distributes promotional items such as T-shirts, pens towels and cigarette lighters bearing family planning messages. In addition to the use of television and radio, PDA also utilizes every possible channel of communication. Approaches include: the Youth-to-Youth Program; informational exhibits; video-mobile vans which visit schools and factories; and the holding of PDA's vasectomy festivals. Informational exhibits on family planning and health care use a variety of audio-visual methods. Video is an effective communication medium. The PDA video material ordinarily consists of family dramas illustrating good and bad family planning practices. By holding vasectomy festivals, PDA provides a media-attracting forum to educate the public and promote vasectomey as the most effective birth control method. Mass media campaigns must be linked with fieldwork outreach. PMID:12314464

  4. Iran rebuilds family planning services.

    PubMed

    Butta, P

    1993-07-01

    After the revolution, the Islamic Republic of Iran instituted pronatalist policies which included lowering the minimum marriage age for girls to 9 years, abolishing some laws securing women's rights, and limiting availability of family planning (FP) services. By 1983, Iran's population growth rate was 3.9% which was among the highest worldwide. Before the revolution, Iran had 37 million people. About 2 million more people were added each year, resulting in a population size of 60 million by 1992. By the mid-1980s, economic development stood idle, there were not enough houses, children attended schools on 3 shifts, and malnutrition was spreading. In 1989, the government formed a population council and reestablished FP services. It also increased the minimum age of marriage for girls to 13 years, slightly improved women status, and eliminated fertility incentives for couples with at least 4 children. It also significantly increased funding for FP (from 560 million to 13 billion rials between 1990 and 1992). Government spending for FP will likely increase 2% annually until 2011. The government initiated a promotion of FP mass media campaign, emphasizing a 2-child family. Some posters showed a family with 2 girls. The mass media campaign promoted specific contraceptive methods (even tubal occlusion and vasectomy), a practice other Middle Eastern countries not do. 80% of sterilization acceptors claimed to learn about sterilization from the radio or newspapers. The Ministry of Health has invited the Association for Voluntary Surgical Contraception (AVSC) to help with its campaign to update sterilization techniques, including the non scalpel vasectomy technique. AVSC hopes to become even more involved in helping Iran update its national FP program. PMID:12318289

  5. Mass media and behavior change: hand in hand.

    PubMed

    1992-01-01

    Since the early 1980s, Johns Hopkins University's Population communication Services has conducted evaluations of mass media campaigns in developing countries which communications personnel have designed to change health and sex behavior. The mass media campaigns involved relaying health and family planning information via radio, television, and pamphlets. The evaluations showed that these campaigns were an effective technique to promote behavior change, e.g. they have boosted demand for contraceptives, condom sales, clinic visits, and inquiries to hotlines. A 6-part television drama incorporating health and family planning into its storyline stimulated behavior change in Pakistan in 1991. 36% of people surveyed after the drama series said they would limit the number of children they would have. 44% planned to improve communication with their spouse. An amusing television promotion in Brazil which ran for 6 months in the late 1980s prompted 58% of new clinic patients in 1 town to seek a vasectomy. 1 clinic experienced an 81% increase in vasectomies. A 6-month campaign to promote condom use in Colombia in 1988-89 resulted in a 75% rise in condom sales. In the mid 1980, a 6-9 month mass media popular music campaign (2 songs and videos disseminated via television, radio, and print materials) in Mexico and Latin America strove to encourage youth to be responsible for their sexual behavior. During the campaign, an adult counseling center received an 800% increase in letters (50-450 letters/month). 4 radio and 5 television spots promoting health and family planning in Kwara State, Nigeria in 1984-87 increased family planning acceptors 500% from 258 to 1526 in the 7 existing clinics. Other successful campaigns took place in the Philippines, Zimbabwe, Indonesia, Turkey, Bolivia and Honduras. PMID:12285445

  6. Increasingly artful. Applying commercial marketing communication techniques to family planning communication.

    PubMed

    Williams, J R

    1992-08-01

    Family planning (FP) and social marketing messages must utilize the rules concerning artfulness developed in the private sector for effective communication in the mass media around the world. They have to compete for the attention of television program viewers accustomed to receiving hundreds of 30-second messages. There are some rules essential to any effective communication program: 1) Command attention. In the US over 1350 different mass media messages vie for attention every single day. FP messages are sensitive, but dullness and passivity is not a requisite. 2) Clarify the message, and keep it simple and direct. Mixed messages equal less effective communication. 3) Communicate a benefit. Consumers do not only buy products, they buy expectations of benefits. 4) Consistency counts. The central message should remain consistent to allow the evaluation of its effectiveness, but execution should vary from time to time and medium to medium. 5) Cater to the heart and the head. Effective communication offers real emotional values. 6) Create trust. Words, graphics, sounds, and casting in the campaign should support 1 central key promise to a single prime prospect. 7) Call for action. Both commercial and social marketing campaigns can calculate results by quantifiable measurement of sales (of condoms) transactions (the number of IUD insertions), floor traffic (clinic visits), attitude shifts, and behavior change. The PRO-PATER Vasectomy Campaign of 1988 in Sao Paulo, Brazil successfully used the above rules for effective communication. During the 1st 2 months of the campaign, phone calls increased by over 300%, new clients by 97%, and actual vasectomies performed by 79%. PMID:12343901

  7. Analysis of the pathogenetic basis for shedding and transmission of ovine gamma herpesvirus 2.

    PubMed

    Hüssy, Daniela; Janett, Fredi; Albini, Sarah; Stäuber, Norbert; Thun, Rico; Ackermann, Mathias

    2002-12-01

    Ovine herpesvirus 2 (OvHV-2), a member of the viral subfamily Gammaherpesvirinae, shares numerous similarities with human herpesvirus 8 (HHV-8). Both viruses are apathogenic in their healthy original host, may cause lymphoprolipherative diseases, cannot routinely be propagated in cell culture, and may be sexually transmitted. However, the pathways of sexual transmission of these viruses, as well as the underlying pathogenetic dynamics, are not well understood. Organs from naturally OvHV-2-infected, as well as OvHV-2-free, sheep were quantitatively analyzed for OvHV-2 by the DNA amplification techniques. The dynamics of OvHV-2 multiplication and excretion were monitored after experimental infections and, most importantly, subsequent to vasectomy. The OvHV-2 DNA load in various tissues and internal organs was not merely reflecting the viral DNA load in the bloodstream, which suggested compartmentalization of OvHV-2. Moreover, OvHV-2 DNA was detected at several portals for virus shedding, i.e., the respiratory, alimentary, and urogenital tracts. Transient OvHV-2 excretion was detected in ejaculates of experimentally infected rams. Upon vasectomy, OvHV-2 DNA reappeared in the ejaculatory plasma, but the titers did not decline after reaching a peak. Spiking and fractionation experiments revealed an inhibitory activity, associated with the spermatozoa, which was able to suppress detection of viral DNA but which was no longer present in samples from vasectomized animals. Therefore, epidemiological studies on viruses that may be transmitted by the ejaculatory pathway and for whose tracing nucleic acid amplification methods are used, i.e., OvHV-2, HHV-8, and the human immunodeficiency virus, should include vasectomized males. PMID:12454175

  8. Analysis of the Pathogenetic Basis for Shedding and Transmission of Ovine Gamma Herpesvirus 2

    PubMed Central

    Hüssy, Daniela; Janett, Fredi; Albini, Sarah; Stäuber, Norbert; Thun, Rico; Ackermann, Mathias

    2002-01-01

    Ovine herpesvirus 2 (OvHV-2), a member of the viral subfamily Gammaherpesvirinae, shares numerous similarities with human herpesvirus 8 (HHV-8). Both viruses are apathogenic in their healthy original host, may cause lymphoprolipherative diseases, cannot routinely be propagated in cell culture, and may be sexually transmitted. However, the pathways of sexual transmission of these viruses, as well as the underlying pathogenetic dynamics, are not well understood. Organs from naturally OvHV-2-infected, as well as OvHV-2-free, sheep were quantitatively analyzed for OvHV-2 by the DNA amplification techniques. The dynamics of OvHV-2 multiplication and excretion were monitored after experimental infections and, most importantly, subsequent to vasectomy. The OvHV-2 DNA load in various tissues and internal organs was not merely reflecting the viral DNA load in the bloodstream, which suggested compartmentalization of OvHV-2. Moreover, OvHV-2 DNA was detected at several portals for virus shedding, i.e., the respiratory, alimentary, and urogenital tracts. Transient OvHV-2 excretion was detected in ejaculates of experimentally infected rams. Upon vasectomy, OvHV-2 DNA reappeared in the ejaculatory plasma, but the titers did not decline after reaching a peak. Spiking and fractionation experiments revealed an inhibitory activity, associated with the spermatozoa, which was able to suppress detection of viral DNA but which was no longer present in samples from vasectomized animals. Therefore, epidemiological studies on viruses that may be transmitted by the ejaculatory pathway and for whose tracing nucleic acid amplification methods are used, i.e., OvHV-2, HHV-8, and the human immunodeficiency virus, should include vasectomized males. PMID:12454175

  9. Awareness, attitude and action about family planning in villages in Maharashtra.

    PubMed

    Patil, P S; Ingle, V N; Patil, V P

    1977-10-01

    A study undertaken in a randomly selected village with a population of 695, a majority of whom were agriculturalists or laborers living in huts or mud houses. All couples in the reproductive age group (125) were interviewed in their homes, husbands and wives separately. Couples belonged to Hindu, Muslim, and Scheduled Caste groups. Of the 250 respondents, 120 were literate. About 96% were aware that births could be prevented, with vasectomy and tubectomy the best known methods. Nearly all the respondents gave friends and relatives as the source of their information; family planning workers and posters were given as the source by less than 1/2. 86% of thoce aware of contraceptive methods found family planning acceptable, most expressing the idea that a small family was easier to raise. All of the 14% opposed to family planning were Muslims whose opposiition stemmed from their religious beliefs. 44 of the couples had adopted family planning -- 24 husbands having had vasectomies and 20 of the wives tubectomies. The reasons most often given for not accepting family planning were desire for more chidlren and fear of complications. Of the sterilized respondents, a large number of the men complained of side effects, and 5 of the women complained of excessive bleeding. All of those who expressed complaints said they would not recommend the operation. It is concluded that while awareness of family planning is at an acceptable level, the problem is to make family planning itself acceptable. 1 recommendation is that sterilized couples should receive special medical attention to make their experiences more positive. PMID:12278139

  10. A Reproductive Management Program for an Urban Population of Eastern Grey Kangaroos (Macropus giganteus).

    PubMed

    Tribe, Andrew; Hanger, Jon; McDonald, Ian J; Loader, Jo; Nottidge, Ben J; McKee, Jeff J; Phillips, Clive J C

    2014-01-01

    Traditionally, culling has been the expedient, most common, and in many cases, the only tool used to control free-ranging kangaroo populations. We applied a reproductive control program to a population of eastern grey kangaroos confined to a golf course in South East Queensland. The program aimed to reduce fecundity sufficiently for the population to decrease over time so that overgrazing of the fairways and the frequency of human-animal conflict situations were minimised. In 2003, 92% of the female kangaroos above 5 kg bodyweight were implanted with the GnRH agonist deslorelin after darting with a dissociative anaesthetic. In 2007, 86% of the females above 5 kg were implanted with deslorelin and also 87% of the males above 5 kg were sterilised by either orchidectomy or vasectomy. In 2005, 2008 and 2009, the population was censused to assess the effect of each treatment. The 2003 deslorelin program resulted in effective zero population growth for approximately 2.5 years. The combined deslorelin-surgery program in 2007 reduced the birth rate from 0.3 to 0.06%/year for 16 months, resulting in a 27% population reduction by November 2009. The results were consistent with implants conferring contraception to 100% of implanted females for at least 12 months. The iatrogenic mortality rates for each program were 10.5% and 4.9%, respectively, with 50% of all mortalities due to darting-related injuries, exertional myopathy/hyperthermia or recovery misadventure. The short term sexual and agonistic behaviour of the males was assessed for the 2007 program: no significant changes were seen in adult males given the vasectomy procedure, while sexual behaviours' were decreased in adult males given the orchidectomy procedure. It is concluded that female reproduction was effectively controlled by implantation with deslorrelin and male reproductive behaviour was reduced by orchidectomy, which together achieved population control. PMID:26480325

  11. Comparison of vasovasostomy techniques in rats utilizing conventional microsurgical suture, carbon dioxide laser, and fibrin tissue adhesives.

    PubMed

    Ball, R A; Steinberg, J; Wilson, L A; Loughlin, K R

    1993-05-01

    An evaluation of vas reanastomoses in rats comparing suture only, carbon dioxide (CO2) laser-assisted, and fibrin-based tissue adhesive was performed in our laboratory. A cohort of 60 known fertile male Sprague Dawley rats initially underwent lower midline abdominal exploration and transection of their vas deferens bilaterally, followed by immediate microsurgical vasovasostomy by one of the three experimental methods. All groups initially had the severed vasa ends coapted by two or three transmural (mucosa through serosa) sutures of 10-0 nylon under an operating microscope. The conventionally sutured group had an additional four to six nylon 10-0 sutures placed externally in the serosa only to complete the anastomosis. The CO2 laser-assisted group underwent laser welding with denaturation of the serosa to seal the anastomosis. A fibrin-based tissue adhesive, produced by combining human cryoprecipitate and thrombin, was placed topically over the coapted vas ends to seal the anastomosis in the third group. Postoperative evaluation revealed similarities among the three surgical groups with the fibrin-based tissue adhesive group resulting in the highest patency rate (89%) and pregnancy rate (85%) as well as the lowest granulation rate (18%) and shortest operative time (27 minutes). The laser-assisted group resulted in the lowest pregnancy rate (68%), while the sewn anastomosis group had the lowest patency rate (76%). Both laser-assisted and conventionally sewn vasectomy reversals required significantly longer operative time (39 and 46 minutes, respectively) compared with the fibrin-based tissue adhesive-assisted procedures (p < 0.01). This study provides evidence that alternative microsurgical techniques may be utilized to perform uncomplicated, expeditious, and successful vasectomy reversals. PMID:8488619

  12. [The problem of overpopulation in Asia].

    PubMed

    Knaus, J P

    1981-06-01

    The relation between medicine and overpopulation is seen in the following: 1) achievements in medicine have decreased mortality leading to population explosion, 2) lack of food supply leads to deficiency diseases, and 3) starvation and overpopulation leads to the social diseases of unemployment and poverty. Population control can be achieved by medical methods of contraception. Japan's overpopulation is contrasted with that of India. In Japan the standard of living is high and food supply adequate because Japan's technological products are exported and food imported. The mostly rural areas of India promote families with many children. The available farmland is not sufficient for all family members. Growing children seek occupations in the cities leading to slum conditions and great poverty and misery as exemplified by Calcutta. In Europe there is a mostly balanced population because industrialization counteracts population growth. Too many children are a financial burden to the parents and the getting of children is prevented by contraception and/or abortion. In developing countries this balance is not yet achieved; industrialization lags behind the application of medical technology which promotes population explosion. To counteract this, medical methods of contraception must be used. In India with an annual population growth of 2.1% (this would lead to a population of 1.17 billion by the year 2008) this control would be best achieved through tubal ligation and/or vasectomy. There is little motivation for other methods in family planning because of the attitude toward poverty and hardship. To achieve a shrinking of their population, vasectomy (easier and less hazardous than tubal ligation) should be performed after the 2nd child. This, obviously, would need a national well-organized, program and a change in attitude of India's inhabitants. If not, the future might lead to rebellion by the poor and starving masses; civil war might break out and thus decimate the

  13. Stiff upper lips.

    PubMed

    Snyder, J D

    1991-01-01

    In an interview with Family Planning World, Helen Axby of the Marie Stopes Clinics explains that the organization's growth at a time when the number of abortions in Great Britain has begun to decline is due to successful management and marketing. Although the British government provides from abortion services, the Marie Stopes Clinics performs over 25,000 abortions a year. According to Axby, the main reason for this is that government restrictions have created a cumbersome process where women often wait 3-4 weeks to receive an abortion. At the Stopes clinics, women receive prompt treatment in a comfortable setting. A consultation is scheduled within a day or two following the initial phone call, and the operation is scheduled at the woman's convenience. Axby explains that the organization conducts extensive advertisement in the Yellow Pages, local newspapers, and women's magazines. Though the clinic operates for profit, its services are far less expensive than what it would cost to obtain them at other private offices. In 1990, the organization grossed about 6.2 million pounds (profits were around 1 million pounds). The profits are used to fund overseas projects. Because of the decline in the number of abortions in Britain, Axby expects the organization to earn less this year. However, Marie Stopes clinics plans to fight to increase its market share of family planning services. Its fastest growing service is vasectomy. Relying on the noninvasive bipolar diathermy technique, the Stopes Clinics have made vasectomy a more simple and comfortable experience for men. Other services include employee screening (for pap smears, breast checks, etc.). Finally, Axby says that the organization might also increase its market share by acquiring its competitors. PMID:12284512

  14. Relative suitability of DMSO and NaHCO3 for reversal of RISUG® induced long-term contraception.

    PubMed

    Ansari, A S; Hussain, M; Khan, S R; Lohiya, N K

    2016-03-01

    Among the vas-based methods on trial, reversible inhibition of sperm under guidance (RISUG(®) ), a co-polymer of styrene and maleic anhydride is being projected as an effective alternative to No Scalpel Vasectomy. RISUG offers long-term contraception with safety, efficacy in human trials and can be delivered by no-scalpel injection. Currently, the procedure is under phase-III clinical trial. However, reversal of this vas-based drug-induced contraception needs to be established in animal models prior to clinical trials to ensure its claim as an effective alternative for vasectomy. In the present investigation, the relative suitability of dimethyl sulphoxide (DMSO) and NaHCO3 for RISUG induced long-term vas occlusion reversal was carried out in albino rats. Animals were allocated into four groups (n = 10), viz., sham-operated control (group-I), vas occlusion with RISUG for 360 days (group-II), vas occlusion with RISUG for 360 days and reversal with DMSO (group-III) and vas occlusion with RISUG for 360 days and reversal with NaHCO3 (group-IV). A variable response in fertility was observed in different groups. Absolute sterility in group III at all mating intervals, while, zero percent fertility in groups II and IV following 90 days of occlusion was observed. Following reversal restoration of fertility with DMSO at 45 days, whereas, reversal by NaHCO3 at 30 days was noticed. Ejaculated spermatozoa of RISUG injected and initial intervals of reversed animals exhibited various degrees of abnormalities. The testes exhibited focal degeneration in vas occluded animals. The occluded lumen of the vas deferens contained an eosinated polymer with exfoliated epithelium. Following vas occlusion reversal, a complete regeneration in the vas epithelium was seen. All other parameters remained unaltered. The reversal with NaHCO3 resulted into an early resumption of fertility when compared with DMSO and the procedure found to be successful, feasible and safe up to F1 generation. Thus

  15. A look at a successful fee-charging urban project.

    PubMed

    Traitongyoo, T

    1985-10-01

    Bangkok's fee-charging Integrated Family Planning and Parasite Control Program (FPPC) is implemented by the Population and Community Development Association (PDA) and has grown from serving 36 schools and raising about US$1500 in 1976 to serving 231 schools and 200 factories and raising over US$75,000 in 1984. In addition to promoting health, the program aims at instilling a lifetime commitment to sensible health and family practices in the community. This urban program has been implemented in conjunction with a rural FPPC program through the financial and technical support of JOICFP, since 1976. Prior to that, PDA provided only family planning services. PDA is currently Thailand's largest private, non-profit organization involved in health care, appropriate technology, refugee assistance, water supply, agricultural marketing, as well as family planning and parasite control. The FPPC program works to mobilize the community to offer its support. Community involvement begins with the management of the program. Another community involvement comes from medical professionals from the local medical university who participate in the program for a fraction of their fees. Community-based family planning volunteers distribute contraceptives throughout their areas. The community also actively supports the FPPC program financially by paying fees. To communicate the benefits that people can derive from the services it offers, Bangkok's Urban FPPC program utilizes sophisticated marketing techniques such as advertising, direct mail, and a variety of public relations efforts. Family planning is publicly promoted in vasectomy festivals held each year throughout Bangkok. Married men are offered vasectomies free of charge if they have had 2 or more children. Exhibitions on parasite control and other health-related topics are also featured together with the sale of promotional items. Many of the program's activities have become major media events. Much of the credit is due to the

  16. Voluntary sterilization in North Tyneside.

    PubMed

    Carnegie-Smith, K

    1984-04-01

    Since 1975, sterilization operations, on both men and women have been performed with increasing frequency within the National Health Service in the North Tyneside Area in northeast England. A prospective study was undertaken to discover some of the reasons why healthy young men and women chose surgical sterilization rather than use the established reversible methods of family planning available to them. The study examined some of the characteristics of those requesting sterilization, attempted to understand why they did so at that particular time, and assessed the patient-perceived morbidity resulting from this elective procedure. The study population included all individuals referred for consultation following the patient's request for voluntary sterilization by vasectomy or occlusive tubal surgery, during the period of 1 year (August 1, 1980-July 31, 1981). Women sterilized in association with a pregnancy outcome were not included in the study. Data on pregnancies and sterilizations in North Tyneside demonstrate a rapid increase in requests for vasectomy after 1975. Patients requesting sterilization were admitted to the study during the initial out-patient appointment with their surgeon. Couples seeking sterilization show similar age range for men (mean 34.2) and women (33.1). The proportion of patients who were not married at the time of the operation is perhaps a reflection of doctors' increasing willingness to perform sterilizations on the unmarried, and of individuals to seek such surgery in a committed manner. The increasing tendency for requests to be received from people still in their early 20s is seen as a problem. Data indicates that married people who request the operation at an early age are also those who were married under age 21, started a family immediately and with a 25% divorce rate. At the other end of the age range, couples who ahve been sucessfully using oral contraceptives have become concerned about its safety, especially after age 35. Data

  17. Contraception, pregnancy, childbirth--when things go wrong.

    PubMed

    Samuels, A

    1986-01-01

    This discussion of contraception, pregnancy, and childbirth covers the following: accepting and discharging patients; legal duty of care; contract law; consent; records; time limit; criminal law; sanctions; children under 16; contraception; failed sterilization, vasectomy, and abortion; abortions; pregnancy; delivery; postnatal care; birth at home; and unqualified persons. The relationship of the doctor to the private patient is governed by the law of contract and in a particular case may impose a greater duty on the doctor than that imposed by tort. The doctor must obtain the consent of the patient and must adhere to the proper standards of competent professional practice, either the generally accepted practice or, if there are 2 or more alternative procedures, one which can be professional supported. Where sterilization (tubal occlusion) is proposed, advice and counseling should be offered. On the birth of a child, drugs may not be administered without the mother's consent. The records of the National Health Service patient appear to belong to the Secretary of State for Social Services and the records of the private patient to the patient. The patient may sue within 3 years from the date of the alleged negligence or the discovery of the negligence. The doctor is most unlikely to be prosecuted for a criminal offense but failure to attend the patient, or gross carelessness, could possibly lead to a manslaughter charge. The Family Practitioner Committee may give a warning, a reprimand, and may stop the payment of fees. The doctor may give contraceptive advice and treatment to an adolescent female under age 16, but the doctor must first conform to 5 guidelines, known as the Fraser Guidelines. These guidelines are listed. The doctor must be aware of the possible risks and side effects of the various contraceptive methods and must evaluate each method and each patient accordingly. A doctor may be liable under the law of contract for a failed sterilization, vasectomy

  18. A Reproductive Management Program for an Urban Population of Eastern Grey Kangaroos (Macropus giganteus)

    PubMed Central

    Tribe, Andrew; Hanger, Jon; McDonald, Ian J.; Loader, Jo; Nottidge, Ben J.; McKee, Jeff J.; Phillips, Clive J. C.

    2014-01-01

    Simple Summary We designed a programme to control free-ranging kangaroos on a Queensland golf course, using contraceptive implants in females and vasectomisation or testicle removal in males. This reduced the numbers of pouch young to about one half of pre-intervention levels and controlled the population over a 2–4 year period. However, the necessary darting caused a mortality rate of 5–10% of captured animals, mainly due to complications before and after anaesthesia. It is concluded that population control is possible but careful management of kangaroos around the time of anaesthesia induction and recovery is important in such programmes to minimise losses. Abstract Traditionally, culling has been the expedient, most common, and in many cases, the only tool used to control free-ranging kangaroo populations. We applied a reproductive control program to a population of eastern grey kangaroos confined to a golf course in South East Queensland. The program aimed to reduce fecundity sufficiently for the population to decrease over time so that overgrazing of the fairways and the frequency of human–animal conflict situations were minimised. In 2003, 92% of the female kangaroos above 5 kg bodyweight were implanted with the GnRH agonist deslorelin after darting with a dissociative anaesthetic. In 2007, 86% of the females above 5 kg were implanted with deslorelin and also 87% of the males above 5 kg were sterilised by either orchidectomy or vasectomy. In 2005, 2008 and 2009, the population was censused to assess the effect of each treatment. The 2003 deslorelin program resulted in effective zero population growth for approximately 2.5 years. The combined deslorelin–surgery program in 2007 reduced the birth rate from 0.3 to 0.06%/year for 16 months, resulting in a 27% population reduction by November 2009. The results were consistent with implants conferring contraception to 100% of implanted females for at least 12 months. The iatrogenic mortality rates for each

  19. Men and family planning: toward a policy of male involvement.

    PubMed

    Pillai, V K; Kelley, A C

    1994-01-01

    The stated aim of this discussion is to examine the extent of male use of family planning and the nature of men's role in family planning in developing countries. Case studies are presented which are successful examples of strategies for involving men in family planning. Policies that aim to increase male involvement must be sensitive to cultural values, apply to a decentralized government approach toward information and supplies, include adequate political will, and consider the costs and benefits of changing values. A male family planning policy would not always be compatible with all fertility values in developing countries or traditional values of the older population. A policy should stress the value of male individuals contributing as much as possible for their own and others' welfare. Community participation is considered important in order to create a feeling of mutual support. A sizeable investment will be required for mass distribution of contraceptive information. Schools are viewed as an ideal place for educating youth about the problems of high fertility and about use of family planning methods, such as the condom. Religious organizations should be used to educate people about responsible parenthood and to minimize barriers to use of modern contraception. Comic books on how to use condoms are suggested as a good source. Local authorities who are trusted are useful in influencing acceptance among local populations. Local personnel may be trained as information disseminators. Adequate contraceptive information needs to be supplied to a wide audience. Lack of supply and inadequate information are given as two key reasons for insufficient use of male contraception. Condoms should be priced to be affordable to the average person and free to those with no income. Program strategies that proved successful are cited for Thailand's Mechai Viravaidya program and Bali's grass-roots program. The vasectomy program in Bangladesh is also noted for its success. Low

  20. Robotic assisted andrological surgery

    PubMed Central

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  1. [Male contraception - the current state of knowledge].

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-08-01

    Contraception is important from a health, psychological and socioeconomic point of view. Due to the fact that male-based contraceptive methods are mostly represented by condoms and vasectomy, researchers are working on the new solutions, which could let the men be more involved in a conscious family planning. In this review we will present the current state of knowledge on this subject. There is a lot going on in the field of hormonal contraception. Studies including testosterone, progestins, synthetic androgens and other derivatives are on a different stages of clinical trials and mostly demonstrate high efficacy rates. Recent discovers of Izumo and Juno proteins, essential for the fertilization process, give hope for an easily reversible, non-hormonal method. Researchers are also trying to interfere with the process of spermatogenesis using BRDT inhibitor - JQ1, or neutralize the sperm by injecting styrene maleic anhydride (SMA) into the lumen of the vas deferens. The other studies explore processes involved in proper sperm motility. A vaccine which induces an immune response to the reproductive system is also an interesting method. The latest research use ultrasound waves and mechanical device which blocks the patency of vas deferens. The aim of the study current state of knowledge male contraception. PMID:27591451

  2. [Male contraception - the current state of knowledge].

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-07-01

    Contraception is important from a health, psychological and socioeconomic point of view. Due to the fact that male-based contraceptive methods are mostly represented by condoms and vasectomy, researchers are working on the new solutions, which could let the men be more involved in a conscious family planning. In this review we will present the current state of knowledge on this subject. There is a lot going on in the field of hormonal contraception. Studies including testosterone, progestins, synthetic androgens and other derivatives are on a different stages of clinical trials and mostly demonstrate high efficacy rates. Recent discovers of Izumo and Juno proteins, essential for the fertilization process, give hope for an easily reversible, non-hormonal method. Researchers are also trying to interfere with the process of spermatogenesis using BRDT inhibitor - JQ1, or neutralize the sperm by injecting styrene maleic anhydride (SMA) into the lumen of the vas deferens. The other studies explore processes involved in proper sperm motility. A vaccine which induces an immune response to the reproductive system is also an interesting method. The latest research use ultrasound waves and mechanical device which blocks the patency of vas deferens. The aim of the study current state of knowledge male contraception. PMID:27590656

  3. Family planning methods: new guidance.

    PubMed

    1996-10-01

    Presented in this report are the recommendations of two expert groups, the Technical Guidance/Competence Working Group of the US Agency for International Development's Maximizing Access and Quality Initiative and the World Health Organization's Family Planning and Population Unit, regarding currently available family planning methods. The former group addressed key biomedical questions and formulated recommendations about 11 groups of family planning methods: combined oral contraceptives, progestin-only pills during breast feeding, progestin-only injectables, combined injectable contraceptives, Norplant implants, copper-bearing IUDs, tubal occlusion, vasectomy, lactational amenorrhea method, natural family planning, and barrier methods. A table presents the relative importance, by method, of procedures such as pelvic exam, blood pressure reading, breast exam, and screening for sexually transmitted diseases and cervical cancer. The medical eligibility recommendations for each method are also presented in tabular form, with four categories for temporary methods: 1) no restrictions on use, 2) advantages generally outweigh theoretical or proven risks, 3) theoretical or proven risks usually outweigh the advantages, and 4) unacceptable health risks. Included among the 41 conditions for which eligibility criteria are specified are age, smoking, thromboembolic disorder, headaches, irregular vaginal bleeding, family history of breast cancer, obesity, drug interactions, parity, breast feeding, postpartum, and postabortion. The new guidance presented in this report enables providers to give family planning clients expanded contraceptive choices while ensuring method safety and effectiveness. PMID:9342775

  4. [IPPF declaration on breast feeding, fertility and postpartum contraception].

    PubMed

    1997-01-01

    Mother's milk protects the newborn against various infections, especially against gastrointestinal infections, as well as strengthening the mother-child bond. Breast-feeding is also associated with birth spacing and plays an important role in the regulation of fertility in countries where the rate of use of contraceptives is low. In breast-feeding women amenorrhea may last several months or even a year, while in women who do not breast-feed menstruation returns 35-40 days postpartum. The risk of getting pregnant in women who rely on amenorrhea for contraception increases with the appearance of the first postpartum menstruation (spotting), with the introduction of food supplement into the diet of the infant, and approximately 6 months after childbirth. Family planning programs have to collaborate with maternal health programs with respect to the need for contraception, including postpartum contraception, which involves the training of nurse-midwives or traditional birth attendants. The choice of contraceptives includes the IUD, with a high degree of efficacy, which is particularly advantageous during breast-feeding. Tubal ligation has no negative effect on breast-feeding, but it also requires proper counseling. Other methods are vasectomy, implants and injectables containing progestational hormones, and estrogen-progesterone containing pills, which should not be used for 6 weeks after childbirth. PMID:12179264

  5. Wolf management in the 21st century: From public input to sterilization

    USGS Publications Warehouse

    Mech, L.D.; Fritts, S.H.; Nelson, M.E.

    1996-01-01

    Human-population increase and land development portend increasing conflict with large predators. Concurrently, changes and diversification of human attitudes are bringing increased disagreement about wildlife management. Animal-rights advocacy resulting from urbanization of human populations conflicts with traditional wildlife management. These forces focus more on wolves than on other wildlife because of strong public and media interest in wolves. Thus wolf management in the future will come under even greater public scrutiny, involve more public input, and may have greater restrictions imposed on it. This will lead to increased complexity in wolf management including more zoning, more experimentation with lethal and non-lethal capture techniques and alternate methods of alleviating damage to pets, livestock, and large ungulate herds, and greater public and private subsidy of wolf damage. One form of non-lethal control of wolf populations that may hold some promise is direct sterilization of males to reduce the biotic potential of the wolf population. Experimental vasectomy of five wild male wolves from four packs in Minnesota indicates that sterile males will continue to hold mates and territories, which would be necessary if sterilization is to be a viable technique for assisting with population control. If sterile males held territories but failed to produce pups, such territories might contain only about a third the number of wolves as fertile pack territories. Because wolves are long-lived in unexploited populations and their territories are large, direct sterilization of relatively few animals each year might significantly reduce populations.

  6. The Filipino male as a target audience in family planning.

    PubMed

    Vitug, W

    1986-01-01

    Since the official launching of the Philippine Population Program in 1970, family planning campaigns have substantially addressed themselves to women. The suggestion to devote equal, if not more, attention to men as family planning targets had been raised by Dr. Mercado as early as 1971. It was not until 1978, that the deliberate inclusion of males as a target audience in family planning became a matter of policy. The Population Center Foundation (PCF), from 1979 to 1982, carried out research projects to determine the most suitable approaches and strategies to reach Filipino men. The objectives of the PCF's Male Specific Program are: 1) to test alternative schemes in promoting male family planning methods through pilot-testing of family planning clinics for men, 2) to develop teaching materials geared toward specific segments of the male population, 3) to undertake skills training in male-specific motivational approaches for program professionals, and 4) to assess the extent of the husband's role in family planning. An important finding of 1 study was that most outreach workers were female stood in the way of the motivation process, thus hampering the campaign. While the consultative motivational skills training improved knowledge, attitudes, and skills of outreach workers with regard to vasectomy and the motivation process, there were certain predispositions that were hindering the fieldworkers' effectiveness in motivating target clients. Overall, in-depth, 1-to-1 motivation in dealing with men is needed to strengthen internalization of family planning values. PMID:12280740

  7. Induction of Contraception by Intraepididymal Sclerotherapy

    PubMed Central

    Park, Hyoung Keun; Paick, Sung Hyun; Kim, Hyeong Gon; Lho, Yong Soo

    2014-01-01

    Purpose The objective of the present study was to evaluate the efficacy of a sclerosing solution for inducing epididymal occlusion in male rats. Materials and Methods Male Sprague-Dawley rats were divided into two groups: an injection group (n=20) and control group (n=20). Before injecting the sclerosing agent, seminal vesiculectomy and sperm identification using electrostimulation were performed in all of the rats. In the injection group, 0.2 mL of 0.1% sodium tetradecyl sulfate solution was injected into the epididymis. In the sham group, only the identification of the epididymis was performed. At 4 and 12 weeks after the injection, semen was collected by electrostimulation and evaluated to assess the contraceptive effect. Epididymis was evaluated by hematoxylin and eosin (H&E) staining. Results After 4 and 12 weeks, semen collection was performed in the two groups. Sperms were not observed in the injection group, while there was no change in the sperms in the sham group. H&E staining showed the obstruction of epididymal tubules and an accumulation of inflammatory cells in the injection group. Conclusions This study showed that the sclerosing agent induced sterilization in male rats. This result suggests that the injection method can replace vasectomy as a contraceptive method. However, a further study of large animals and a clinical study are needed. Further, the long-term effectiveness of this method needs to be studied. PMID:25237657

  8. The economic value of contraception: a comparison of 15 methods.

    PubMed Central

    Trussell, J; Leveque, J A; Koenig, J D; London, R; Borden, S; Henneberry, J; LaGuardia, K D; Stewart, F; Wilson, T G; Wysocki, S

    1995-01-01

    OBJECTIVES. The purpose of the study was to determine the clinical and economic impact of alternative contraceptive methods. METHODS. Direct medical costs (method use, side effects, and unintended pregnancies) associated with 15 contraceptive methods were modeled from the perspectives of a private payer and a publicly funded program. Cost data were drawn from a national claims database and MediCal. The main outcome measures included 1-year and 5-year costs and number of pregnancies avoided compared with use of no contraceptive method. RESULTS. All 15 contraceptives were more effective and less costly than no method. Over 5 years, the copper-T IUD, vasectomy, the contraceptive implant, and the injectable contraceptive were the most cost-effective, saving $14,122, $13,899, $13,813, and $13,373, respectively, and preventing approximately the same number of pregnancies (4.2) per person. Because of their high failure rates, barrier methods, spermicides, withdrawal, and periodic abstinence were costly but still saved from $8933 to $12,239 over 5 years. Oral contraceptives fell between these groups, costing $1784 over 5 years, saving $12,879, and preventing 4.1 pregnancies. CONCLUSIONS. Contraceptives save health care resources by preventing unintended pregnancies. Up-front acquisition costs are inaccurate predictors of the total economic costs of competing contraceptive methods. Images FIGURE 1 FIGURE 2 PMID:7702112

  9. Immunocapture-Selected Reaction Monitoring Screening Facilitates the Development of ELISA for the Measurement of Native TEX101 in Biological Fluids*

    PubMed Central

    Korbakis, Dimitrios; Brinc, Davor; Schiza, Christina; Soosaipillai, Antoninus; Jarvi, Keith; Drabovich, Andrei P.; Diamandis, Eleftherios P.

    2015-01-01

    Monoclonal antibodies that bind the native conformation of proteins are indispensable reagents for the development of immunoassays, production of therapeutic antibodies and delineating protein interaction networks by affinity purification-mass spectrometry. Antibodies generated against short peptides, protein fragments, or even full length recombinant proteins may not bind the native protein form in biological fluids, thus limiting their utility. Here, we report the application of immunocapture coupled with selected reaction monitoring measurements (immunocapture-SRM), in the rapid screening of hybridoma culture supernatants for monoclonal antibodies that bind the native protein conformation. We produced mouse monoclonal antibodies, which detect in human serum or seminal plasma the native form of the human testis-expressed sequence 101 (TEX101) protein—a recently proposed biomarker of male infertility. Pairing of two monoclonal antibodies against unique TEX101 epitopes led to the development of an ELISA for the measurement of TEX101 in seminal plasma (limit of detection: 20 pg/ml) and serum (limit of detection: 40 pg/ml). Measurements of matched seminal plasma samples, obtained from men pre- and post-vasectomy, confirmed the absolute diagnostic specificity and sensitivity of TEX101 for noninvasive identification of physical obstructions in the male reproductive tract. Measurement of male and female serum samples revealed undetectable levels of TEX101 in the systemic circulation of healthy individuals. Immunocapture-SRM screening may facilitate development of monoclonal antibodies and immunoassays against native forms of challenging protein targets. PMID:25813379

  10. Comparison of four lasers (λ = 650, 808, 980, and 1075 nm) for noninvasive creation of deep subsurface lesions in tissue

    NASA Astrophysics Data System (ADS)

    Chang, Chun-Hung; Wilson, Christopher R.; Fried, Nathaniel M.

    2015-07-01

    Lasers have been used in combination with applied cooling methods to preserve superficial skin layers (100's μm's) during cosmetic surgery. Preservation of a thicker tissue surface layer (millimeters) may also allow development of other noninvasive laser procedures. We are exploring noninvasive therapeutic laser applications in urology (e.g. laser vasectomy and laser treatment of female stress urinary incontinence), which require surface tissue preservation on the millimeter scale. In this preliminary study, four lasers were compared for noninvasive creation of deep subsurface thermal lesions. Laser energy from three diode lasers (650, 808, and 980 nm) and a Ytterbium fiber laser (1075 nm) was delivered through a custom built, side-firing, laser probe with integrated cooling. An alcohol-based solution at -5 °C was circulated through a flow cell, cooling a sapphire window, which in turn cooled the tissue surface. The probe was placed in contact with porcine liver tissue, ex vivo, kept hydrated in saline and maintained at ~ 35 °C. Incident laser power was 4.2 W, spot diameter was 5.3 mm, and treatment time was 60 s. The optimal laser wavelength tested for creation of deep subsurface thermal lesions during contact cooling of tissues was 1075 nm, which preserved a surface layer of ~ 2 mm. The Ytterbium fiber laser provides a compact, low maintenance, and high power alternative laser source to the Neodymium:YAG laser for noninvasive thermal therapy.

  11. Navajo Nation expands family planning services.

    PubMed

    Haws, J; Crawford, G

    1996-01-01

    An AVSC training program, conducted in cooperation with the Navajo Nation Family Planning Corporation (NNFPC), has the potential to profoundly affect sterilization provision and acceptability on the Navajo Nation reservation. AVSC trained a family physician from the Northern Navajo Medical Center (New Mexico) in the no-scalpel vasectomy technique. This physician expects to provide 30 such sterilizations in the one-year period following the training and is preparing to teach reservation physicians from other health centers to perform the procedure. In addition, a joint AVSC-NNFPC course on sterilization counseling was presented to 30 nursing staff from the New Mexico Center. Central to this training was consideration of the obstacles to sterilization acceptance posed by Navajo cultural beliefs. Sensitivity to some women's desire to keep the procedure private, due to concerns their husbands will abandon them if they can no longer bear children, and to the potential need to include mothers and grandmothers in counseling sessions, is required. Also salient for female counselors and nurses are cultural taboos against a woman discussing sexual matters with a man with whom she is not intimate. In late 1996, AVSC will provide a sterilization counseling update for all NNFPC counselors working at centers throughout the four-state reservation. PMID:12347635

  12. Early sexual maturity in male hamadryas baboons (Papio hamadryas hamadryas) and its reproductive implications.

    PubMed

    Zinner, Dietmar; Krebs, Ellen; Schrod, Annette; Kaumanns, Werner

    2006-04-01

    We present data on sexual maturity in young hamadryas baboon males (Papio hamadryas hamadryas) and its reproductive consequences in a large captive baboon colony. Hamadryas baboons live in a multilevel social system, with one-male units (OMUs) as the smallest social entity. Male leaders of OMUs are believed to monopolize matings within their OMUs; hence mating is believed to be polygynous and monandrous. In a captive colony of hamadryas baboons, we found evidence that young males less than 4 years old fathered at least 2.5% of 121 offspring born subsequent to vasectomy of all adult males, and males aged 4-5 years fathered at least 16.5% of the offspring. Additional evidence that these young males are able to sire offspring came from a morphological comparison of sperm from hamadryas males of different ages. The sperm of a 48-month-old hamadryas baboon were morphologically indistinguishable from viable sperm from adult males, whereas sperm from a 45-month-old male showed some aberrations. If successful copulations by adolescent males constitute a regular pattern even in free-ranging hamadryas baboons, a hamadryas male's chances to reproduce would not be limited to his role as an OMU leader as previously assumed, and a male's reproductive career would consist of two phases: the adolescent phase, and the OMU leader male phase. PMID:16331661

  13. The effect of medroxyprogesterone acetate on behavioural responses of captive female hamadryas baboons (Papio hamadryas).

    PubMed

    Guy, Amanda J; Schuerch, Franziska S; Heffernan, Scott; Thomson, Peter C; O'Brien, Justine K; McGreevy, Paul D

    2008-11-01

    Female hormonal contraception is considered here as an alternative to vasectomy for population control in social groups of captive hamadryas baboons (Papio hamadryas). While female hormonal contraceptive methods have been successful, behavioural effects of such agents represent a potential welfare concern. This study examined the effect of medroxyprogesterone acetate (MPA; 3.5mg/kg) on perineal tumescence and behaviour in three social groups (total of 3 males, 22 females) of captive hamadryas baboons. The agent had little effect on social interactions such as grooming relationships, aggression and affiliation (all P>0.05), but did cause a reduction in sexual behaviour (P<0.001). Females-mounting-females and females receiving mounting was decreased during MPA treatment compared with the minimal tumescence phase (P<0.001). Age strongly influenced the contraceptive's duration: there was a significant correlation between age and latency of return to oestrus post-MPA (r=0.832, P<0.001) with the latency increasing by 2.61 days per year of age on average. Age also influenced the frequency of behaviours such as affiliation and aggression (P<0.001 and P=0.044, respectively). The absence of adverse behavioural effects further supports the use of MPA in the hamadryas baboon, and its potential use in other non-human primates. PMID:17980521

  14. [Children born to Hansen's disease patients in Amami-Oshima, Kagoshima, Japan].

    PubMed

    Moriyama, Kazutaka; Kikuch, Ichiro; Ishii, Norihisa

    2009-09-01

    In the Japanese leprosaria, it was very difficult or almost impossible for leprosy patients to give birth to their children. There were various reasons for this situation. Leprosy in the women mostly worsened in pregnancy and some of the children developed leprosy. Because of the chronic nature of the disease, marriage was encouraged in Japanese leprosaria, so that vasectomy was usually enforced in men who were wed, while artificial abortion was enforced in pregnant women. The only one exception was the situation of the Amami Wako-en Leprosarium. The Wako-en Leprosarium was started in 1943, and between 1946 and 1953, it was under American rule. Later it was transferred to Japanese rule. Religions such as Buddhism, Christianity and other religions greatly helped with leprosy patients, and in the Wakoen, it was Catholicism which prevailed. Catholic believer Joan Matsubara (later the secretary of Wako-en), Father Patrick Finn, Kaoru Ohira (director) outlined how children born to Hansen's disease patients would be grown up and made the internal rules of the couples' dormitory, while this was impossible in other leprosaria. Between 1953 and 1954, children were brought up by Matsubara's family or nurses. And since November 1954, children were brought up at nurseries (firstly named "Children's House" and later at "Naze Engel House" and children between 2 and 3 years went to "White Lily House". The children could meet their parents at times and now they are full-fledged grown-up citizens. PMID:19803374

  15. Racial variation in tubal sterilization rates: The role of patient-level factors

    PubMed Central

    Borrero, Sonya; Abebe, Kaleab; Dehlendorf, Christine; Schwarz, Eleanor Bimla; Creinin, Mitchell D.; Nikolajski, Cara; Ibrahim, Said

    2010-01-01

    Objective To assess racial differences in attitudes and knowledge about sterilization. Design Cross-sectional survey Setting Questionnaires were mailed to participants’ home addresses Patients 193 women aged 18–45 who had undergone tubal sterilization. Intervention(s) None Main Outcome Measure Attitudes and knowledge about tubal sterilization and awareness of contraceptive alternatives Results We received 193 completed surveys (64% response rate). AA woman were more likely to have a family member who had undergone tubal sterilization, to report that their mothers influenced their sterilization decisions, and to report that prior unintended pregnancy and desire to avoid insertion of a foreign object were very important factors in their decision to choose sterilization over other methods. Compared to white women, AA women more often thought that sterilization reversal could easily restore fertility (62 % vs 36%); that a woman’s sterilization would reverse itself after 5 years (60% vs 23%); and that a man cannot ejaculate after vasectomy (38% vs 13%). Fewer AA women had ever heard of intrauterine contraception (90% vs 98%). Racial differences in knowledge remained statistically significant after adjusting for socioeconomic confounders. Conclusions Misinformation about sterilization and limited awareness of contraceptive alternatives among AA women may contribute to racial disparities in tubal sterilization rates. PMID:20579640

  16. Hot issues in female and male hormonal contraception.

    PubMed

    Gava, Giulia; Lantadilla, Claudia; Martelli, Valentina; Fattorini, Anna; Seracchioli, Renato; Meriggiola, Maria C

    2016-02-01

    In recent years a number of significant developments in the field of female hormonal contraception have been made which have produced new formulations and delivery systems providing high efficacy, safety and important non-contraceptive benefits. In particular long-acting reversible contraception (LARC) formulations have been demonstrated to ensure extremely high efficacy in typical use, minimal contraindications, optimal safety in all women thereby representing the best option for most women of all ages. Their effectiveness is not reliant upon user adherence and their ability to reduce unintended pregnancies and abortions has been proven. Unfortunately the same considerations cannot be made for male hormonal contraception. Although a large number of men are interested and would welcome the opportunity to use male contraceptive methods, no safe, effective and reversible methods are available on the market. Current methods available for men are limited to condoms and vasectomy. Highly effective prototype regimens have been developed but the pharmaceutical industry is unwilling to pursue further development and market these products. Of all new approaches to male contraception, hormonal methods are the closest to clinical application. These are based on the reversible suppression of luteinizing hormone and follicle stimulating hormone with subsequent reversible inhibition of spermatogenesis and consequent replacement to maintain androgen dependent physiological functions. Most approaches tested combination regimens such as testosterone and a progestin or testosterone and a GnRH analog. PMID:26633041

  17. Effects of Mass Media and Cultural Drift in a Model for Social Influence

    NASA Astrophysics Data System (ADS)

    Mazzitello, Karina I.; Candia, Julián; Dossetti, Víctor

    In the context of an extension of Axelrod's model for social influence, we study the interplay and competition between the cultural drift, represented as random perturbations, and mass media, introduced by means of an external homogeneous field. Unlike previous studies [J. C. González-Avella et al., Phys. Rev. E 72, 065102(R) (2005)], the mass media coupling proposed here is capable of affecting the cultural traits of any individual in the society, including those who do not share any features with the external message. A noise-driven transition is found: for large noise rates, both the ordered (culturally polarized) phase and the disordered (culturally fragmented) phase are observed, while, for lower noise rates, the ordered phase prevails. In the former case, the external field is found to induce cultural ordering, a behavior opposite to that reported in previous studies using a different prescription for the mass media interaction. We compare the predictions of this model to statistical data measuring the impact of a mass media vasectomy promotion campaign in Brazil.

  18. Use of analgesic drugs for pain management in sheep.

    PubMed

    Lizarraga, I; Chambers, J P

    2012-03-01

    Awareness of pain and its effects is increasing within the veterinary profession, but pain management in food animals has been neglected. Sheep seldom receive analgesics despite various conditions, husbandry practice and experimental procedures being known to be painful, e.g. footrot, mastitis, vaginal prolapse, castration, vasectomy, penis deviation, and laparoscopy. The evidence supporting use of analgesic drugs in this species is reviewed here. Opioid agonists are of dubious efficacy and are short acting. α₂-agonists such as xylazine are good, short-lived analgesics, but induce hypoxaemia. Non-steroidal anti-inflammatory drugs (NSAID) such as ketoprofen provide long-lasting analgesia, but not as marked as that from α₂-agonists; they should be more widely used for inflammatory pain. Local anaesthetics reliably block pain signals, but may also induce motor blockade. Balanced analgesia using more than one class of drug, such as an α₂ agonist (e.g. medetomidine) and N-methyl-D-aspartate antagonist (e.g. ketamine), with the combination selected for the circumstances, probably provides the best analgesia for severe pain. It should be noted that there are no approved analgesic drugs for use in sheep and therefore the use of such drugs in this species has to be off-label. This information may be useful to veterinary practitioners, biomedical researchers, and regulators in animal welfare to develop rational analgesic regimens which ultimately may improve the health and welfare of sheep in both farming and experimental conditions. PMID:22352925

  19. Robotic assisted andrological surgery.

    PubMed

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

    The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery. The potential advantages of robotic assisted platforms include elimination of tremor, improved stability, surgeon ergonomics, scalability of motion, multi-input visual interphases with up to three simultaneous visual views, enhanced magnification, and the ability to manipulate three surgical instruments and cameras simultaneously. This review paper begins with the historical development of robotic microsurgery. It then provides an in-depth presentation of the technique and outcomes of common robotic microsurgical andrological procedures, such as vasectomy reversal, subinguinal varicocelectomy, targeted spermatic cord denervation (for chronic orchialgia) and robotic assisted microsurgical testicular sperm extraction (microTESE). PMID:23241637

  20. [Role of men in contraception, as users and partners].

    PubMed

    Aspilcueta-Gho, Daniel

    2013-07-01

    Reproductive health programs have focused their attention on women; in general, they have not worked much with men. Gender is not only a determinant of inequality, but it also provides explanations for the different factors that have an impact on men and women's health, their disease and their death. This article addresses the factors that are prioritized over the information and decisions concerning the exercise of sexuality and how to regulate reproduction. With regards to the beginning of sexual life, men seem to start earlier, in average, they have their first sexual relation at 16.8 years old. As to the use of contraceptive methods, currently 54.2% of men declare to use them. Out of these, 39.5% choose modern methods whereas 14.5% prefer traditional ones. In Peru, among the modern methods available are the barrier methods (the condom being the most used), the chemical methods or spermicides, and the surgical methods (vasectomy). Among the traditional ones are the "rhythm" based on abstinence during the fertile phase of the menstrual cycle, and the coitus interruptus. The father's role is one of power. Gender relations are relations of power, and parenthood is part of these relations. The father is, above all, the provider of filiation. Marginalization of men in the reproductive process is evident. Their support to their partner is suboptimal, whether it is during pregnancy, during delivery or to prevent the death of the mother. PMID:24100826

  1. Use of a domestic Korean black goat (Capra hircus coreanae) with its chest crayon-harnessed in detecting estrus of Himalayan tahrs (Hemitragus jemlahicus)

    PubMed Central

    Yong, Hwanyul

    2014-01-01

    The reliability of a Korean black goat (Capra hircus coreanae) to detect estrus in Himalayan tahrs (Hemitragus jemlahicus) for an artificial breeding program was investigated. Estrus in six female Himalayan tahrs was synchronized using fluorogestone acetate (FGA) sponges. Thirteen days later, 200 IU of PMSG and 100 IU of hCG were injected before removing the sponges and simultaneously injecting 5 mg of PGF2α the next day. Penetration of the cervical canal and the thickness and location of red crayon marks were examined 40~43 h later. Two females treated with sponges containing 60 or 45 mg of FGA had estrogen levels of 8.7 and 11.1 pg/mL, respectively. No red marks were found on the backs of these two tahrs. The remaining females had higher levels of estradiol, and the red crayon marks were clearly shown. The cervical folds of these tahrs were readily penetrated and the insemination gun was smoothly inserted into the uterine body. In conclusion, a Korean domestic goat with its chest crayon-harnessed was successfully used to detect estrus of Himalayan tahrs. This technique might be utilized as a part of breeding programs for wild goats and avoid the need for a vasectomy of conspecific males. PMID:24690603

  2. Proteins of human semen. I. Two-dimensional mapping of human seminal fluid

    SciTech Connect

    Edwards, J.J.; Tollaksen, S.L.; Anderson, N.G.

    1981-08-01

    The proteins in human seminal plasma were mapped by high-resolution two-dimensional electrophoresis (ISO-DALT and BASO-DALT systems). When analyzed under dissociating conditions, samples from normal fertile males revealed a pattern of over 200 proteins, ranging in mass from 10,000 to 100,000 daltons. Comparison of the mapped proteins from these males and those who had undergone vasectomy allowed us to identify one series of glycoproteins as missing from the semen from vasectomized individuals. Glycoproteins isolated by affinity chromatography with use of concanavalin A were also mapped. Some of the protein spots were identified either by coelectrophoresis with purified proteins or by the electrophoretic transfer of proteins to nitrocellulose sheets and subsequent detection by immunological procedures. The proteins identified include a number of serum proteins as well as prostatic acid phosphatase and creatine kinase. Proteolytic events shown to occur during the liquefaction of semen that occurs early after collection indicate the importance of carefully controlled collection and preparation methods for clinical evaluation of seminal plasma. Ethylenediaminetetraacetic acid and phenylmethylsulfonyl fluoride inhibit this proteolysis.

  3. India: orientation camps boost new motivational strategy; group discussion on the social aspects of the family welfare program.

    PubMed

    1980-01-01

    About 40,000 orientation camps for influential village leaders were planned to reactivate India's family welfare programme. Each camp averaged 40 participants, and total participation was estimated to be 1.6 million. Emphasis is placed on interpersonal communication and group communication. Special informative and motivational materials; film shows and folk-art programs were provided at the camps. This endeavor has resulted in improving the climate in relation to family planning. Approximately 100,000 community health volunteers are involved in these efforts. A group discussion organized on the family welfare program in September 22, 1979 brought out the following issues: 1) the use of incentives/disincentives in persuading people to accept family planning; 2) predominant factors in the rural areas such as malnutrition which undermine population programs; 3) need for involving voluntary organization in the family welfare program, in addition to creating an awareness of the demographic situation through educational channels; 4) introduction of some insurance schemes for old-age security; 5) approaching family planning programs at the macro level to improve the economic situation, and at micro level to intensify motivational aspects of the program; and 6) more competent handling of the vasectomy program by trained experts. PMID:12262029

  4. Proteins of human semen. I. Two-dimensional mapping of human seminal fluid.

    PubMed

    Edwards, J J; Tollaksen, S L; Anderson, N G

    1981-08-01

    The proteins in human seminal plasma were mapped by high-resolution two-dimensional electrophoresis (ISO-DALT and BASO-DALT systems). When analyzed under dissociating conditions, samples from normal fertile males revealed a pattern of over 200 proteins, ranging in mass from 10 000 to 100 000 daltons. Comparison of the mapped proteins from these males and those who had undergone vasectomy allowed us to identify one series of glycoproteins as missing from the semen from vasectomized individuals. Glycoproteins isolated by affinity chromatography with use of concanavalin A were also mapped. Some of the protein spots were identified either by co-electrophoresis with purified proteins or by the electrophoretic transfer of proteins to nitrocellulose sheets and subsequent detection by immunological procedures. The proteins identified include a number of serum proteins as well as prostatic acid phosphatase and creatine kinase. Proteolytic events shown to occur during the liquefaction of semen that occurs early after collection indicate the importance of carefully controlled collection and preparation methods for clinical evaluation of seminal plasma. Ethylenediaminetetraacetic acid and phenylmethylsulfonyl fluoride inhibit this proteolysis. PMID:7273394

  5. Immunocapture-Selected Reaction Monitoring Screening Facilitates the Development of ELISA for the Measurement of Native TEX101 in Biological Fluids.

    PubMed

    Korbakis, Dimitrios; Brinc, Davor; Schiza, Christina; Soosaipillai, Antoninus; Jarvi, Keith; Drabovich, Andrei P; Diamandis, Eleftherios P

    2015-06-01

    Monoclonal antibodies that bind the native conformation of proteins are indispensable reagents for the development of immunoassays, production of therapeutic antibodies and delineating protein interaction networks by affinity purification-mass spectrometry. Antibodies generated against short peptides, protein fragments, or even full length recombinant proteins may not bind the native protein form in biological fluids, thus limiting their utility. Here, we report the application of immunocapture coupled with selected reaction monitoring measurements (immunocapture-SRM), in the rapid screening of hybridoma culture supernatants for monoclonal antibodies that bind the native protein conformation. We produced mouse monoclonal antibodies, which detect in human serum or seminal plasma the native form of the human testis-expressed sequence 101 (TEX101) protein-a recently proposed biomarker of male infertility. Pairing of two monoclonal antibodies against unique TEX101 epitopes led to the development of an ELISA for the measurement of TEX101 in seminal plasma (limit of detection: 20 pg/ml) and serum (limit of detection: 40 pg/ml). Measurements of matched seminal plasma samples, obtained from men pre- and post-vasectomy, confirmed the absolute diagnostic specificity and sensitivity of TEX101 for noninvasive identification of physical obstructions in the male reproductive tract. Measurement of male and female serum samples revealed undetectable levels of TEX101 in the systemic circulation of healthy individuals. Immunocapture-SRM screening may facilitate development of monoclonal antibodies and immunoassays against native forms of challenging protein targets. PMID:25813379

  6. The etiology of prostate cancer: what does the epidemiology suggest

    SciTech Connect

    Ross, R.K.; Paganini-Hill, A.; Henderson, B.E.

    1983-01-01

    The two most important demographic characteristics of prostate cancer in Los Angeles are the high rates among blacks, which are two times those among whites and four times those among Asians, and the rapid increase in rates with age after age 40. Despite the high rates among blacks, a birth cohort analysis indicates that mortality rates among black men born after 1900 have decreased. In this report, epidemiologic and experimental evidence supporting each of three etiologic hypotheses--industrial exposure to cadmium, sexual transmission by an infectious agent, and endocrine factors--are reviewed. Evidence from descriptive data in Los Angeles suggests that only a small portion of cases might be attributable to industrial exposures. In a cohort study of Catholic priests, we found no deficit of prostate cancer mortality, strong evidence against sexual transmission of the disease. Experimental evidence and a limited amount of human data support an endocrine hypothesis. Preliminary results of a case-control study of prostate cancer are presented, but these results are unable to distinguish among these hypotheses further. This study finds a substantial protective effect of vasectomy, an event that is accompanied by reduced prostatic function and size, but this result is thus far statistically insignificant.

  7. Aspirin use is associated with lower prostate cancer risk in male carriers of BRCA mutations.

    PubMed

    Cossack, Matthew; Ghaffary, Cameron; Watson, Patrice; Snyder, Carrie; Lynch, Henry

    2014-04-01

    Previous studies have shown that male BRCA mutation carriers stand at increased risk of developing prostate cancer and have concerns about developing cancer. Genetic counseling practitioners often discuss strategies for reducing the risk of cancer for patients at high risk due to their genetic background. Addressing modifiable health habits is one such strategy. Unfortunately, modifiable risk factors for prostate cancer have only been documented in the general population and have not yet been studied in the BRCA carrier subpopulation. Therefore, this study aimed to identify modifiable risk factors for prostate cancer in BRCA carriers. We examined prostate cancer risk factors in 74 men who were part of families with a BRCA mutation. This study examined nine dichotomous variables including: exercise, history of vasectomy, smoking history, alcohol use, finasteride use, statin use, aspirin use, coffee use, and vitamin use. The survey was sent to all cases of prostate cancer in the Hereditary Cancer Center Database at Creighton University with a known BRCA status. This study confirmed the protective benefits of daily aspirin use, which have been observed in previous studies of the general population, and suggests its benefit in BRCA carriers. Protective benefits from regular vigorous exercise and daily coffee use trended towards significance, but neither factor withstood the Bonferroni Correction for multiple comparisons. PMID:23881471

  8. Fertility in men after treatment for stage 1 and 2A seminoma.

    PubMed

    Nalesnik, Jeffrey G; Sabanegh, Edmund S; Eng, Tony Y; Buchholz, Thomas A

    2004-12-01

    The purpose of this article is to assess the long-term fertility and attitudes towards fecundity in men after radical inguinal orchiectomy and radiation therapy (RT) for seminoma, and also to assess how often sperm cryopreservation is being offered to patients with seminoma prior to treatment. A retrospective review was conducted at 3 institutions (Wilford Hall Air Force Medical Center, Brooke Army Medical Center, and Fitzsimmons Army Medical Center) to identify patients who had undergone treatment of stage 1 or 2A seminoma during the period from 1975 to 1997. Seventy-three of 212 (34%) patients meeting the selection criteria of stage 1 or 2A seminoma provided information for this analysis. This was thought to be a good response rate, given that many of the patients had changed duty stations or had separated from the military by the time this study started. We performed a review of RT and tumor board records of 73 patients who were treated for testicular seminoma at selected treatment facilities from 1975 to 1997. Patients completed questionnaires and phone interviews that focused on prior fertility, the desire to father (more) children, other fertility-affecting factors (varicocele, cryptorchidism, infection, and erectile dysfunction), and incidence of physician counseling with regard to cryopreservation. All patients were asked to obtain a current semen analysis (SA). Eleven (15%) patients reported that they had tried to father children since completion of their RT. Seven of 11 (64%) successfully achieved pregnancy within a mean time of 3.5 years since RT (range: 1 month to 5 years). Of the 4 couples that were not successful, 1 had severe female factor infertility problems and a second had organic erectile dysfunction. A third had a past surgical history remarkable for vasectomy with subsequent vasectomy reversal. Nine patients provided SA. Mean sperm count and motility were 24.2 Mil/mL (range: 5-81 Mil/mL) and 63.1% (range: 30-90%), respectively (normal SA

  9. Sterilisation.

    PubMed

    Parsons, A D

    1985-05-01

    The discussion identifies some of the issues in counseling for sterilization and outlines the information which the counselor should make available to the couple. The most appropriate person to counsel a couple about sterilization is usually their general practitioner. He/she already will have some background knowledge about the couple, which will shorten the information-gathering part of the counseling process and help in understanding the problems the couple may experience in reaching their decision. Wherever the couple is seen, more than 1 consultation may be necessary. The basic requirement for counseling is an unhurried and nonthreatening atmosphere. Except in the unusual but increasing case of the man or woman without permanent partner, it is mandatory to see the couple together. This may seem obvious, yet many sterilizations (particularly for women) are still being carried out after a consultation with only 1 partner. Even though the counselor may already know the couple well, it is worth reviewing certain features of their situation. Age has been considered 1 of the most important factors in deciding whether to "allow" a sterilization. There is some disagreement among surgeons and gynecologists about this, so it is important to know what is available locally. If the couple have children and the vast majority of those requesting sterilization do, the age of these may be insignificant. Pregnancy is not a good time to make irreversible decisions, so immediate postpartum sterilization should probably be avoided except where the couple's decision predates the pregnancy. In the years since the liberalization of the divorce laws in the US, there has been a steady increase in the frequency of 2nd and 3rd marriages. In view of this, careful consideration should be given as to whether vasectomy, or female sterilization is appropriate. A high percentage of those who request a reversal of sterilization had their operation at a time when their relationship was unstable

  10. Have you heard the rumour?

    PubMed

    Nakato, L

    1994-01-01

    Rumors and misinformation about the use of contraceptives can arise from general fears about contraception, fears about specific methods, and fears based on a poor understanding of human physiology. In Uganda, general fears about contraception include the notion that usage encourages promiscuity in women, that contraception causes sickness, and that the use of contraception is not socially acceptable. Specific fears about oral contraceptives include the notions that they burn all the women's eggs, that they cause changes in weight, that they cause high blood pressure, and that they are not effective. Specific fears about the IUD are that it can move within the body and that a woman can conceive with it in place (which is true). The condom is thought to be able to disappear in the uterus or to slip off inside a woman's body and require surgical removal. Vasectomy is believed to make men impotent or mentally disturbed. Tubal ligation is thought to stop menstruation or to "overturn" the tubes. Medical personnel can be the source of some of these rumors when they lack appropriate training. Uninformed users can also start rumors. In order to combat these misconceptions and increase the practice of family planning (FP) in Uganda, the FP delivery system must be standardized, FP personnel must be adequately trained, FP providers must counsel clients, satisfied users should disseminate FP information and motivation in their communities, and IEC (information, education, and communication) programs should be increased. In addition to misconceptions, nutritional and sexual taboos affect maternal and child health in Uganda. Some prohibit women from eating high protein foods; others prohibit pregnant women from eating salt. Other practices include 1) deciding whether an infant is really a member of the clan by the behavior of its dried umbilical cord when thrown in water and 2) allowing men instead of women to decide how many children a woman should have. PMID:12318958

  11. Tissue-specific populations of leukocytes in semen-producing organs of the normal, hemicastrated, and vasectomized mouse.

    PubMed

    Mullen, Thomas E; Kiessling, Rachel L; Kiessling, Ann A

    2003-03-01

    Semen HIV is separate and distinct from blood HIV and work has revealed that seminal plasma HIV particles do not arise from infected cells in semen. These findings indicate that semen-producing organs contain multiple, separate populations of HIV host cells. To test this hypothesis, we have examined leukocytes in semen-producing organs of male mice. Cells expressing F4/80 (tissue-specific macrophage marker) were abundant in testicular interstitium and as dendritic-like cells in the lumenal epithelium of the epididymis, especially the initial segment. Cells expressing CD45 (panleukocyte marker) were found rarely in the testicular interstitium, commonly in epididymal epithelium, were most abundant in the interstitium of the epididymis, and were more readily released from minced tissues than were F4/80(+) cells. Unlike the testis and epididymis, F4/80(+) cells in seminal vesicles also appeared to be CD45(+). Seminal vesicle leukocytes were restricted to the epithelium surrounding the lumen and were not released by mincing. CD11b (monocyte/B cell marker) was detected in testicular and seminal vesicle interstitium, but not in the epididymis. Hemicastration and vasectomy caused a limited redistribution of the leukocytes. These findings confirm the existence of tissue-specific populations of leukocytes in semen-producing organs and indicate that some populations are highly tissue adherent. The regionalized, tissue-adherent macrophages in the testicular interstitium, the initial segment of the caput epididymis, and the seminal vesicle epithelium suggest the existence of reservoirs of HIV-infected cells in humans that could contribute virus particles, but not infected cells, to semen and possibly blood. PMID:12689416

  12. As the Third World turns.

    PubMed

    Hagerman, E

    1991-01-01

    Throughout the 3rd World, family planners have turned to television in order to spread their message. Combining education and entertainment in the form of advertisements and soap operas, television offers a way to provide clear and memorable information about an otherwise sensitive issue. In 1977, Mexico's Miguel Sabido developed the idea of using television as a means of social instruction. His initial soap opera dealt with adult literacy, and the success of that program led him to develop a show focusing on family planning called "Come Along with Me." Following the airing of this soap opera, attendance to family planning clinics increased by 32%. Since then, Mexico has produced a series of soap operas dealing with sex education, women's status, and the treatment of children. Soon, Mexican viewers will see a soap opera addressing the issue of AIDS. Family planners in other countries have also begun employing television. Conventional communication methods require trained counselors travelling villages, and most often, those most in need of family planning are the most difficult to reach. But over the last 10 years, the number of televisions in the Third World has doubled, and there is now approximately 1 television for every 12 people in the developing nations. In Turkey, advertisements have been used to promote modern methods of contraception. In Brazil, vasectomy has been one of the topics of ad campaigns. Mexico, the Philippines, and Nigeria have also experimented with the use of music videos. Nigeria has already had great success in integrating family planning themes to an already existing variety show. Family planning visits have increased by 47%. International agencies have recognized the value of television and have provided financial support. PMID:12343296

  13. [Comparison of urinary and seminal N-acetyl-beta-glucosaminidase isoenzymes].

    PubMed

    Yasumoto, R; Asakawa, M; Yamamoto, M; Doi, Y; Kawashima, H; Umeda, M; Tanabe, S; Nishisaka, N; Kakinoki, K; Maekawa, M

    1987-11-01

    N-acetyl-beta-glucosaminidase (NAG) and its isoenzymes were measured in the urine and seminal plasma of healthy volunteers. Urinary NAG level was 2.62 +/- 1.30 U/L (mean +/- standard deviation), 1.99 +/- 0.77 U/g creatinine and seminal NAG level was 2370 +/- 1007 U/l. Urinary NAG level was 2.59 +/- 1.44 U/l, 1.93 +/- 0.80 U/g creatinine in males and 2.67 +/- 1.15 U/l, 2.08 +/- 0.78 U/g creatinine in females, and there was no significant sex difference. NAG isoenzymes in the urine and seminal plasma were divided into two major peaks, A and B. The A:B ratio was 78.0 +/- 6.5: 21.9 +/- 6.5 in the urine and 24.7 +/- 3.2: 75.2 +/- 3.2 in the seminal plasma, and was significantly different. Urinary NAG isoenzyme was 80.3 +/- 6.7: 19.6 +/- 6.7 in males and 74.1 +/- 4.3: 25.9 +/- 4.3 in females, and there was no significant difference between the sexes. These results indicated that urinary and seminal NAG can be differentiated by measuring the isoenzymes. Furthermore, the comparison of seminal NAG isoenzymes before and after vasectomy indicated that seminal NAG may be affected not only by the sperm but also by the prostatic fluid. PMID:3445866

  14. Statistics.

    PubMed

    1993-02-01

    In 1984, 99% of abortions conducted in Bombay, India, were of female fetuses. In 1986-87, 30,000-50,000 female fetuses were aborted in India. In 1987-88, 7 Delhi clinics conducted 13,000 sex determination tests. Thus, discrimination against females begins before birth in India. Some states (Maharashtra, Goa, and Gujarat) have drafted legislation to prevent the use of prenatal diagnostic tests (e.g., ultrasonography) for sex determination purposes. Families make decisions about an infant's nutrition based on the infant's sex so it is not surprising to see a higher incidence of morbidity among girls than boys (e.g., for respiratory infections in 1985, 55.5% vs. 27.3%). Consequently, they are more likely to die than boys. Even though vasectomy is simpler and safer than tubectomy, the government promotes female sterilizations. The percentage of all sexual sterilizations being tubectomy has increased steadily from 84% to 94% (1986-90). Family planning programs focus on female contraceptive methods, despite the higher incidence of adverse health effects from female methods (e.g., IUD causes pain and heavy bleeding). Some women advocates believe the effects to be so great that India should ban contraceptives and injectable contraceptives. The maternal mortality rate is quite high (460/100,000 live births), equaling a lifetime risk of 1:18 of a pregnancy-related death. 70% of these maternal deaths are preventable. Leading causes of maternal deaths in India are anemia, hemorrhage, eclampsia, sepsis, and abortion. Most pregnant women do not receive prenatal care. Untrained personnel attend about 70% of deliveries in rural areas and 29% in urban areas. Appropriate health services and other interventions would prevent the higher age specific death rates for females between 0 and 35 years old. Even though the government does provide maternal and child health services, it needs to stop decreasing resource allocate for health and start increasing it. PMID:12286355

  15. [Family planning in China].

    PubMed

    Suyin, H

    1972-01-01

    Family planning in People's Republic of China between 1956 to 1970 has been marked by rapid change and total interrelation with the political and social developments. Since 1949, the Communist government has taken several measures to protect the mother and child. The campaign for family planning was started in 1956 by public meetings, posters, lectures with films, and an extensive distribution of contraceptive means. However, in 1965 there were still 2 trends among women: 1, based on tradition, supported the idea that a large number of children was a source of honor, prosperity and security; the other taking hold among younger women was in favor of family planning. The rural population was the latest to start practicing family planning. In 1963 a movement of socialist education was launched together with the formation of mobile medical teams to inform and educate people all over the country and to make known the various forms available for family planning. The contraceptive methods used included: male and female sterilisation (vasectomy for men and tube ligation for women), IUD, and condom; abortion, legal for women who already had children or if it was necessary for the mother's health; and oral contraceptives, which were produced in China. Medical services were reorganized and teams of "bare-foot doctors" were sent all over China. They lectured on health measures and fertility regulation. Intellectuals were sent to live in villages and exchange their knowledge with that of the peasants and workers. The tendency has been to limit the number of children to 2 or 3. The young people are recommended to postpone their marriage, women till they are 25, men till later. Nationally produced contraceptive means are being experimented with such as herbs, or a new intrauterine plastic device called "flower". The regions with national minorities like Tibet, the Inner Mongolia and Sinkiang had been under underpopulated and therefore population growth has been encouraged mainly

  16. A recipe for success: ingredients for a successful family planning program.

    PubMed

    Merrill, J

    1992-09-01

    The basic elements of a successful family planning (FP) program are variable between countries. Providing better access to modern contraceptives, access to general and reproductive health care, and increasing economic and educational opportunities contribute to reducing fertility rates. Effective distribution is constrained by rural, isolated populations and cultural attitudes. Indonesia has used floating clinics located on boats to reach inaccessible areas; Norplant and hormonal injection availability also contribute to the 53% contraceptive prevalence rate. The Japanese Organization for International Cooperation in Family Planning has shipped bicycles to developing countries. The result has been improved status among peers and greater program success. Contraceptive social marketing programs (CSM) have been successful in some countries to distribute contraceptives through local channels such as shops and stalls; people seem willing to pay also. CSM has been successful in Egypt in increasing condom sales. IUD use increased from 11% to 42% between 1975-88 with CSM. Multimedia promotion that is carefully researched and targeted is another way to increase contraceptive prevalence (CP) rates. A Brazilian multimedia vasectomy campaign led to an 80% monthly increase in Pro-Pater male health clinics. 240,000 women in Turkey were encouraged through multimedia efforts to switch to modern methods. In Zimbabwe, men have been the target of efforts to educate them about the advantages of small families. Women are recruited to implement FP services in INdia and in poor neighborhoods; an increase from 12% to 61% was achieved. Highly motivated workers with a respect for the community's values is essential to any successful FP program as is government support. China's policy has drawn criticism; China has welcomed a UN program which provides financial motivation. Thailand has been successful due to the commitment between public and private sectors; in 17 years CP rose from 10% to

  17. The KAP-gap in Nepal: reasons for non-use of contraception among couples with an unmet need for family planning.

    PubMed

    Shrestha, A; Stoeckel, J; Tuladhar, J M

    1991-03-01

    This report summarizes the findings of a study designed to identify the reasons for non-use of family planning among Nepalese women who want to space or limit childbirth. The study's initial phase involved focus group sessions of women with unmet need for family planning who were asked their reasons for non-use. Researchers used this information to develop an in-depth questionnaire. Researchers then randomly selected a total sample of 5,152 women. After interviewing the women, researchers concluded that 31.6% the sample had unmet need for family planning. Consequently, researchers administered the questionnaire to the unmet demand population, which was almost equally divided among women who want to either spacing or limit childbirth. The study analyzes both reasons for the general non-use of contraception and reasons for the non-use of specific contraceptive methods (oral contraceptives, laparoscopy, and vasectomy). Although varying among the different contraceptive methods, the most commonly cited reasons were: 1) causes headache, weakness, nausea; 2) causes weight loss; 3) causes heavy bleeding; 4) insufficient money for nutritious foods; 5) causes weakness and cannot work; 6) currently in poor health; 7) husband disapproves; and 8) affects breastfeeding and dries breast-milk. Explaining the benefits of the study, the report indicates that the information can be incorporated into the training curriculum of health workers, and can be used to target information, education, and communication campaigns. Furthermore, evident in the responses that cite lack of nutritious foods and weakness, the study reveals that nutrition and food supplement programs could help increase contraceptive use. PMID:12343262

  18. Advocacy in the Western Hemisphere Region: some FPA success stories.

    PubMed

    Andrews, D J

    1996-01-01

    The International Planned Parenthood Federation's Vision 2000 Strategic Plan has emphasized advocacy and the training of family planning associations (FPAs) in the Western Hemisphere region. During the summer of 1995 training programs in advocacy leadership management were sponsored for six FPAs in the Bahamas, Suriname, Belize, Colombia, Honduras, and Brazil. At the Western Hemisphere Regional Council Meeting in September 1995 awards were presented to FPAs for media outstanding projects. These FPAs used outreach to the community to promote the goals of Vision 2000. The Bahamas FPA won the Rosa Cisneros Award for articles published in a magazine that is distributed in primary and secondary schools and deals with the activities, achievements, and opinions of students. Issues include: love, relationships, responsibility, and teen pregnancy. A weekly television talk show also addresses the issues facing youth including education, music, community work, sexuality, pregnancy, and the relationship between teenagers and adults. The Family Planning Association of Honduras was also nominated for the award for a radio show on the health of mothers and children, the problems of adolescents, and FP. The newspaper Tiempo received the award for feature articles on social issues and FP. In 1994 the Association distributed thousands of booklets on contraceptives as well as fliers on vasectomy, female sterilization, oral contraceptives, IUDs, condoms, responsible parenthood, high-risk pregnancy, vaginal cytology, and cervical cancer. Similar posters were placed in hospitals and health centers, in 1997 FP posts, and 400 commercial outlets. The Family Planning Association of Suriname also carried out an impressive advocacy program during the period of 1968-93 with the goals of establishing a balance between population growth and the available resources to achieve well-being with regard to education, health care, nutrition, and housing. PMID:12291093

  19. Contraceptive methods use -- the gender difference.

    PubMed

    1995-04-01

    Male involvement in family planning programs has been recognized as an important strategy towards shared responsibility between men and women in reproductive decisions as well as in the prevention of STDs and AIDS. Bolstering male involvement is among the objectives of the International Conference on Population and Development (ICPD) Program of Action. One of the achievements of Cairo was the recognition of the need to increase men's responsibility for their sexuality and child rearing roles. The contraceptive prevalence rate and the difference in use of male and female contraceptive methods in selected Asian and Pacific countries are presented. Data on Pacific Islands was not available by contraceptive methods used except for Fiji (1974). There is above 70% contraceptive use in Hong Kong, Republic of Korea, Australia, Taiwan, Singapore, and China, with low use in Pakistan and Nepal. The data show that the type of contraceptive used is very much gender biased, indicating that the burden of contraceptive use is on women. The male methods of vasectomy, condom, and withdrawal are used by fewer couples than the female methods of female sterilization, pills, injectables, IUDs, and vaginal barriers for most countries except Japan. In Japan 44% of couples rely on male methods, mainly condoms; however, the use of pills constitutes less than 1%. Hong Kong and Singapore also have higher use of condoms than other countries (about 1/4 of married couples). Male sterilization is relatively lower than female sterilization for all countries. The highest use is in Korea, with 11% of the couples having undergone male sterilization, however, female sterilization is also the highest for Korea with 37% of the couples using this method. No matter what the level of the socioeconomic development of the country, the responsibility of regulating reproduction seems to lie with the women. PMID:12346435

  20. Abnormal Accumulation of Collagen Type I Due to the Loss of Discoidin Domain Receptor 2 (Ddr2) Promotes Testicular Interstitial Dysfunction

    PubMed Central

    Zhao, Hu; Bu, Xin; Li, Zhen; Zhao, Jie; Gong, Wei-dong; Wu, Zhi-qun; Yao, Li-bo; Li, Wei; Zhang, Yuan-qiang

    2015-01-01

    Background Loss of functional allele for discoidin domain receptor 2 (Ddr2) results in impaired Leydig cell response to luteinizing hormone (LH), low testosterone production and arrested spermatogenesis in older male Ddr2slie/slie mice. However, the underlying mechanism responsible for this phenotype remains unknown. Herein, we reported for the first time that the deregulated expression of Ddr2 cognate ligand, namely collagen type I (COL1), may account for the disruption of the testicular steroidogenesis in Ddr2slie/slie mutant testes. Methodology/Principal Findings Expression of Ddr2 increased gradually along postnatal development, whereas COL1 expression became negligible from adulthood onwards. In Ddr2slie/slie mutant testis, however, in contrast to the undetectable staining of Ddr2, COL1 expression was constantly detected, with the highest values detected during adulthood. In the experimental vasectomy model, Ddr2slie/slie mutant mice exhibited an early androgen deficiency than wild-type mice, along with the accumulation of fibrotic tissue in the interstitium. Functionally, ablation of endogenous Ddr2 resulted in a significant decrease of testosterone (T) level in TM3 cells in the presence of higher concentration of COL1 treatment. Conversely, overexpression of Ddr2 could help TM3 cells to maintain a normal testicular steroidogenesis even in the presence of high concentration of COL1. Additionally, attenuated expression of Ddr2 correlates to the deregulated level of serum T levels in human pathological testes. Conclusions Abnormal accumulation of interstitial COL1 may be responsible for the steroidogenic dysfunction in Ddr2slie/slie mutant testes. PMID:26158267

  1. Y-STRs in forensic medicine: DNA analysis in semen samples of azoospermic individuals.

    PubMed

    Soares-Vieira, José Arnaldo; Billerbeck, Ana Elisa Correia; Iwamura, Edna Sadayo Miazato; Zampieri, Ricardo Andrade; Gattás, Gilka Jorge Fígaro; Munoz, Daniel Romero; Hallak, Jorge; Mendonca, Berenice Bilharinho; Lucon, Antonio Marmo

    2007-05-01

    The incidence of rape has increased, especially in metropolitan areas, such as the city of São Paulo. In Brazil, studies about it have shown that the majority of this type of crime is committed by the relatives and persons close to the victim. This has made the crime more difficult to be denounced, as only 10% of the cases are reported to competent police authorities. Usually, cytological exams are carried out in sex crime investigations. The difficulty in showing the presence of spermatozoa is frequent, but it does not exclude the presence of male DNA. The absence of spermatozoa in material collected from rape victims can be due to several factors, including the fact that the agressor suffers from azoospermia. This condition can be the result of a successful vasectomy. As the majority of DNA in the ejaculation sample is from spermatozoa, there is much less DNA to be analyzed. This study presents the application of Y-STRs (DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, and DYS393) in DNA analysis of sperm samples from 105 vasectomized men. The study demonstrated a great variation in DNA concentration. DNA extraction and amplification was possible in all sperm samples even in the absence of spermatozoa. The same profile was observed, for each individual, from DNA extracted from blood, pre- and postvasectomy semen samples. The use of markers specific for Y chromosome in sex crime cases, especially in the absence of spermatozoa, is very important, mainly because in most situations there is a small quantity of the agressor's DNA in the medium and a large quantity of the victim's DNA. PMID:17456093

  2. Two horses of a different color: CSM in Thailand and Colombia.

    PubMed

    1985-01-01

    The Colombian Association for Family Welfare (PROFAMILIA) and Indonesia's Community Development Association (PDA) operate social marketing projects which might more appropriately be called social sales projects. Unlike other social marketing projects, these 2 projects seek profits from their contraceptive sales. The profits are then used to subsidize other programs operated by these 2 nonprofit organizations. Indonesia's PDA initiated its sales project in 1974. It operates both an urban contraceptive retail sales (CRS) program and a rural community-based distribution sales (CBD) program. The CRS program sells 3 types of condoms, which it delivers directly to the 1750 retailers involved in the program. The condoms sell for US$.03-US$.07, somewhat more than condoms sold in most social marketing projects. The CBD project covers 10,200 villages in 157 of Indonesia's 620 districts. Each village has a CBD volunteer who sells oral contraceptives (OCs) and condoms and also promotes family planning and rural development. The program sells Norinyl, Ovostat, and Eugynon for US$.19-US$.30/cycle. PDA runs other profit-making projects. For example, it sells promotional T-shirts and calendars at its vasectomy clinics and through its CBD program. PDA also established the taxable Population and Development Corporation, which engages in marketing activities. Profits from the corporation are channeled back to PDA. PROFAMILIA also operates both an urban sales program and a rural community-based distribution program. In the urban program, condoms are sold at normal retail prices and OCs at prices 30% below retail prices. The profits derived form the urban sales are used to subsidize the rural project. In 1981, the urban program began selling 6 noncontraceptive products, e.g., distilled water and disposable diapers. Currently, the program sells only distilled water, as the other products failed to yield a profit. A table provides sales information for both the PDA and PROFAMILIA

  3. Some aspects of the sterilization program in Malaysia.

    PubMed

    Arshat, H; Ali, J; Noor Laily Abu Bakar

    1984-06-01

    Sterilization is most often indicated when the desired family size is reached and no more children are desired. Because of technical advances and societal changes surgical sterilization is increasingly becoming the most utilized method of contraception. Since female sterilization is more common, several methods have been devised to make it safe and reliable. The traditional large abdominal incision (laparotomy) is now replaced by minilaparotomy, which is a small abdominal incision. Other techniques, such as transvaginal and trancervical approaches require no incision at all. These method permit occlusion of any part of the fallopian tube. Minilapatomy is the recommended method of female sterilization for 3rd world countries. Laparoscopic sterilization appears to be more psychologically acceptable to 3rd world women who have an inherent dread of surgery. A higher incidence of hematoma formation has been reported in puerperal laparoscopic sterilizations and the failure rate is also higher than in other methods. Other complications associated with laparoscopic sterilization include wound sepsis, surgical emphysema of the parieties and uterine perforation. Laparoscopic sterilizations can be performed under local, general, spinal or epidural anesthesia. Local and general anesthesia is the commonest. Both tubal ligations and vasectomies have been available in Malaysia since the 1960s. Laparoscopy was 1st introduced in Malaysia in the early 1970s. Several laparoscopy centers have been established in Malaysia to provide specialized family planning services. Outpatient laparoscopic sterilization is a feature of the Kuala Lumpur Specialist Center. Traditonally doctors and specialists in Malaysia received their practical training in sterilization techniques during their internship or residency. Since 1980, however, a formal training program was initiated. Because laparoscopy provides interval sterilization without major abdominal surgery, this procedure has played a major

  4. India creates social marketing organization.

    PubMed

    1984-01-01

    India, in a major policy shift toward reversible birth controls methods, will form a new organization to promote private sector contraceptive sales. The government, through a recently signed agreement with the Agency for International Development (AID), plans to establish a private nonprofit Contraceptive Marketing Organization (CMO) in fiscal year 1984. This momentous move marks a full circle return to a 1969 proposal by AID and Ford Foundation consultants. Funded at about $500 million over a 7 year period, the CMO will function as a semi-autonomous entity run by a board of governors representing government and such public and public sectors as health, communications, management, manufacturing, marketing, advertising, and market research. According to the agreement called the India Family Planning Communications and Marketing Plan, the CMO's activities will cover procurement and distribution of condoms, oral contraceptives (OCs), and other yet to be determined contraceptive methods. Of the $500 million in funds, the government of India has pledged 2/3, AID roughly $50 million in grants and loans, with the balance expected from such sources as the UN Fund for Population Activities. The CMO's goal is a marked increase in contraceptive use by married couples of reproductive age from the current 6% rate to 20% by 1990. As of 1982, India has 122 million such couples, with 1% purchasing commercial products, 2% buying Nirodh Marketing Program condoms and 3% relying on free government contraceptives. Besides creating the CMO, the India/AID pact outlines intensified public sector family planning promotions and activities. Some Indian health experts believe the government's decision to expand social marketing's role rests with a significant decade long decline in the popularity of such permanent birth control measures as vasectomy and tubal ligation. PMID:12313308

  5. High-Frequency Ultrasound Imaging of Noninvasive Laser Coagulation of the Canine Vas Deferens

    PubMed Central

    Cilip, Christopher M.; Pierorazio, Phillip M.; Ross, Ashley E.; Allaf, Mohamad E.; Fried, Nathaniel M.

    2011-01-01

    Background and Objectives A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery (e.g. hematoma, infection, acute and chronic pain, sterilization failure) and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. In this study, high-frequency ultrasound is used to confirm successful laser thermal coagulation and scarring of the vas in a short-term canine model. Materials and Methods Bilateral noninvasive laser coagulation of the vas was performed in a total of 9 dogs using a laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 0.5 Hz, and 3-mm-diameter spot. Cryogen spray was used to cool the scrotal skin surface and prevent burns during the procedure. A clinical ultrasound system with a 13.2-MHz high-frequency transducer was used to image the vas before after the procedure. Burst pressure measurements were performed on excised vasa to confirm thermal occlusion. Results Day 0 and 28 burst pressures averaged 291 ± 31 mmHg and 297 ± 26 mmHg, respectively, significantly greater than ejaculation pressures of 136 ± 29 mmHg. Ultrasound showed a hyperechoic vas segment after thermal coagulation (Day 0) and scarring (Day 28). Doppler ultrasound showed normal blood flow through the testicular artery, indicating no collateral thermal damage to proximal structures. Conclusions High-frequency ultrasound may be used as a noninvasive diagnostic tool to assist in determining successful short-term laser thermal coagulation and scarring of the vas. PMID:21956632

  6. Testicular obstruction: clinicopathological studies.

    PubMed Central

    Hendry, W. F.; Levison, D. A.; Parkinson, M. C.; Parslow, J. M.; Royle, M. G.

    1990-01-01

    Genital tract reconstruction has been attempted in subfertile men with obstructive azoospermia (370 patients) or unilateral testicular obstruction (80 patients), and in vasectomised men undergoing reversal for the first (130 patients) or subsequent (32 patients) time. Histopathological changes in the obstructed testes and epididymes, and immunological responses to the sequestered spermatozoa have been studied to gain insight into possible causes of failure of surgical treatment. The results of surgery have been assessed by follow-up sperm counts and occurrence of pregnancies in the female partners. The best results were obtained with vasectomy reversal (patency 90%, pregnancy 45%), even after failed previous attempts (patency 87%, pregnancy 37%). Epididymovasostomy gave good results with postinfective caudal blocks (patency 52%, pregnancy 38%), while postinfective vasal blocks were better corrected by total anatomical reconstruction (patency 73%, pregnancy 27%) than by transvasovasostomy (patency 9%, no pregnancies). Poor results were obtained with capital blocks (patency 12%, pregnancy 3%), in which substantial lipid accumulation was demonstrated in the ductuli efferentes; three-quarters of these patients had sinusitis, bronchitis or bronchiectasis (Young's syndrome). There is circumstantial evidence to suggest that this syndrome may be a late complication of mercury intoxication in childhood. After successful reconstruction, fertility was relatively reduced in those men who had antibodies to spermatozoa, particularly amongst the postinfective cases. Similarly, impaired fertility was found in men with unilateral testicular obstruction and antibodies to spermatozoa. Mononuclear cell infiltration of seminiferous tubules and rete testis was noted occasionally, supporting a diagnosis of autoimmune orchitis; although rare, this was an important observation as the sperm output became normal with adjuvant prednisolone therapy. Images Figure 4 Figure 6 Figure 7 Figure 10

  7. Brdt Bromodomains Inhibitors and Other Modern Means of Male Contraception.

    PubMed

    Zdrojewicz, Zygmunt; Konieczny, Radosław; Papier, Paulina; Szten, Filip

    2015-01-01

    Compared to efficient and secure female contraception, a vasectomy and condoms are the only options for men. The choice of male contraceptive methods is limited, so contraception mainly rests on the shoulders of women. Several concepts are considered: testosterone administration--inhibiting pituitary secretion of lutropin (LH) and follicle stimulating hormone (FSH), progestogen--affecting the secretion of gonadotropin and gonadoliberin (GnRH) antagonists. New potential targets for non-hormonal male contraception were discovered: glyceraldehyde-3-phosphate-dehydrogenase (GAPDHS)--specific to male germ cells and voltage-gated cation channel (CatSper). Both are responsible for sperm motility. Drugs such as thioridazine used in schizophrenia treatment and phenoxybenzamine (antihypertensive activity) exhibit a contraceptive effect. Similar action exhibits an analogue of lonidamine--adjudin and an antagonist of retinoic acid receptors (BMS-189453). Researchers are working on a contraceptive vaccine, whose active ingredient is epididymal protease inhibitor (Eppin). Another promising method acts by blocking Bromodomain testis-specific proteins (Brdt) involved in the process of spermatogenesis. JQ1-the Brdt inhibitor causes reversible infertility without affecting the endocrine signaling pathways. A recent discovery of Juno as the binding partner for Izumo1 identifies these proteins as the cell-surface receptor pair, essential for gamete recognition and this interaction can be inhibited by an anti-Juno monoclonal antibody. Our review shows that the situation of men can change and investigators are close to the optimal solution. In the near future men will be able to choose the best contraceptive suited to their needs. PMID:26469117

  8. Male contraception: a clinically-oriented review.

    PubMed

    Kanakis, George A; Goulis, Dimitrios G

    2015-01-01

    Despite the variety of available female contraceptive methods, many pregnancies (~50%) are still undesired. Many men (>60%) want to participate equally with their partner in family planning; however, male contraceptive methods (MCMs) account for only 14% of those used worldwide and no pharmaceutical MCM is available so far. The only two MCMs currently available are condoms, which despite protecting against sexually transmitted diseases have high failure rates (~19%), and vasectomy, which though very efficient (99%) is poorly reversible (<50%). Among MCMs under investigation, male hormonal contraceptives (MHCs) are those that have come closest to commercialization. The action of MHCs relies on the disruption of spermatogenesis that exogenous androgen administration evokes by suppressing the hypophyseal-gonadal axis. Various regimens of androgens as monotherapy or in combination with progestins have been tested in clinical trials achieving a Pearl Index <1.0 (equal to that of the female oral contraceptive pill); however, concerns regarding the variable response rates observed (non-responders: 5-20%), the impracticality of parenteral administration and long-term prostate-associated or cardiovascular morbidity have deflected the interest of the pharmaceutical industry from further research. Non-hormonal contraception methods may be, at least theoretically, more specific by selectively disrupting spermatogenesis and sperm transport or fertilizing ability. Nevertheless, only a few have been tested in clinical trials (Reversible Inhibition of Sperm Under Guidance, RISUG, and Intra Vas Plugs); most of them are still in pre-clinical development or have been abandoned due to toxicity (gossypol). Consequently, until a reliable, safe and practical MCM is developed, women will continue to bear most of the contraception burden. PMID:26732151

  9. Ethical issues in male sterilization in developing countries.

    PubMed

    Rizvi, S A; Naqvi, S A; Hussain, Z

    1995-11-01

    The history of sterilization dates back to the time of Hippocrates, when female sterilization was recommended for preventing hereditary mental diseases. James Blundell introduced surgical sterilization in 1823 for the prevention of high risk pregnancies. Vasectomy was first performed in the US at the end of the 19th century, mainly to prevent hereditary disorders. Male sterilization was a means of genocide during Nazi rule in Germany. Religious beliefs have the most powerful impact on the practice or nonpractice of family planning. In the teachings of Islam, Christianity, and Judaism, only sporadic references explicitly prohibit contraception, yet various religious edicts have interpreted these references too broadly by advocating prohibition of most contraceptive methods. Recently, the world community endorsed the basic right of couples to decide the number of children they want and the right to family planning with free informed choice. An integral part of a successful family planning program is voluntarism. In Europe and North America sterilization is legal, except in Italy, France, and Turkey. In Latin America sterilization is illegal in a number of countries; in Burma and Vietnam restrictions are in place; and in Africa fertility regulation is illegal in one-third of the countries. Informed consent before sterilization during counseling by a skilled, unbiased counselor is indispensable. All family planning services should be part of the national health care system including the voluntary contraception services. Incentives may compromise voluntarism. Most programs require a minimum age and a minimum number of children, marital status, and spousal consent. For sterilization, a waiting period of 1-30 days has been recommended. The exclusion of childless and single individuals has been challenged as a violation of human rights. For mentally retarded people parents or guardians provide consent. Major ethical issues in the future could emerge concerning novel

  10. Onsite Provision of Specialized Contraceptive Services: Does Title X Funding Enhance Access?

    PubMed Central

    Riedel, Julie Cross; Menz, Mary; Darney, Philip D.; Brindis, Claire D.

    2014-01-01

    Abstract Background: This article presents the extent to which providers enrolled in California's Family Planning, Access, Care, and Treatment (Family PACT) program offer contraceptive methods onsite, thus eliminating one important access barrier. Family PACT has a diverse provider network, including public-sector providers receiving Title X funding, public-sector providers not receiving Title X funding, and private-sector providers. We explored whether Title X funding enhances providers' ability to offer contraceptive methods that require specialized skills onsite. Methods: Data were derived from 1,072 survey responses to a 2010 provider-capacity survey matched by unique identifier to administrative claims data. Results: A significantly greater proportion of Title X–funded providers compared to non–Title X public and private providers offered onsite services for the following studied methods: intrauterine contraceptives (90% Title X, 51% public non–Title X, 38% private); contraceptive implants (58% Title X, 19% public non–Title X, 7% private); vasectomy (8% Title X, 4% public non–Title X, 1% private); and fertility-awareness methods (69% Title X, 55% public non–Title X, 49% private) (all p<0.0001). The association between onsite provision and Title X funding remained after stratifying individually by clinic specialty, facility capacity to provide reproductive health services (based on staffing), and rural/urban location. Conclusions: Extra funding for publicly funded family-planning programs, through mechanisms such as Title X, appears to be associated with increased onsite access to a wide range of contraceptive services, including those that require special skills and training. PMID:24405313

  11. Clinical aspects and perinatal outcomes after cryopreservation of embryos and gametes.

    PubMed

    Rodriguez-Wallberg, K A

    2015-04-01

    Cryopreservation techniques play today a central role in assisted reproduction, as they enhance the overall efficacy of in vitro fertilization (IVF) treatments by allowing the banking of supernumerary embryos obtained in these treatments, and their later use. The transfer of frozen/thawed embryos was established nearly 30 years ago, and although it has been clinical routine for a long time, the importance of freezing embryos has been newly emphasized. As recognized downsides of IVF treatment include the high prevalence of perinatal complications due to multiple births, the recommended practice of transferring fewer embryos in the fresh IVF treatment cycle, with the goal of performing single embryo transfer and the cryostorage of remaining embryos for their later use in frozen-thawed cycles, one at a time, is currently the trend. Also of great importance, cryopreservation techniques for spermatozoa and oocytes have additionally permitted gamete storage for long-term and the implementation of several new treatment modalities for assisted reproduction. Most of these methods are applied today in clinical programs of fertility preservation and third-part reproduction, such as sperm- and egg donor programs. Use of frozen thawed sperm has been in clinical use for over 50 years and banking sperm has been routinely offered to men, usually before gonadotoxic treatments, but also in many cases, practised as a "safety policy" previously to a vasectomy. Freezing methods for women's egg have required a much longer time to achieve a comparable effective clinical standard. Only recently, with the development of vitrification of oocytes, the clinical standard was recognized and since 2013 when the label "experimental" was removed, the freezing of oocytes could be regarded as an established method, and its use extended into clinical practice for fertility preservation but also performed after personal requirements, so called, "social freezing". PMID:25714875

  12. Optical and thermal simulations of noninvasive laser coagulation of the human vas deferens

    NASA Astrophysics Data System (ADS)

    Schweinsberger, Gino R.; Cilip, Christopher M.; Trammell, Susan R.; Cherukuri, Harish; Fried, Nathaniel M.

    2011-03-01

    Successful noninvasive laser coagulation of the canine vas deferens, in vivo, has been previously reported. However, there is a significant difference between the optical properties of canine and human skin. In this study, Monte Carlo simulations of light transport through tissue and heat transfer simulations are performed to determine the feasibility of noninvasive laser vasectomy in humans. A laser wavelength of 1064 nm was chosen for deep optical penetration in tissue. Monte Carlo simulations determined the spatial distribution of absorbed photons inside the tissue layers (epidermis, dermis, and vas). The results were convolved with a 3-mm-diameter laser beam, and then used as the spatial heat source for the heat transfer model. A laser pulse duration of 500 ms and pulse rate of 1 Hz, and cryogen spray cooling were incident on the tissue for 60 s. Average laser power (5-9 W), cryogen pulse duration (60-100 ms), cryogen cooling rate (0.5-1.0 Hz), and increase in optical transmission due to optical clearing (0-50 %), were studied. After application of an optical clearing agent to increase skin transmission by 50%, an average laser power of 6 W, cryogen pulse duration of 60 ms, and cryogen cooling rate of 1 Hz resulted in vas temperatures of ~ 60°C, sufficient for thermal coagulation, while 1 mm of the skin surface (epidermis and dermis) remained at a safe temperature of ~ 45 °C. Monte Carlo and heat transfer simulations indicate that it is possible to noninvasively thermally coagulate the human vas without adverse effects (e.g. scrotal skin burns), if an optical clearing agent is applied to the skin prior to the procedure.

  13. Review and follow-up of patients using a regional sperm cryopreservation service: ensuring that resources are targeted to those patients most in need.

    PubMed

    Tomlinson, M; Meadows, J; Kohut, T; Haoula, Z; Naeem, A; Pooley, K; Deb, S

    2015-07-01

    Are all patients undergoing chemotherapy for long-term sperm banking at risk of permanent sterility? Male fertility is generally lower in men with cancer and all patient groups are at risk of azoospermia. Careful management is required to ensure that samples are not stored for excessively long periods should they not be required. A retrospective analysis of 1688 patient records and prospective recall of patients for semen testing were performed. Pre-therapy fertility was compared with a group of pre-vasectomy patients as a comparator. Those who fail to bank spermatozoa, rates of disposal of samples and the utilization in assisted reproduction were also examined. Sperm quality was poorest in testicular cancer (TC) patients followed by those with Hodgkin's lymphoma (HL) prior to treatment. Post-therapy data were available in 376 patients (42%). Sperm number was lowest (and azoospermia highest at 77%) in patients with HL treated with regimens other than adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). Non-HL NHL and leukaemic patients had similarly high rates of azoospermia at 46 and 55%. HL patients treated with ABVD (11%) and TC patients (9.7%) had the lowest rates of azoospermia. Azoospermia was seen in every treatment group except for TC patients receiving carboplatin. Only 45 patients used their samples in ART (4.5%) in 10 years. Little is known about the fertility status of the patients not coming forward for follow-up testing, those conceiving naturally, those with no intention of conceiving and some which may have psychological reasons for not attending. In conclusion, virtually all patients undergoing chemotherapy are potentially at risk of temporary or permanent infertility. However, as uptake and utilization of stored material remain low, sperm banks should be carefully managed to ensure that resources are targeted to the patients most in need. PMID:26084986

  14. Noninvasive laser coagulation of the canine vas deferens, in vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Ross, Ashley E.; Jarow, Jonathan P.; Fried, Nathaniel M.

    2010-02-01

    Development of a noninvasive vasectomy technique may eliminate male fear of complications (incision, bleeding, infection, and scrotal pain) and result in a more popular procedure. This study builds upon previously reported ex vivo tissue studies by exploring acute and short-term chronic in vivo canine studies. Isolation of the canine vas was achieved using a conventional vas ring clamp method. No perforation of the scrotal skin was necessary to occlude the vas. Laser radiation with a wavelength of 1075 nm, average power of 11.2 W, 500-ms pulse duration, 0.5 Hz pulse rate, and 3-mm-diameter spot was synchronized with cryogen spray cooling of the scrotal skin surface in a total of 8 dogs (n = 16 vasa) for a treatment time of 60 s. Burst pressure measurements were conducted at Days 0 and 21 (n = 8 vasa each day) to quantify the strength of vas closure. The vas was successfully thermally occluded in 15/16 (94%) procedures with 14/15 (93%) vas recording burst pressures above ejaculation pressure. One vas was not present, and another vas recorded a bursting pressure below ejaculation pressure. The coagulated vas bursting pressure averaged 283 +/- 34 mm Hg at Day 0 and 260 +/- 77 mm Hg at Day 21, significantly higher than reported vas ejaculation pressures of 136 +/- 29 mm Hg. Minor scrotal skin burns were observed during the recovery period. Noninvasive thermal occlusion of the vas is feasible in an in vivo canine model. Elimination of minor skin burns and longer term chronic in vivo canine studies are needed to confirm azospermia after vas occlusion without recanalization.

  15. Comparison of 808, 980, and 1075nm lasers for noninvasive thermal coagulation of the canine vas deferens, ex vivo

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher M.; Schweinsberger, Gino R.; Fried, Nathaniel M.

    2011-03-01

    Successful noninvasive laser coagulation of the canine vas deferens, in vivo, has been previously reported. However, the therapeutic window for treatment is relatively narrow. This study determines the dependence of vas thermal coagulation on laser wavelength for development of a noninvasive laser vasectomy procedure. Noninvasive laser coagulation of canine vas tissue, ex vivo, was performed using three commonly available near-infrared laser wavelengths: 808, 980, and 1075 nm. Each laser delivered an average power of 9.2 W, 500-ms pulse duration, pulse rate of 1.0-Hz, and 3.2-mm diameter laser spot, synchronized with cryogen spray cooling of the scrotal skin surface for a total treatment time of 60 s. Vas burst pressures were measured to determine strength of vas closure and compared to previously reported ejaculation pressures. Gross inspection of vas and scrotal skin was also performed immediately after the procedure as an indicator of thermal coagulation and skin burns. The 1075 nm laser produced the highest vas burst pressures (288 +/- 28 mmHg), significantly greater than previously reported ejaculation pressures (136 +/- 29 mmHg). The 808 nm wavelength produced insufficient vas burst pressures of 141 +/- 61 mmHg, and minor scrotal skin burns were observed in at least one case. The 980 nm wavelength was unable to produce thermal coagulation of the vas, with low burst pressures (89 +/- 58 mmHg) and severe scrotal skin burns. The 1075 nm wavelength was the only near-IR wavelength that consistently thermally coagulated the vas with a strong degree of closure and without any scrotal skin burns.

  16. Acquired von Willebrand syndrome with a type 2B phenotype: diagnostic and therapeutic dilemmas.

    PubMed

    Scepansky, Ellen; Othman, Maha; Smith, Hedy

    2014-01-01

    In this report, we provide evidence of an acquired von Willebrand syndrome (AVWS) with a type 2B phenotype rather than the expected type 1 or 2A. The patient was referred prior to surgical removal of a fibrous mass within the maxillary sinus. His first bleeding 7 years earlier following a retinal tear had been complicated by monocular blindness. Several mucocutanous bleedings followed. Hematological investigations revealed von Willebrand factor (VWF):Ag 91 IU/ml, factor VIII 86 IU/ml, VWF:RCo 34 IU/ml and profound thrombocytopenia with platelet clumping. VWF multimer analysis showed a loss of high-molecular-weight multimers and his plasma aggregated normal platelets under low ristocetin concentration, consistent with type 2B von Willebrand disease (VWD). Sequencing of VWF exon 28 and of the platelet GP1BA gene to investigate the possibility of platelet-type VWD failed to reveal mutations. Serum protein electrophoresis showed a monoclonal IgG protein and led to the diagnosis of monoclonal gammopathy of unknown significance (MGUS), raising suspicion of an AVWS. Over 2 years, he experienced severe gingival bleedings and traumatic intracerebral hemorrhage. Following debridement of the sinus mass, the patient required 20 units of packed red blood cells, despite high-dose Humate-P, continuous Amicar and twice-daily platelet transfusions. Bleeding finally ceased following infusion of activated factor VIIa. A history of prior uncomplicated vasectomy and tendon laceration, no family history of bleeding, the inability to identify a causative mutation in either exon 28 VWF or platelet GP1BA and the MGUS led to diagnosis of AVWS with a type 2B phenotype. This case highlights the difficulties in assigning a diagnosis and the management of bleeding in a patient with an atypical presentation of AVWS. PMID:24296552

  17. The enter-educate approach.

    PubMed

    Piotrow, P T; Coleman, P L

    1992-03-01

    This article describes how the Population Communication Services (PCS) has seized on the "enter-educate" approach, the blending of popular entertainment with social messages, to change reproductive health behavior. The enter-educate approach spreads its message through songs, soap operas, variety shows, and other types of popular entertainment mediums. Because they entertain, enter-educate projects can capture the attention of an audience -- such as young people -- who would otherwise scorn social messages. And the use of population mediums makes it possible to reach a variety of audiences. Funded by USAID, PCS began its first enter-educate project in response to the increasing number of teenage pregnancies in Latin America. PCS developed 2 songs and videos, which featured popular teenage singers to serve as role models, to urge abstinence. The songs became instant hits. Since then, PCS has mounted more then 80 major projects in some 40 countries. Highlights of programs range from a successful multi-media family planning campaign in Turkey to humorous television ads in Brazil promoting vasectomy. Recently, PCS initiated projects to teach AIDS awareness. At the core of the enter-educate approach is the social learning theory which holds that much behavior is learned through the observation of role-models. Health professionals work alongside entertainers to produce works that have audience appeal and factual social messages. The enter-educate approach works because it is popular, pervasive, personal, persuasive, and profitable. PCS has found that enter-educate programs pay for themselves through cost sharing and cost recovery. PMID:12284960

  18. [Children and bankers in Bangladesh].

    PubMed

    Hartmann, B

    1991-06-01

    This critique of the World Bank's role in developing country population programs begins with a description of a 1987 case in which an 80-year- old Bangladeshi man was persuaded to undergo vasectomy and then robbed of his incentive payment by the health agent. For over 20 years, the World Bank has pressured 3rd World governments to implement population control programs. Although there are divergent opinions within the World Bank, the most dominant is the neomalthusian view that the poor through their high fertility help perpetuate their own poverty. This view hides the real source of poverty in the Third World: the unequal distribution of resources within these countries and between the developed and developing countries. The World Bank has always been blind to the inequalities, and has associated with the elites of developing countries who monopolize the resources of their countries and thereby impede authentic development. Furthermore, the emphasis on population control distorts social policy and hinders the implementation of safe and voluntary family planning services. In many countries the World Bank has required governments to give greater priority to population control than to basic health services. It has pressured them to relax contraceptive prescription norms and has promoted the more effective methods without regard to proper use or side effects. In Bangladesh the World Bank has sponsored sterilization programs that rely on coercion and incentives. In that country of enormous inequities, 10% of landowners control over 50% of lands, while nearly half the population is landless and chronically underemployed. Political power is concentrated in the military government, which annually receives over 1.5 billion dollars in external aid. External aid primarily benefits the wealthy. 3/4 of the population are undernourished and less than 1/3 are literate or have access to basic health care. The poor of Bangladesh, as in many other countries, feel that their only

  19. The Epidemiology of Anti-Sperm Antibodies Among Couples with Unexplained Infertility in North West Bank, Palestine

    PubMed Central

    Yasin, Ahmad Lotfi; Basha, Walid Salim

    2016-01-01

    Introduction Anti sperm antibodies (ASA) can present in serum and semen and they may lead to impair the sperms function leading to infertility. The precise mechanism of generation of these antibodies is yet to be discovered. Aim This study was performed to determine the prevalence of anti-sperm antibodies (ASA) in patients with unexplained infertility. The study was initiated also to explore the possible factors that may associate with ASA formation and how ASA status is associated with pregnancy rates after going with in vitro fertilization – intracytoplasmic sperm injection (IVF-ICSI). Materials and Methods A cross-sectional study was conducted on 42 normal infertile couples consulting Razan Medical Center for Infertility & I.V.F. in Nablus, Palestine, from December 2012 – March 2013. Serum levels of immunoglobulins G (IgG) ASA were measured in participants (males and females) using enzyme-linked immunosorbent assay (ELISA). In addition, participants also filled a questionnaire about the presence of previous varicocele repair, inguinal hernia repair, orchitis, testicular trauma and vasectomy reversal among males and severe coitus bleeding and coitus during menses or puerperium among females. Couples were also asked about previous IVF-ICSI procedures and the outcome of the procedure in terms of either they got pregnant or not. Data was analysed using SPSS software. Results The prevalence of ASA was 14.3% (6/42) among all couples, 9.5% (4/42) among males and 4.8% (2/42) among females. There was no significant relationship between previous varicocele repair, previous inguinal hernia repair, or orchitis and formation of ASA (p value =0.64, 0.56, and 0.26 respectively). Previous trauma, vasovasostomy, severe coitus bleeding and coitus during menses or puerperium were not observed in any of the study sample. ASA did not seem to affect the outcome of IVF-ICSI (p-value =0.54). Conclusion Prevalence of ASA in infertile couples in the north part of Palestine is similar

  20. A poisoned inheritance to our children.

    PubMed

    Johannisson, E

    1993-09-01

    The editorial by Henry J. Leese published in the October 1992 issue of Human Reproduction dealt with the problems of world population growth. The United Nations Population Fund publication on the state of world population 1990 declared that, at the start of the 1990s, decisive action is needed to top population growth, attack poverty, and protect the environment. The world's population was 5.3 billion in 1993. According to projections, southern Asia will account for 31% of the total increase of the world's population and Africa for 23% during the next 10 years. Developed countries like Europe, the former Soviet Union, North America, and Japan will account for only 6% of the increase. In 1969-1971, the total number of malnourished was 460 million, and it is projected to increase to 532 million by the end of this century. The total number of illiterates is projected to rise from 742 million in 1985 to 889 million by year 2000. During the last decade, the income per person has risen significantly in east Asia, where population has grown most slowly. In Africa, where the population has increased very fast, the income per capita has grown least. The World Fertility Survey in 1990 showed that less than 25% of women in 23 out of 38 countries had larger families than they would have desired. A survey in 1987 revealed that, in developing countries, 45.3% of contraception was sterilization, 23.1% was the IUD, and only 15.5% used hormonal contraception. In developed countries, sterilization accounted for 14.2% of contraception, IUDs for only 7.8%, and hormonal contraceptives for 18.4%. In East Asia, 93% of people have an acceptable access to a variety of contraceptive methods, 57% in South East Asia and Latin America, whereas in sub-Saharan Africa, only 9%. Worldwide, less than 30% of the contraceptive users rely on methods for male contraception, e.g., withdrawal, condoms, vasectomy or abstinence. The WHO Special Program of Research on Human Reproduction and the Population

  1. Importance of male fertility control in family planning.

    PubMed

    Tulsiani, Daulat R P; Abou-Haila, Aida

    2014-01-01

    The world population, currently estimated to be almost seven billion, is expected to double in less than four decades. The projected population growth will cause severe competition for existing resources, not to mention the issue of overcrowding of the planet and additional greenhouse gases that will have an adverse effect on the ecological health of the planet. A recent survey conducted by the United Nations Population Control Division shows that the majority of today's young men in many countries are willing to participate in family planning by taking full control of their fertility, an important global health issue. However, the contraceptive needs of tens of millions of men/couples go unmet every single day and results in millions of unwanted pregnancies. Ever since the approval of the birth control pill by the Food and Drug Administration (FDA) in 1960, scientists have been hoping for a male equivalent. It has, however, been a difficult road, in part because of the complicated science of the male reproductive system. It is easier to control a monthly event of ovulation in women than to regulate the production of millions of fertile spermatozoa every day in men. Thus, the contraceptive options for men have not changed in decades and are still limited to the use of condoms, a timely withdrawal/pulling out (coitus interruptus) or vasectomy, a minor surgical procedure in which the vas deferens is occluded to prevent the release of spermatozoa during ejaculation. The first two approaches have a relatively higher failure rate, whereas the last approach is largely irreversible and not suitable for younger men. In this article, we will discuss various approaches currently available for men to take control of their fertility. Our intention is to discuss the details of three similar approaches that will provide safe, affordable and reversible contraception for men and are close to being approved for use by millions of men around the globe. The availability of safe

  2. A review of the health of people in Jakarta.

    PubMed

    1985-10-01

    A survey was conducted in Jakarta to determine the knowledge and behavior of urban people toward health. The results of the survey will serve as the basis for developing appropriate health-related interventions. Areas included in the study were the following: nutrition, immunization, environmental health, family planning and health services. Information was also obtained on the availability of facilities in the homes. 4 sites in Jakarta were chosen for the project. 1000 family respondents were selected to give general information and another 400 family respondents were selected to give specific information. The sampling was done by a combination of the stratification, cluster and simple random methods. The strata were the middle-income and lower income groups. The data were collected in January 1975. Most of the household heads were 30 to 39 years old, had attended senior high school, and most worked in the private sector. Most of the families were Moslem. The study showed that there was inadequate knowledge of good nutrition, particularly for children under 5 years old. Few of the respondents knew of the importance of breastfeeding. Most of the families had adequate knowledge of immunization. About 80% knew about DPT and polio vaccines. The families were ignorant about diseases brought about by poor environmental conditions. They were also unaware of the consequences of improper garbage disposal. On average, each family had 3.36 living children, while the child death rate was 12%. Most of the families were familiar with oral and injectable contraceptives; 60% were familiar with condoms; and 10% with vasectomy. 68% of the families had been family planning acceptors. 62.3% of the families practiced self-medication: 11.3% went to a private doctor; 4.1% went to other health facilities and personnel; and 22.5% took their sick to the puskesmas (public health centers). The morbidity rate is high. The number of families with access to communication media is high. 7 out of

  3. East Asia Review, 1973. To sum up.

    PubMed

    Keeny, S M

    1974-05-01

    Observations are made related to the review of family planning activities in East Asia in 1973. The number of new acceptors for the region increased from 2.7 million in 1972 to 3.4 million in 1973. The leaders were Indonesia, which almost doubled its achievement of calendar year 1972, the Philippines, and Korea. In Thailand, the number of new acceptors dropped by about 10%. South Vietnam is the only country in the region without an official policy. Most couples still think that the ideal number of children is 4, with at least 2 sons. Some religious opposition does exist, particularly with reference to sterlization and abortion. More attention is being paid to women in their 20s. Sterilization and condoms are becoming more popular. Korea reports a sharp increase in vasectomies. Better methods and continuation rates should be stressed. In Taiwan a couple who start with 1 method and continue to practice some method lower their reproduction rate by 80%. More responsibility is being delegated to nurses and midwives, but too slowly. In Indonesia, the number of field workers rose from 3774 in 1972 to 6275 in 1973. The Philippines and Thailand are experimenting to see what kind of workers get best results and under what kind of salary and incentive arrangements. In-service training tends to be neglected, but preservice training is improving. Costs, in general, have risen, though in Korea the cost per acceptor has dropped from US$8.00 to US$7.80. Korea and Taiwan have reduced their annual population growth rates by more than 1/3 in 10 years, from 30 to 19-20 per 1000 each. Singapore's rate is 17 and Hong Kong's 14 (exclusive of inmigration). The number of couples currently practicing contraception in Singapore is 71%. Target systems assigning quotas to clinics are generally used except in Thailand and Malaysia, where programs emphasize maternal and child health, rather than population planning. Most programs require about 10 years to get the annual growth rate down to 2% by

  4. [Anita: a Maya peasant woman on the rise].

    PubMed

    Elmendorf, M

    1980-01-01

    Chan Kom, a village of 623 inhabitants in the Yucatan peninsula whose population lives primarily by slash-and-burn maize agriculture, has been well studied by social scientists for over 50 years. The roles of women during that time have been interpreted by men, and it is the object of this article to examine the needs and desires of women and the ways in which they seek to improve life for themselves and their families. Anita at 38 has 7 living children from 10 pregnancies. Her husband is a subsistence farmer who works part time at a variety of jobs. The oldest daughter married at 17. A 16-year-old son Emiliano attended an agricultural vocational school to which his family sent him after great sacrifice. After completing school Emiliano became a promoter for the National Indigenist Institute. A daughter finishiing primary school wished to continue studying but her father objected that she would probably get married and her mother worried about her safety if she left home to study. She and a sister were sent to live with the daughter of her mother's comadre in a nearby city in the hope that she would learn office work. A 12-year-old son at home, who is not such a good student, helps the father in farming. 2 little girls are the only other children still at home. Anita's last 2 deliveries were difficult and dangerous, and for 3 years she and her husband have been attempting to avoid another pregnancy, using a combination of withdrawal and rhythm. She and her husband discussed vasectomy with a Maya-speaking North American doctor, but came to no decision. Anita states that many Maya women do not menstruate between pregnancies, or do so only once or twice. Anita has had 2 miscarriages and 2 daughters since deciding that she wanted no more children. She accepted a prescription for pills but was afraid to take them. Fear of disturbing the "tipte," a regulating organ believed by Maya women to lie behind the navel, prevented her from choosing sterilization. PMID:12264283

  5. Effectiveness of publications in family planning program.

    PubMed

    Noor Laily Abu Bakar; Tan, B A; Tey, N P; Yusuf, Y

    1983-12-01

    The aim of the present study is to evaluate the degree of exposure to to Information, Education, and Communication (I.E.C.) publications such as pamphlets and booklets on contraceptive methods among those who have attended the dialog sessions; and to investigate the effects of such exposure on contraceptive use as well as the ppropensity to talk about family planning. The survey, conducted by the National Family Planning Board and assisted by the Sciences University of Malaysia in 1978/79, covers 6 states. A total of 1190 respondents were selected from those who attended dialog sessions during that period. Of the total sample, 723 respondents (60.8%) were contacted and interviewed. The I.E.C. publications evaluated in this survey include booklets on methods of contraception; pamphlets on the pill, IUD, condom, rhythm method, tubal ligation, vasectomy; booklets on responsible parenthood, flip charts and posters. 61% of the respondents have been exposed to at least 1 form of the I.E.C. materials. About 17 to 18% of currently married respondents have been exposed to pamphlets on tubal ligation, rhythm methods, IUD and condom; 22% have been exposed to pamphlets on the pill and 43% to booklets on contraceptive methods. In gerneral, those who have been exposed to pamphlets on a particular method were more likely to use that method. Among those who have been exposed to pamphlets on the pill 26.4% were using the pill compared to 16.2% who have not been exposed. The proportion of condom users were 3 times more after exposure to pamphlets on the condom: 16% vs. 4.7%. About 50% of currently married respondents were using a contraceptive method at the time of the survey. Of those who have not been exposed to I.E.C. materials, only 34.4% were using a method, compared to 53-60% of those who had been exposed. Exposure to I.E.C. materials and its interaction with ethnicity act as the most important factor in accounting for the differntials in contraceptive use, both in the

  6. The Mayer Hashi Large-Scale Program to Increase Use of Long-Acting Reversible Contraceptives and Permanent Methods in Bangladesh: Explaining the Disappointing Results. An Outcome and Process Evaluation

    PubMed Central

    Rahman, Mizanur; Haider, M Moinuddin; Curtis, Sian L; Lance, Peter M

    2016-01-01

    ABSTRACT Background: Bangladesh has achieved a low total fertility rate of 2.3. Two-thirds of currently married women of reproductive age (CMWRA) want to limit fertility, and many women achieve their desired fertility before age 30. The incidence of unintended pregnancy and pregnancy termination is high, however. Long-acting reversible contraceptives (LARCs), consisting of the intrauterine device and implant, and permanent methods (PM), including female sterilization and vasectomy, offer several advantages in this situation, but only 8% of CMWRA or 13% of method users use these methods. Program: The Mayer Hashi (MH) program (2009–2013) aimed to improve access to and the quality of LARC/PM services in 21 of the 64 districts in Bangladesh. It was grounded in the SEED (supply–enabling environment–demand) Programming Model. Supply improvements addressed provider knowledge and skills, system strengthening, and logistics. Creating an enabling environment involved holding workshops with local and community leaders, including religious leaders, to encourage them to help promote demand for LARCs and PMs and overcome cultural barriers. Demand promotion encompassed training of providers in counseling, distribution of behavior change communication materials in the community and in facilities, and community mobilization. Methods: We selected 6 MH program districts and 3 nonprogram districts to evaluate the program. We used a before–after and intervention–comparison design to measure the changes in key contraceptive behavior outcomes, and we used a difference-in-differences (DID) specification with comparison to the nonprogram districts to capture the impact of the program. In addition to the outcome evaluation, we considered intermediate indicators that measured the processes through which the interventions were expected to affect the use of LARCs and PMs. Results: The use of LARCs/PMs among CMWRA increased between 2010 and 2013 in both program (from 5.3% to 7.5%) and

  7. Vaso-vasostomy using microsurgical techniques. A preliminary report.

    PubMed

    Gojaseni, P; Visuthikosol, V

    1979-12-01

    weeks in 1 patient. 1 patient, on whom vasectomy was performed 15 years previously, showed negative smears intraoperatively and poor sperm count postoperatively. The volume of the ejaculates was 3-4 ml. The motility ranged from 40-60%. All patients except 1 had positive smears intraoperatively. Thus far there is no information on the pregnancy rate. In sum, initial results were encouraging. PMID:12265372

  8. Knowledge regarding family planning methods among rural women of Faridkot district of Punjab.

    PubMed

    Kaur, H P

    1991-07-01

    A researcher analyzed data on 60 married women of reproductive age living in the villages of Kaoni and Assa Buttar in Faridkot District, Punjab state, India, to determine their knowledge levels of various aspects of family planning methods. 80% of the women could neither read nor write. About half lived in an extended family, while the rest lived in a nuclear family. All the women knew about family planning. The women considered the purpose of family planning to be limiting family size (80%), spacing children (53.3%), and preventing conception of children (33.3%). Indeed 40% used a family planning method to space their children, 33.3% to limit family size, and 26.7% to cease childbearing. The leading known methods included the copper T IUD (100%), tubectomy (93.3%), vasectomy (86.6%), and condom (86.6%). 60% of the women and 13.2% of their husbands used a contraceptive. The major methods ever used were tubectomy (46.6%), condom (26.6%), the loop IUD (13.6%), oral contraceptives (13.3%), and the copper T IUD (13.3%). Friends and relatives constituted the most frequently reported knowledge sources for all family planning methods except jelly, cream, and diaphragm which none of the women knew about. Husbands tended to be the leading information source about condoms. Authorities were not major contributors to these rural women's family planning knowledge. All the women trusted family planning and believed it to be good for their health. 86.6% thought it was also good for their children's health and that it allowed parents to provide a better life for their children. The main reasons for stopping family planning use were 1) wanted a child (20%), 2) physical discomfort (13.3%), and 3) method failure (6.6%). The leading reasons for not using a family planning method at all included 1) wanted a child (20%) 2) unhappy marriage (13.3%), and 3) high cost (6.6%). PMID:12286548

  9. The Right to Informed Choice. A Study and Opinion Poll of Women Who Were or Were Not Given the Option of a Sterilisation with Their Caesarean Section

    PubMed Central

    Verkuyl, Douwe A.; van Goor, Gerda M.; Hanssen, Marjo J.; Miedema, Margreet T.; Koppe, Marnix

    2011-01-01

    Background In the Netherlands, caesarean sections (CSs) are rarely combined with tubal occlusion (TO), partly because discussing CS/TO near delivery is considered unethical and earlier hypothetical counselling – i.e. suppose you happen to need a CS – is rare. This results in more unintended pregnancies and is inconsistent with informed choice. We explored whether TO should indeed not be made routinely available to eligible women. Methods and Findings A questionnaire was mailed to 515 Para ≥2 who underwent in the past ≥1 CS. 498 (96.7%) responded. They were on average 35.3 years old, had 2.5 children, had undergone 1.6 CSs, and 3.3 years had passed since their index delivery, either a CS (393) or vaginal birth (105) after a previous CS. 87% of the 498 believed that pregnant mothers with ≥1 children should be routinely counselled about CS/TO. Indeed, 58% and 85% respectively, thought women/couples expecting their second or third child should still be given the TO option days before delivery, if omitted earlier. Counselled women, 138/498 (27.8%), were far more often satisfied than those without CS/TO option. 33/393 had a CS/TO. None indicated regret in the questionnaire. Another 119 also would have elected a CS/TO if given that option. Therefore, 152 (38.7%) of 393 Para ≥2 had or would have liked a concurrent TO. 118/119 wrote they still regretted missing this opportunity. The exception's husband had had a vasectomy. 100/119 were good TO candidates: they were ≥28 years when they delivered an apparently healthy baby of ≥37 weeks. The current contraceptive use of these 100 suggests that this group will have at least 8 unintended pregnancies before age 50. Conclusion The experiences and opinions of previous potential candidates for a CS/TO do not support the reluctance of Dutch obstetricians to counsel pregnant Para ≥1 about the TO option for a (potential) CS. PMID:21445338

  10. Policy considerations for the introduction and promotion of the lactational amenorrhea method: advantages and disadvantages of LAM.

    PubMed

    Kennedy, K I; Kotelchuck, M

    1998-09-01

    Some attributes of LAM are unquestionably positive, such as the fact that it is effective. Clinical trials of LAM have upheld the Bellagio Consensus that the chance of pregnancy is less than 2% in the first 6 months postpartum in amenorrheic women who are fully or nearly fully breastfeeding. Secondary data analyses in numerous settings have drawn the same conclusion. Whether as a strategy or a method, used correctly or even if used imperfectly, LAM is a reliable way to avoid pregnancy. To the extent that LAM represents an additional contraceptive option, this is also clearly positive since a broad array of contraceptive options maximizes the likelihood of finding a good fit between user and method, and increases contraceptive use. Other characteristics of LAM represent potentially positive impacts. If LAM is shown to be an effective conduit to other modern methods, the implications are profoundly positive. If LAM is cost effective, for households and/or for programs, this will also make the method extraordinarily attractive. Conversely, some aspects of LAM are negative, such as the fact that it affords no protection against STDs, it requires counseling from a well-informed provider, and intensive breastfeeding can make heavy demands on the woman's time. Many of the remaining attributes of LAM may not be important to a policy decision about LAM promotion. For example, whether LAM is actualized as a strategy or a method may not be important to a decision to promote LAM, although it has a huge impact on how services are delivered. Some factors may be profound on a local or individual level. For example, one simple factor, such as the absence of full/nearly full breastfeeding, can rule out the method as an option, while another, such as the fact that it provides the needed waiting period during vasectomy counseling, can make LAM the method of choice. Although LAM seems unlikely to have widespread popularity in societies like the United States, within such settings are

  11. The use of contraception among abortion applicants.

    PubMed

    Krishnamoni, D; Jain, S C

    1985-01-01

    consisted mainly of young women whose parental attitude had deterred them from seeking help with birth control. The 181 women who had used some form of contraception within the last 6 months or earlier but not at the time of conception were mainly over age 17. More than half of them were unmarried. Less than 1/3 had elementary school education, and half had high school or more education. The complaint of side effects caused by the method was the most common reason for non-use among this group. In most instances the method complained about was oral contraception. More than half of the consistent users were married and almost 3/4 had high school or better education. The contraceptive that appears to have had the highest failure rate among the consistent users was the condom. Almost 1/3 of the women claimed that they had depended on the condom. The oral contraceptive, the IUD, and irreversible methods such as tubal ligation and vasectomy had a failure rate of 2% each. PMID:4005776

  12. [Survey of men provides reliable data on contraception in the Dominican Republic].

    PubMed

    1987-01-01

    % who were sterilized and 9% who used pills. The responses of men when asked about their wives' contraceptive use were about the same. However, men reported higher use of male methods. 9% of men but only 1% of women reported using rhythm, 7% of men but 3% of women withdrawal, and 5% of men and 2% of women condoms. Among men not using a method, 61% reported they might use rhythm, condoms, withdrawal, or vasectomy in the future. 94% of men approved of at least 1 female method, but approval of specific methods varied widely. Over 80% of men in union approved of female sterilization and rhythm, but only 37% approved of pills and 41% of IUDs. The researchers concluded that men cooperate sufficiently to justify similar surveys in other Latin American countries, and that men can be reliable sources of information for programming and evaluation of family planning programs. PMID:12269052

  13. A brief introduction to China's family planning programme.

    PubMed

    Shen, G

    1984-08-01

    bring free contraceptives directly to the people, and family planning motivators are found in almost all villages, neighborhood committees, factories, and military units. As a result of these efforts, China made great strides in controlling population growth and improving MCH during the last decade. The birth rate declined from 27.93 to 18.62, and the total fertility rate declined from 4.01 to 2.48. 124 million couples were practicing contraception by the end of 1983. 41% used IUDs, 37.4% relied on tubal ligation, 12.9% relied on vasectomy, 5.1% on oral contraceptives, and 1% on other methods. The quality of maternal and child care also improved. 92.7% of all deliveries are now performed by trained midwifes. Infant and maternal mortality rates declined considerablely in recent years. Currently the respective rates are 35.68/1000 live births and 0.5/1000 live births. In 1983 alone, the gross national agricultural and industrial output increased by 46.1%. Since 1979 per capita income increased annually by 18.3% among rural residents and by 10.7% among urban workers. China controls and operates its own population program, but in recent years, it increased its cooperation with UN Fund for Population Activities, other UN agencies, and nongovernment agencies. China recently completed its 3rd national census, and demographic research institutes have been established in 10 universities. PMID:12266994