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... prior to deciding to proceed with a vasectomy. Urology Care Foundation Fact Sheet: Vasectomy Reviewed January 2011 You are leaving The Urology Care Foundation has no control over the content ...




... Publications link in the menu on the left. Common Name Vasectomy Medical or Scientific Name Vasectomy Last Updated Date: 07/16/2013 Last Reviewed Date: 06/03/2013 Related A-Z Topics Contraception and Birth Control Sexually Transmitted Diseases (STDs) NICHD News and Spotlights ...


Unintended Pregnancy Prevention: Vasectomy  


... occur. CDC research has estimated there is a probability of 11 per 1,000 procedures over 2 ... women did not regret their husband's vasectomies, the probability of regret over five years was about 6%. ...


Vasectomy offers many advantages.  


Vasectomy, surgical sterilization for men, is very safe, has few side effects, and results in reported annual pregnancy rates of less than 1%. However, men in only a few countries widely adopt vasectomy as their contraceptive method of choice even though it is safer and easier to perform than female sterilization. Approximately 45 million men worldwide have been vasectomized, largely in China, Thailand, India, Korea, the UK, Canada, and the US. Vasectomy is not available in many developing countries, and even if it is available and men have heard of it, many have the misconception that vasectomy causes weakness and adversely affects male sexual function. When trying to increase the access, acceptability, and uptake of vasectomy, enough providers must be trained so that their services are readily available, sustained promotional campaigns should encourage method use, and male clinics and services should be available to help men feel comfortable. Competent counseling is essential to success. The myths and facts of vasectomy, the no-scalpel approach, and promotional campaigns are discussed. PMID:12321061

Finger, W R



Noninvasive laser vasectomy  

NASA Astrophysics Data System (ADS)

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.

Cilip, Christopher Michael


Fournier's gangrene following vasectomy.  


Routine vasectomy was performed on a 29-year old man for whom rheumatoid arthritis had been diagnosed 4 years previously and treated with nonsteroidal anti-inflammatory drugs. The man experienced a flare-up of arthralgia in the wrists 2 weeks prior to the vasectomy. He was treated with a single course of parenteral methyl prednisolone and was in remission at the time of the surgery. On the day following the vasectomy, the patient noticed some erythema around the wound and felt unwell but did not seek medical advice until 4 days later. He was clinically toxic when he presented and experiencing painful gangrene of the scrotum. Treatment was begun immediately with parenteral benzyl penicillin, tobramycin and metronidazole plus aggressive debridement; 30 ml of pus drained and beta hemolytic streptococci Group A, sensitive to penicillin, were cultured. Within a few hours, further spread of gangrene along the penile shaft was noted. He was given hyperbaric oxygen treatment for 3 days followed by secondary debridement. No further spread of the gangrene occurred. 1 week later there was a good tranulating bed over the anterior scrotum. Meshed split skin graft was applied with tie-over dressings. An almost 100% take was achieved 4 weeks later. If hyperbaric oxygen had been employed immediately after surgery, spread of the gangrene might have been avoided. The use of hyperbaric oxygen should be considered as a firstline treatment. PMID:3401669

Chantarasak, N D; Basu, P K



Study Links Vasectomy to Aggressive Prostate Cancer  


... page, please enable JavaScript. Study Links Vasectomy to Aggressive Prostate Cancer But the finding doesn't prove ... a vasectomy may be at increased risk for aggressive prostate cancer, a new study suggests. But the ...


Vasectomy effectiveness in Nepal: a retrospective study  

Microsoft Academic Search

The main purpose of this retrospective, cross-sectional study was to evaluate the effectiveness of vasectomy in an ongoing public sector program in Nepal. We evaluated semen samples from men who had previously had a vasectomy, and asked about the occurrence of pregnancies in the men’s partners. In addition, the surgeons who performed the vasectomies completed a questionnaire about their techniques.

Hanif Nazerali; Shyam Thapa; Melissa Hays; Laxmi R. Pathak; Kalyan R. Pandey; David C. Sokal



Vasectomy effectiveness in Nepal: a retrospective study.  


The main purpose of this retrospective, cross-sectional study was to evaluate the effectiveness of vasectomy in an ongoing public sector program in Nepal. We evaluated semen samples from men who had previously had a vasectomy, and asked about the occurrence of pregnancies in the men's partners. In addition, the surgeons who performed the vasectomies completed a questionnaire about their techniques. A two-stage stratified sampling procedure was used to select 1263 men from among over 30,000 men, who had previously undergone a no-scalpel vasectomy, mostly by ligation and excision, in 32 districts between July 1996 and June 1999. Semen samples were preserved and analyzed at a central laboratory. A US andrology laboratory validated the lab results. Twenty-three men (2.3%, 95% confidence interval [CI] 1.1-3.6) had >/=500,000 sperm/mL in their semen. Fifteen of those men reported pregnancies conceived after their vasectomy. In addition, six men with azoospermia reported pregnancies for which conception occurred within 3 months after vasectomy. Eleven men with azoospermia reported pregnancies for which conception occurred more than 3 months after vasectomy. Reported pregnancy was more likely in younger partners. The life table pregnancy rates for all men interviewed were 0.7 (95% CI 0.2-1.1), 1.7 (95% CI 1.4-2.1) and 4.2% (95% CI 3.2-5.2) at 3, 12 and 36 months, respectively. In low-resource, programmatic settings, vasectomy failure rates may be higher than commonly cited rates, especially in younger populations. Additional research is needed to determine if other occlusion techniques could reduce failure rates. Counseling on vasectomy should always convey the possibility of failure and partner pregnancy. PMID:12742564

Nazerali, Hanif; Thapa, Shyam; Hays, Melissa; Pathak, Laxmi R; Pandey, Kalyan R; Sokal, David C




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... a form of contraception. It does NOT prevent sexually transmitted diseases such as AIDS or herpes. Procedure This operation ... PERMANENT and that it does NOT help prevent sexually transmitted diseases. Some risks and complications may occur. Knowing about ...


What Are the Risks of Vasectomy?  


... Opportunities & Mechanisms Active Funding Opportunity Announcements, notices & mechanisms Peer Review Review of the scientific & technical merit of grant ... J. I. (2003). Testicular pain following vasectomy: A review of postvasectomy pain syndrome. Journal of Andrology, 24 , 293-298. [top] U.S. Centers ...


Incidence of sperm antibodies before and after vasectomy.  

PubMed Central

Sperm-agglutinating antibodies were present in three (2-6%) of 117 fertile men and in 19 (33-9%) of 56 men who had been vasectomized. Twenty-four of the 56 vasectomized men had been studied before vasectomy; sperm-agglutinating antibodies were present in one (4-3%) compared with eight (33-3%) after vasectomy. No sperm-immobilizing antibodies were detected before vasectomy but were present in 10 (17-9%) of the 56 men after vasectomy. PMID:1010880

Hunter, J; Logan, H; Greer, G



The quality of marriage before and after vasectomy.  


A randomly selected sample of 145 couples were seen at the time of a vasectomy request and a year or 18 months later, regardless of whether the vasectomy had been performed, to assess the quality of marriage before and after vasectomy. The sample was seen by 10 different doctors and studied in a seminar at the Cassel Hospital, Ham (UK). All doctors had had training in dealing with psychosexual problems. As part of each interview, the marital pattern was assessed using the following scale: 1) joint, warm, reciprocal, rewarding, showing loving concern; 2) fair, strains but a bearable modest success; and 3) real strains, contained but with difficulty; 4) major strains for both and marital war or major apathy; and 5) impending disaster (breakdown, illness, break up, divorce, or other cause). Using this scale, it became apparent that the majority of marriages improved in quality following vasectomy. This was the case in all age groups. It also appeared that the majority of requests came from successful marriages (score 1 and 2), in some of which strains apparent before vasectomy were not observed afterwards. 90% of the youngest age group had only minor strains whereas in the oldest group 56% had minor strains and 44% major difficulties in the marital relationship. The 94 successful marriages showing only minor strain hoped that vasectomy would prevent further pregnancies and would remove the need for contraception. They felt that they had reached the limit of parenthood and must have absolute protection against pregnancy. Following vasectomy, these marriages improved. Minor sexual problems disappeared, and tensions were eased. The exceptions were couples who had colluded; 3 couples were about to separate and hid their problems. 2 couples hid the husband's history of previous depressive illness. Both the men became severely depressed afterwards. The 37 marriages showing difficulties had also hoped that vasectomy would prevent further pregnancies and the need for contraception. Many also believed that it would improve their sex life as well. Others saw vasectomy as part of the in fighting in marital warfare. Those engaged in longstanding marital warfare remained unchanged as did those with severe sexual difficulties, especially when the husband had believed his wife's frigidity would be improved. Lesser degrees of sexual difficulty seemed to improve especially when these were based on such extreme fears of pregnancy that impotence or frigidity had resulted. PMID:12265816

Howard, G



Semen characteristics and plasma levels of testosterone after bilateral vasectomy in bucks.  


The effects of bilateral vasectomy on the seminal characteristics were assessed in six bucks of the Canarian breed. In addition, we tried to establish the effects of vasectomy on the plasmatic concentrations of testosterone and the libido of the bucks. Semen samples were collected once a week from 8 weeks before to 16 weeks after vasectomy; blood samples were collected prior to vasectomy, and then at once and 1 week after vasectomy and every 2 weeks from the week 4 to the end of the experiment. One week after the vasectomy, ejaculated spermatozoa were non-motile and the percentage of live spermatozoa was below 5% in all vasectomized males; in addition, the total number of cells/ejaculate was 3100 x 106 and 30 x 106 spermatozoa in the control and vasectomized males, respectively. Our results suggest that the vasectomized males may be used as oestrus detectors, without risks of accidental fecundating, only 1 week after vasectomy. Before vasectomy, no significant differences were observed in plasma levels of testosterone between the vasectomized and control males (5.4 +/- 1.2 and 3.9 +/- 1.4 ng/ml, respectively); from 4 to 12 weeks after vasectomy, a marked decrease in the testosterone concentration in all males (vasectomized and control bucks) was observed. From 12 weeks after vasectomy until the end of the experiment, four of the vasectomized males and the control males recovered their normal libido. The results suggest that vasectomy did not exert a remarkable effect on the steroidogenic functionality of the testicle. PMID:12464078

Batista, M; Prats, N; Calero, P; González, F; Cabrera, F; Medrano, A; Gracia, A



[Vasovasostomy after vasectomy. The surgical results 1986-1989].  


The frequency of vasovasostomy has increased dramatically in recent years. A significant percentage of men who have previously undergone vasectomy are now seeking restoration of their fertility. The most common reason for requesting a reversal is remarriage. There were 90 bilateral vasovasostomies performed in 90 patients between 1986 and 1989. The procedure was done according to the technique described by Howards, in a single layer with 7 x 0 prolene and under fourfold magnification. The success rate was 87% for presence of spermatozoa in the ejaculate, 48% for pregnancy. The fertility rate decreases slowly with increasing interval between vasectomy and reanastomosis. These results are statistically significant. In cases of good anatomical and andrological conditions, the chance of restoration of fertility is good. The experience of the urologist is often more important than the details of the technique. PMID:1561725

Noldus, J; Otto, U; Salamon, J; Schulze, W; Klosterhalfen, H



Original research article Pregnancy rates after vasectomy: a survey of US urologists  

Microsoft Academic Search

We surveyed 2000 US urologists using mailed questionnaires. The aim of this survey was to estimate the incidence of pregnancy after vasectomy and to gather information on the surgical methods used. Of 586 responding urologists, 538 reported performing vasectomies, and they reported a total of 177 pregnancies during the preceding 5 years. Ninety pregnancies (51%) were attributed to unprotected intercourse

Catherine Deneux-Tharaux; Erum Kahn; Hanif Nazerali; David C. Sokal


The use of vasectomy in stray cat population control  

E-print Network

Figure 7 Male cats trapped for vasectomy. . . . 20 Number of cats trapped using standard animal control procedures. . . . . . . 21 INTRODUCTION Stray Cat Ecology The problem of overpopulation of cats in the United States is both insidious..., these new cats will breed to whatever population numbers the area will support. Additionally, overpopulation of pet cats supply a continuous source ("seed stock") for the stray cat population. Finally, elimination of cat populations causes distress...

Mahlow, Jane Caryl



Role of no scalpel vasectomy in male sterilization.  


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

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



As U.S. Economy Worsened, Vasectomy Rates Rose, Study Finds  


... the cost of raising children in an uncertain job market may have spurred an uptick in vasectomies, a new study suggests. "Despite an unchanged desire for more children, men in relationships reported planning for smaller families," said a team ...


Incidence of disease after vasectomy: a record linkage retrospective cohort study.  

PubMed Central

OBJECTIVE--To determine whether vasectomy is associated with an increased risk of several diseases, and in particular testicular cancer, after operation. DESIGN--Retrospective cohort study using linked medical record abstracts. SETTING--Six health districts in Oxford region. SUBJECTS--13,246 men aged 25-49 years who had undergone vasectomy between 1970 and 1986, and 22,196 comparison subjects who had been admitted during the same period for one of three specified elective operations, appendicitis, or injuries. MAIN OUTCOME MEASURES--Hospital admission and death after vasectomy or comparison event. RESULTS--The mean durations of follow up were 6.6 years for men with a vasectomy and 7.5 years for men with a comparison condition. The relative risk of cancer of the testis in the vasectomy cohort (4 cases) compared with that in the other cohorts (17 cases) was 0.46 (95% confidence interval 0.1 to 1.4), that of cancer of the prostate (1 v 5 cases) 0.44 (0.1 to 4.0), and that of myocardial infarction (97 v 226 cases) 1.00 (0.8 to 1.3). There was no evidence of an increase associated with vasectomy in the incidence of a range of other diseases. CONCLUSIONS--Vasectomy was not associated with an increased risk of testicular cancer or the other diseases studied. With respect to prostatic cancer, while we found no cause for concern, longer periods of observation on large numbers of men are required. PMID:1571679

Nienhuis, H.; Goldacre, M.; Seagroatt, V.; Gill, L.; Vessey, M.




Microsoft Academic Search

Five groups of male rhesus monkeys, Gp. I–sham-vasectomized stock diet-fed (SVS), Gp. II–vasectomized stock diet-fed (VS), Gp. III–sham-vasectomized atherogenic diet-fed (SVA), Gp. IV–vasectomized atherogenic diet-fed (VA) and Gp. V–atherogenic diet-fed vasectomized monkeys (AV) were observed for a period of 1½ years. Vasectomy per se had no effect on the level of serum or tissue lipids either alone or in combination

Neelam Bansal; S Majumdar; NK Ganguly



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


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

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



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


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

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



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

NASA Astrophysics Data System (ADS)

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.

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



Vasectomy Reversal  


... March 2013 You are leaving The Urology Care Foundation has no control over the content of this site. Click OK to proceed. Urology A - Z A Adrenal Gland Disorders Adrenal Medulla ...


Vasectomy Reversal  

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... our ability to do the procedure or the post-operative course. So careful, meticulous hemostasis is obtained. ... no additional issues in the scrotum in the post-operative period, making examination of understanding of what ...


Long-term vasectomy: effects on the occurrence and extent of atherosclerosis in rhesus monkeys.  

PubMed Central

We demonstrated previously that atherosclerosis develops more extensively in vasectomized cynomolgus macaques fed an atherogenic diet and speculated that the immunologic response to sperm antigens may have exacerbated the atherosclerosis. We report here that rhesus monkeys vasectomized for 9-14 yr and fed monkey chow (devoid of cholesterol and low in fat) rather than an atherogenic diet also had more extensive and severe atherosclerosis than did control animals of the same age. The extent of atherosclerosis was considered as the percentage of intimal surface with plaques. No control animals were found to have plaques in the thoracic aorta, but 7 of 10 vasectomized monkeys were affected. The plaques in the vasectomized monkeys occupied about 13% of the intimal surface. In 4 of 7 control monkeys and 7 of 10 vasectomized monkeys there were lesions in the abdominal aortas; the lesions were considerably more extensive and severe in the vasectomized animals. Lesions were also more common in iliac arteries of vasectomized animals, and the extent was increased about threefold. Plaques were seen at the carotid bifurcation in all of the animals of both the control and vasectomized groups. The carotid bifurcation plaques of the vasectomized monkeys were larger than those of the control animals on the right but not on the left side. Histologically, the lesions of vasectomized monkeys did not appear to be qualitatively different from those of control animals, even though they were larger and contained more collagen, lipid, and mucopolysaccharides. Grossly, the distribution of the lesions in the vasectomized animals was different from that in the control animals, and that of lesions induced by atherogenic diets, i.e., the lesions were distributed randomly within the artery rather than around bifurcations. More extensive atherosclerosis was noted among vasectomized animals that were found to lack demonstrable circulating free antisperm antibodies. On the basis of the observations made in this study, we suggest that the antisperm antibodies that form after vasectomy may result in circulating immune complexes that exacerbate atherosclerosis. Images PMID:6765957

Clarkson, T B; Alexander, N J



A clinical and ultrasonographic study of the testes and related structures of goats and rams after unilateral vasectomy.  


The semen quality, plasma testosterone concentrations and ultrasonographic changes were studied for up to 20 weeks after the unilateral vasectomy of two adult goats and two rams, and the gross and histological changes were examined post mortem. An intact ram and an intact goat served as controls. There was a marked decrease in the sperm concentration and the total numbers of sperm per ejaculate in both species. However, there seemed to be no effect on ejaculatory volume, mass motility and individual motile sperm, percentages of dead and abnormal sperm and plasma concentrations of testosterone. Ultrasonographically, the epididymal tail lost its characteristic heterogeneous texture and appeared enlarged. Anechoic masses, representing sperm granulomata, were visible within the epididymal tail of both the rams, and the epididymal head of one of the goats and at the cut end of the vas deferens in the other. They were observed as early as four to six weeks after surgery and their nature was confirmed post mortem. The sequential ultrasonographic changes in the testis and the epididymis are described. PMID:8533254

Ahmad, N; Noakes, D E



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

NASA Astrophysics Data System (ADS)

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 functional occlusion of the seminal duct. The application of Histoacryl® additionally may be easily reversible by laser treatment.

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



[Spontaneous recanalization after vasectomy].  


Two cases of spontaneous recanalisation could be reoperated. The recanalisation was proved histologically. The reasons were analysed. The own technique is presented: resection of at least two centimeters of the vas, ligature, electrocoagulation, proximally turning-up fixation of the end, distally immersing the end in a tobacco-pouch. PMID:8119817

Pestalozzi, D M; Bannwart, F; Knönagel, H



Comparative Effects of Vasectomy Surgery and Buprenorphine Treatment on Faecal Corticosterone Concentrations and Behaviour Assessed by Manual and Automated Analysis Methods in C57 and C3H Mice  

PubMed Central

Establishing effective cage-side pain assessment methods is essential if post-surgical pain is to be controlled effectively in laboratory animals. Changes to overall activity levels are the most common methods of assessment, but may not be the most appropriate for establishing the analgesic properties of drugs, especially in mice, due their high activity levels. Use of drugs that can affect activity (e.g. opioids) is also a problem. The relative merits of both manual and automated behaviour data collection methods was determined in two inbred mouse strains undergoing vasectomy following treatment with one of 2 buprenorphine dose rates. Body weights and the effects of surgery and buprenorphine on faecal corticosterone were also measured. Surgery caused abnormal behaviour and reduced activity levels, but high dose buprenorphine caused such large-scale increases in activity in controls that we could not establish analgesic effects in surgery groups. Only pain-specific behaviour scoring using the manual approach was effective in showing 0.05 mg/kg buprenorphine alleviated post-vasectomy pain. The C57 mice also responded better to buprenorphine than C3H mice, indicating they were either less painful, or more responsive to its analgesic effects. C3H mice were more susceptible to the confounding effects of buprenorphine irrespective of whether data were collected manually or via the automated approach. Faecal corticosterone levels, although variable, were higher in untreated surgery mice than in control groups, also indicating the presence of pain or distress. Pain-specific scoring was superior to activity monitoring for assessing the analgesic properties of buprenorphine in vasectomised mice. Buprenorphine (0.01 mg/kg), in these strains of male mice, for this procedure, provided inadequate analgesia and although 0.05 mg/kg was more effective, not completely so. The findings support the recommendation that analgesic dose rates should be adjusted in relation to the potential severity of the surgical procedure, the mouse strain, and the individual animals' response. PMID:24098748

Wright-Williams, Sian; Flecknell, Paul A.; Roughan, Johnny V.



Comparative effects of vasectomy surgery and buprenorphine treatment on faecal corticosterone concentrations and behaviour assessed by manual and automated analysis methods in C57 and C3H mice.  


Establishing effective cage-side pain assessment methods is essential if post-surgical pain is to be controlled effectively in laboratory animals. Changes to overall activity levels are the most common methods of assessment, but may not be the most appropriate for establishing the analgesic properties of drugs, especially in mice, due their high activity levels. Use of drugs that can affect activity (e.g. opioids) is also a problem. The relative merits of both manual and automated behaviour data collection methods was determined in two inbred mouse strains undergoing vasectomy following treatment with one of 2 buprenorphine dose rates. Body weights and the effects of surgery and buprenorphine on faecal corticosterone were also measured. Surgery caused abnormal behaviour and reduced activity levels, but high dose buprenorphine caused such large-scale increases in activity in controls that we could not establish analgesic effects in surgery groups. Only pain-specific behaviour scoring using the manual approach was effective in showing 0.05 mg/kg buprenorphine alleviated post-vasectomy pain. The C57 mice also responded better to buprenorphine than C3H mice, indicating they were either less painful, or more responsive to its analgesic effects. C3H mice were more susceptible to the confounding effects of buprenorphine irrespective of whether data were collected manually or via the automated approach. Faecal corticosterone levels, although variable, were higher in untreated surgery mice than in control groups, also indicating the presence of pain or distress. Pain-specific scoring was superior to activity monitoring for assessing the analgesic properties of buprenorphine in vasectomised mice. Buprenorphine (0.01 mg/kg), in these strains of male mice, for this procedure, provided inadequate analgesia and although 0.05 mg/kg was more effective, not completely so. The findings support the recommendation that analgesic dose rates should be adjusted in relation to the potential severity of the surgical procedure, the mouse strain, and the individual animals' response. PMID:24098748

Wright-Williams, Sian; Flecknell, Paul A; Roughan, Johnny V



Studies in Family Planning, Volume 3, Number 8.  

ERIC Educational Resources Information Center

"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…

Population Council, New York, NY.


Female Sterilization: Risk of Ectopic Pregnancy After Tubal Sterilization  


... Female Sterilization: Ectopic Pregnancy Back to Female Sterilization Female Sterilization: Risk of Ectopic Pregnancy After Tubal Sterilization ... and Health Promotion Home Contraception Medical Eligibility Criteria Female Sterilization Vasectomy Reproductive Health Home Data and Statistics ...


Vasitis nodosa and associated clinical findings.  

PubMed Central

To establish the prevalence of vasitis nodosa in patients who had undergone vasectomy segments of vas deferens resected from 40 patients at the time of vasectomy reversal were examined histologically and immunohistochemically. The findings were correlated with clinical history and postoperative outcome. Controls comprised segments of normal vas deferens excised at vasectomy. Twenty of the 40 vasovasostomy specimens showed vasitis nodosa; in 13 this was associated with sperm granulomas and in two with spermatocoeles. The vasitis nodosa was characterised by multiple small ductules extending from the central lumen of the vas into the muscle layers and adventitia. In 14 cases there was mucinous metaplasia of the epithelium lining the ductules. The number of nerve fibres in the submucosa and muscle layers was reduced after vasectomy. In patients with vasitis, however, hyperplasia of nerve fibres in the adventitia (16 of 20 cases) and formation of neuromas were seen. Nerve fibre hyperplasia was seen in only one, and sperm granulomas and spermatocoeles in none of the 20 specimens without vasitis nodosa. The development of vasitis nodosa was independent of the patients' age or the interval between vasectomy and reversal. The restoration of fertility did not seem to be affected by previous vasitis nodosa. Images Fig 1 Figs 2a and b Fig 3 Fig 4 Fig 5 PMID:3366928

Hirschowitz, L; Rode, J; Guillebaud, J; Bounds, W; Moss, E



[Self concept patterns according to the Tennessee self concept scale in vasectomized men and their partners].  


This study investigates 40 couples whose male partners had voluntarily undergone vasectomy as a permanent contraceptive method. The Tennessee self concept scale test was used to examine changes, if any, in personality characteristics. The only changes were in self-perception of conflict and identity, while adjustment-disadjustment patterns, and psychosis and neurosis patterns remained identical to those tested before vasectomy. The typical negative characteristics of Mexican men and women, i.e., confusion regarding self-perception, passivity, dependence, social insecurity, and the positive ones, such as ability to socially communicate, and emotional perception, were not changed, as was unchanged the conflict as to sexual identity which often prevents Mexicans to fully enjoy sexual gratification. Changes in intellectual capacity were measured, before and after vasectomy, with the Beta test. Both men and women showed an increased capacity in intellectual performance. PMID:540755

González de Malo, S M; Giner Velázquez, J; Oscos, A



Microsurgical vasovasostomy  

PubMed Central

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

Herrel, Lindsey; Hsiao, Wayland



DCTD — Developmental Therapeutics Program (DTP)

DTP’s Biological Testing Branch oversees animal-production facilities that produce inbred, outbred, and hybrid strains of rats and mice. This program provides researchers nationwide with genetically defined, pathogen-free laboratory animals, as well as animal-related services such as jugular vein cannulations, vasectomies, ovariectomies, and castrations.


Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association. Qualified medical expenses  

E-print Network

·Oxygenandoxygenequipment ·Pediatrician ·Physician ·Physiotherapist ·Podiatrist ·Postnataltreatments(forhealthcare) ·Ultravioletraytreatment ·Vaccines ·Vasectomy ·Vitamins(ifprescribed) ·Wheelchair ·X-rays Eligible HSA medical expenses




... sperm that is released through the penis during orgasm). You must use a latex or synthetic condom, even if you have had a vasectomy (surgery that prevents a man from causing a pregnancy), every time you have sexual contact with a female who is pregnant or able to become pregnant ...


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


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 option in zoo animals, even in endangered species. Ongoing use of gamete and embryo freezing may salvage vanishing species. PMID:24437091

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



Correlations between two markers of sperm DNA integrity, DNA denaturation and DNA fragmentation, in fertile and infertile men  

Microsoft Academic Search

Objective: To evaluate two different assays of human sperm DNA integrity, DNA denaturation (DD) and DNA fragmentation (DF), and to correlate these with standard semen parameters.Design: Prospective, observational study.Setting: University infertility clinic.Patient(s): Forty consecutive semen samples from 33 nonazoospermic men presenting for infertility evaluation and 7 fertile men presenting for vasectomy.Intervention(s): Assessment of sperm concentration, motility, morphology, DD and DF.Main

Armand Zini; Ryszard Bielecki; Donna Phang; Maria Teresa Zenzes



Polychlorobiphenyl congeners, p,p? DDE, and sperm function in humans  

Microsoft Academic Search

170 seminal samples from fertile men, men with idiopathic oligospermia or azoospermia and men status post vasectomy were analyzed for 74 polychlorobiphenyl (PCB) congeners,p,p'-DDE, mirex, and hexachlorobenzene using the technique of glass capillary gas chromatography with electron capture detection. Low concentrations of 32 PCB congeners were measured (mean total PCB residue of 5.8 ng\\/g wet weight). The application of multiple

Brian Bush; Alan H. Bennett; John T. Snow



Chromosomes of human sperm: Variability among normal individuals  

Microsoft Academic Search

The chromosomal constitution of 2468 human sperm cells been investigated by fusion of human sperm with hamster eggs. The overall frequency of cells with structural aberrations was 7.7%, ranging from 1.9% to 15.8%, and varying significantly among individuals. The highest frequency occurred in sperm from the oldest donor (49 years), who also had had a vasectomy reversal three years prior

B. Brandriff; L. Gordon; L. Ashworth; G. Watchmaker; D. Moore; A. J. Wyrobek; A. V. Carrano



Local Anesthesia and Nerve Blocks  

Microsoft Academic Search

\\u000a Many inguino-scrotal procedures in urology can be performed under local anesthesia. Sometimes local anesthetics are used to\\u000a supplement post-operative pain relief in patients who had general anesthesia. The common nerve blocks are an inguinal block\\u000a for hernia repairs and inguinal orchidectomies, a cord block for vasectomies, and a penile block for circumcision and frenuloplasty.\\u000a The testis and scrotum are innervated

Hashim Hashim


Influence of reproductive tract obstruction on expression of epididymal proteins and their restoration after patency  

PubMed Central

Vasectomy is a simple and reliable method of male contraception. A growing number of men after vasectomy request vasectomy reversal due to various reasons. The pregnancy rate is lower than the patency rate after vasovasostomy and the pregnancy rate is time dependent. In this study, we evaluated the influence of reproductive tract obstruction on expression of epididymal proteins and their restoration after patency. Adult male Wistar rats were studied 30, 60 and 120 days after vasectomy, 30 days after vasovasostomy or after sham operations. Two-dimensional gel electrophoresis, mass-spectrometric technique, multidatabase search, Western blotting and real-time PCR were used to analyze the expression regulation of epididymal proteins. Total integrated intensity and total spot area of autoradiograms showed a consistent downward trend with time after obstruction, and this trend remained after patency. The intensity of the autoradiographic spots in three patency groups showed three trends: a downward trend, similar intensity and an upward trend compared with the correspondent obstruction group, respectively. Further verified experiments on human epididymis 2 (HE2), fertilization antigen-1 (FA-1), clusterin and PH20 demonstrated that compared with the correspondent obstruction group, the translation levels of HE2 and the mRNA transcription levels of HE2 showed an upward trend in patency groups, especially in the groups of obstruction for 60 days where the expression levels of HE2 were significantly upregulated after patency (P<0.05). Reproductive tract obstruction provokes a disregulation of gene expression in the epididymis and this disregulation remained after patency. Successful reversal may recover some proteins and the recovery is time dependent. Obstruction differentially alters mRNA transcription of different proteins and the content of proteins seemed to be easier to be influenced than the gene transcription. PMID:22922320

Li, Bing-Kun; Wang, Xiang; Liu, Chun-Xiao; Zheng, Shao-Bo; Li, Hu-Lin; Li, Li-Ping; Xu, A-Bai



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

NASA Astrophysics Data System (ADS)

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.

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



Noninvasive laser coagulation of the canine vas deferens, ex vivo  

NASA Astrophysics Data System (ADS)

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.

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



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)

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.

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



Mental health and population growth.  


Although overpopulation has produced psychological ill-effects upon animals observed in experiments, it has not yet been shown that overpopulation has severe psychological ill effects upon humans. The psychological effects of various methods of contraception demand our more immediate attention. Few studies in India have been carried out upon the psychological after-effects of vasectomy, for example, but those that have indicate that the commonest complaint in post-vasectomy cases has been multiple somatic symptoms without any demonstrable physical basis. The after-effects of tubectomy can be broadly classified into 3 areas--menstrual, sexual, and psychological. The most commonly reported psychological disturbances following tubectomy are anxiety, depression, irritability, apprehension, memory impairment, hysterical fits and psycho-neurosis, which occur in 15% to 20% of cases. 3 studies on the prevalence of symptoms after abortion show that they are less severe as compared with tubectomy and vasectomy. 1 study of the psychological effect of the contraceptive pill showed high prevalence of depressive symptoms. 1 study of the IUD showed a decrease in sexual desire. All of the studies reviewed were conducted in India, but Western literature on the subject is in general no better. The author proceeds to give a methodological critique of some of the major studies done outside India and proposes suggestions for future studies. He does note, however, that studies done in the U. S. and in the U. K. report markedly fewer psycho-sexual symptoms among patients in those countries than occur among patients in India. He conjectures that this difference is due to voluntary and highly motivated use of contraception in the West as opposed to coercive and poorly motivated adoption of contraception in India. PMID:12336154

Wig, N N




PubMed Central

OBJECTIVE: To compare the efficacy of, and complications associated with, vasectomies performed in two medical clinics. DESIGN: Retrospective cohort study. SETTING: A private medical clinic and a family planning clinic at a teaching hospital in the Quebec City region, where one doctor performs all surgery. PARTICIPANTS: The 1223 men who underwent a first vasectomy between January 1994 and February 1996. INTERVENTIONS: Isolations of the vas deferens through the scrotum was performed using the no-scalpel technique in both clinics. At the private clinic (n = 775), vasectomy was performed by ligature with tantalum clips. At the family planning clinic (n = 448), a combination of cauterisation of the abdominal end of the vas deferens, leaving the testicular end open, and fascial interposition with a clip was used. MAIN OUTCOME MEASURES: Rate of postoperative complications (painful granuloma; noninfectious inflammation of the vas deferens, epididymis, and testes; hematoma; infection; undiagnosed pain) and rate of recanalization (early and late). RESULTS: At the private clinic, 39 patients (5.0%) consulted for postoperative complications, compared with 55 patients (12.3%) at the family planning clinic (chi (2)1 = 21.0; P < 0.001). Of the patients who underwent semen analysis, 15 (2.8%) at the private clinic and 4 (1.2%) at the family planning clinic experienced early or late recanalization (chi (2)1 = 2.2; P < .14). CONCLUSION: The rate of consultation for postoperative complications was lower at the private clinic than at the family planning clinic, but the efficacy of the procedure appeared to be higher at the family planning clinic. The surgical techniques used at the two clinics might partially explain these differences. PMID:9789666

Labrecque, M.; Bedard, L.; Laperriere, L.



Family planning and its effects on the lives of women in China.  


This report presents findings from a family planning (FP) survey of the population in 2 counties in North Anhui province and 2 counties in South Jiangsu province, China. FP views differed between the older and younger generation. About 66% viewed FP as positive. One women noted the increase in women's status. Young women and men preferred the husband's role as breadwinner and wife's role in the home. Preference for a son as a first child was expressed by 13% of men and women in South Jiangsu and 25-30% in North Anhui. Respondents from North Anhui indicated that sons were valuable for old age support and as persons to carry on the family name. Some mothers reported pressure from mothers-in-law to bear a son. Over 33% in South Jiangsu desired a stronger FP role for men, expressed in their acceptance of vasectomy. Over 50% wanted men to use condoms. In North Anhui, 60% wanted more men to undergo vasectomy; 52% wanted men to use condoms. 97% in South Jiangsu and 91% in North Anhui used contraception. Nearly 82% of contraceptive users in South Jiangsu and 31% in North Anhui used the IUD. 29% of husbands in North Anhui and under 1% in South Jiangsu had obtained a vasectomy. Nearly 20% of women in South Jiangsu and 9% in North Anhui had had a pregnancy due to contraceptive failure. Fertility was 1.3 children/woman in South Jiangsu and 1.8 in North Anhui. After focus groups, researchers recommended improvements in quality of care and services to adolescents and youth, wider choices of methods, and promotion of the value of daughters. PMID:12321926

Barnett, B



Male contraception: history and development.  


Although the twentieth century has seen great strides in the development of female contraception, not a single new agent has been introduced as an approved method for common use for male contraception. Condoms (considered uncomfortable by some) and vasectomy (a permanent invasive procedure) are the only options provided to men, leaving an undue burden on women to bear contraceptive responsibility. Significant developments have, however, been made with regard to hormonal and nonhormonal contraception, and minor, reversible, procedural contraception. This article reviews the currently available, soon to be available, and theoretically possible methods of male contraception. PMID:24286773

Kogan, Paul; Wald, Moshe



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

NASA Astrophysics Data System (ADS)

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.

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



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

NASA Astrophysics Data System (ADS)

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.

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



Contraceptives: choice for the millions?  


India adds each year the population of Sub-Saharan Africa to the earth. User based factors determining the type of contraceptive that is used most often in a country are sociocultural practices including religion, literacy, women's status and their role in decision making, men's status, misconceptions, and convenience of use. Service related factors include knowledge and skill of the provider, attitude of the provider, accessibility of family planning services, cost of the contraceptives, and quality of services. The government, nongovernmental organizations, and the pharmaceutical firms tend to be the contraceptive researchers and suppliers. The mass media are used to disseminate information on contraceptives. They often relay sensational reports about a contraceptive method that results in its reduced use. Temporary or spacing family planning methods include natural family planning methods, condoms, IUDs, oral contraceptives, implants, and injectables, spermicides and vaginal barriers. The natural family planning methods are sexual abstinence, especially in the postpartum period; rhythm or calendar method; and coitus interruptus. The most cost-effective method is also the most popular method--sexual sterilization. Even though female sterilization is more difficult to perform than vasectomy, it is more common than vasectomy. Contraception should become a people's movement rather than be forced upon the people. People should insist on good quality, affordable contraceptive services as their basic right. PMID:12345776

Dhall, A



Women's contraceptive attitudes and use in 1992.  


Women aged 15-44 rate the pill, the condom, vasectomy and female sterilization most highly, according to 1992 data from an annual survey by Ortho Pharmaceutical Corporation of contraceptive attitudes and method use. The 6,955 survey respondents underrepresent women who are black or who have household annual incomes greater than $50,000, but they are similar to all American women in age, marital status and region of the country. About 74-84% of women giving an opinion view these methods favorably and 64% rate the hormonal implant favorably. The proportion of unmarried women who had had intercourse increased from 76% in 1987 to 86% in 1992. As a result, proportions of women at risk of unintended pregnancy rose from 72% to 77%. Contraceptive use also rose, from 92% to 94%. The most commonly used method is the pill (39%), followed by the condom (25%), female sterilization (19%) and vasectomy (12%). Married women exposed to the risk of unintended pregnancy are more likely to use sterilization (48%), while unmarried women are more likely to use the pill (52%) and the condom (33%). Pill use has increased since 1987, especially among married women, and condom use has increased among all women. Among unmarried women at risk of unintended pregnancy, condom use rose from 18% in 1987 to 33% in 1992. Among condom users, 40% of unmarried users and 13% of married users also use another method. PMID:8405344

Forrest, J D; Fordyce, R R



Quinacrine Pellet Method of Nonsurgical Female Sterilization in Iran: Preliminary Report on a Clinical Trial  

E-print Network

ealth has taken various steps to promote family planning, from erecting billboards with messages discouraging people from having large families, to pro- viding free oral contraceptives. Modern contraceptives are available in Iran and are used by roughly half of women in both urban and rural areas. Among urban women, 19% use the pill, 11% each have undergone voluntary ster- ilization and use the IUD, 8% rely on the condom and are protected by their husband 's vasectomy; in rural areas, 27% use the pill, 11% have had a tubal occlusion, use the IUD or condom and 1% have Sheitaneh Soroodi-Moghaddam is a family planning specialist in private practice in Tehran, Iran. 122 a husband who has had a Given the prevalence of tubal occlusion, the cost of hospitalization for sterilization and the risks associated with any surgical procedure, nonsurgical fema

Sheitaneh Soroodi-moghaddam


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


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

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



Surgical sterilization of free-ranging wolves.  

PubMed Central

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

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



Robotic instrumentation: Evolution and microsurgical applications  

PubMed Central

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

Parekattil, Sijo J.; Moran, Michael E.



Achievements of the Iranian family planning programmes 1956-2006.  


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

Simbar, M



Male adolescent sexual behavior, the forgotten partner: a review.  


It is encouraging that after years of focusing attention on the female's ability and responsibility to manage her reproductive behavior, the male is finally beginning to receive notice and attention. Ironically, before the widespread use of the Pill and the IUD, men and male birth control methods played an important role in family planning. Even today, reliance on vasectomies, the condom and withdrawal account for 25% of the contraceptive use among couples and trend statistics point to an increased interest among selected populations in the use of barrier methods that require partner cooperation for effective use. Yet, most small scale and nationwide knowledge, attitudes and practice (KAP) studies focus on the female, particularly the teen-age female. With the exception of fragmentary survey data, pertinent information about male adolescent sexual activity is virtually nonexistent. The growing consensus among researchers and planners is that it is now crucial to research the forgotten partner--the adolescent male. PMID:6558293

Finkel, M L; Finkel, D J



Fine-tuning control of testicular functions.  


The effect of testicular administration of peptides synthesized in the testis (somatostatin, oxytocin) or peptide antagonists (opioid receptor antagonists naloxone, nalmefene, anti-corticotrop hormone-releasing hormone antiserum, beta-endorphin antiserum), partial denervation of the testis, and combination of local treatment with peptides/peptide antagonists and denervation was studied on testicular steroidogenesis in immature hemicastrated rats. The observations indicate that beta-endorphin, corticotrop hormone-releasing hormone, oxytocin, and somatostatin exert a stimulatory, whereas enkephalin has an inhibitory action on steroidogenesis. Surgical (vasectomy) or pharmacological (local injection of 6-hydroxydoparnine) denervation suppresses testosterone secretion. Following partial denervation of the testis the effect of naloxone or oxytocin on steroidogenesis observed in fully innervated gonad is not present or the effect is paradoxical. These results indicate that steroidogenesis is fine-tuned by local peptide actions, and neural inputs. Data further suggest an interaction between local peptide action and neural control. PMID:9503381

Gerendai, I



Unilateral duplication of vas deferens: a cadaveric case report  

PubMed Central

Duplication of vas deferens is a rare congenital anomaly. All previously reported cases of this rare anomaly were identified during procedures such as orchiepexy, inguinal hernia repair, vasectomy, varicocoelectomy, and radical prostatectomy. Here, we report a case of unilateral duplicated vas deferens noted in an adult cadaver during regular dissection for medical students. The right spermatic cord contained 2 separate and completely developed cord-like structures. Both cords communicated separately with the tail of the epididymis. When traced cranially, both traversed the inguinal canal as content of the spermatic cord and finally fused at the level of the deep inguinal ring. No other variations were found in the testis or epididymis, and no variations were seen in the left spermatic cord. In addition, no associated renal abnormalities were noted. PMID:23560239

Sirasanagandla, Srinivasa Rao; Nayak, Satheesha B.; Jetti, Raghu



A Case of Duplicated Vas Deferens Found Incidentally during Varicocelectomy  

PubMed Central

Duplication of the vas deferens is a very rare congenital anomaly in which two vasa deferentia coexist within the spermatic cord. Duplication of the vas deferens can be found during herniorrhaphy, vasectomy, and varicocelectomy performed on the spermatic cord or around the spermatic cord. However, it is estimated that the incidence of duplication of the vas deferens is under-reported and under-recognized. Unless anomalies of the vas deferens such as duplication of the vas deferens are recognized by surgeons, it will be difficult to reduce vas deferens injuries and achieve a satisfactory surgical outcome. In addition, care should be taken in cases of duplication of the vas deferens because it can be complicated by non-testicular genitourinary anomalies. We report a case of duplication of the vas deferens discovered during routine varicocelectomy. PMID:24459663

Lee, Jun Nyung; Kim, Hyun Tae; Chung, Sung Kwang



[The problem of overpopulation in Asia].  


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 population. PMID:7281040

Knaus, J P



Progress in male contraceptive research.  


80% of the world's contraceptive users are women. This gender-based usage has occurred due to the emphasis of family planning programs and contraception research on female methods. Even if men desired to take responsibility for contraception, only the condom and vasectomy are available and have a reasonable assurance of protection. The Population Council has been researching male contraception through its Center for Biomedical Research. An oral contraceptive derived from gossypol, a cottonseed plant pigment, is being tested after successful clinical trials were performed in China during the 1970s. Also being investigated are male hormonal methods that regulate sperm production while protecting against loss of potency, loss of libido, and changes in secondary sex characteristics. A hormonal implant, effective for one year, has been in Phase I clinical trials since 1993. A small Phase I clinical trial is in process for a vaccine/implant for men that is effective for one year. Testing with injectables for men has suggested that different hormonal mixes could increase cardiovascular risk for men and exacerbate prostate cancer. Research has focused on new materials for condoms. Kraton-type materials are made from block copolymers and polyurethanes, and these condoms have shown some promise. The advantages of these products are that they are allergen-free, less susceptible to oxidation, and can be of thinner construction, which would increase sensitivity and acceptability. The percutaneous chemical method of no-scalpel vasectomy has been studied as a means of blocking passage of sperm in the vas deferens. In China and India, injections with liquid silicone, polyurethane, neem-oil, and n-butyl-cyanoacrylate mixed with phenol are being studied. Zinc injections that cause the epididymis to atrophy are being tested on animals in the US. Lasers and fiber cautery are other methods under investigation. Increased funding is essential for these and other research efforts. PMID:12288916



An inverse relationship exists between seminal plasma inhibin and serum follicle-stimulating hormone in man.  


Inhibin concentrations were measured in 109 seminal plasma samples obtained from 32 normal subjects, 51 infertile patients with either azoospermia or oligospermia, and 20 patients 2-8 months post vasectomy. The infertile group included 14 azoospermic patients with raised peripheral plasma FSH levels (6.8-30.2 IU/liter) and 17 azoospermic patients in whom FSH levels were normal. Only 6 of the 20 patients with oligospermia had raised FSH levels. Seminal plasma inhibin was measured in individual samples using a quantitative in vitro rat anterior pituitary cell culture bioassay in which FSH cell anterior pituitary cell culture bioassay in which FSH cell content was measured after 72 h of incubation with the inhibin-containing material. Biopotencies were determined using combined multiple parallel line assays with reference to an inhibin standard with a potency of 1 U/mg. The concentrations of inhibin in normal seminal plasma were 31.4 +/- 3.0 U/ml, which contrasted with the low levels found in azoospermic patients with high plasma FSH levels. Of these, seven had undetectable inhibin levels (less than 2.5 U/ml) and seven had values ranging from 4.2-8.5 U/ml. These concentrations were significantly lower than those in azoospermic patients, in whom FSH was not raised (18.9 +/- 2.2 U/ml). Seminal plasma inhibin levels post vasectomy were 16.9 +/- 2.3 U/ml and were not significantly different from those measured in azoospermic-normal FSH patients. Peripheral plasma FSH levels were expressed as a function of seminal plasma inhibin concentrations (r = -0.736; P less than 0.001; excluding those patients with vasal obstruction). These findings show that inhibin-like activity in seminal plasma is reduced in infertile men with raised peripheral plasma FSH levels, and that a reciprocal inverse relationship exists between serum FSH and seminal plasma inhibin concentrations. PMID:6782118

Scott, R S; Burger, H G



Aetiology of testicular cancer: association with congenital abnormalities, age at puberty, infertility, and exercise. United Kingdom Testicular Cancer Study Group.  

PubMed Central

OBJECTIVE--To determine the risk of testicular cancer associated with undescended testis, inguinal hernia, age at puberty, marital status, infertility, vasectomy, and amount of exercise. DESIGN--A population based case-control study with a questionnaire administered by an interviewer and with relevant supplementary data extracted from general practitioners' notes. SETTING--Nine health regions within England and Wales. SUBJECTS--794 men, aged 15-49 years, with a testicular germ cell tumour diagnosed between 1 January 1984 and 1 January 1987; each had an age matched (within one year) control selected from the list of their general practitioner. RESULTS--There was a significant association of testicular cancer with undescended testis (odds ratio 3.82; 95% confidence interval 2.24 to 6.52) and inguinal hernia (1.91; 1.12 to 3.23). The excess risk associated with undescended testis was eliminated in men who had had an orchidopexy before the age of 10 years. There were positive associations with early age at voice breaking, early age at starting to shave, and infertility. There was a significant association with a sedentary lifestyle and a moderate protective effect of exercise. There was no association with vasectomy. CONCLUSION--This study confirms previous reports that developmental urogenital abnormalities result in an increased risk of testicular cancer. The trend to perform orchidopexy at younger ages may reduce the risk associated with undescended testis. The increased risks associated with early age at puberty and low amounts of exercise may be related to effects of exposure to endogenous hormones. Changes in both of these factors may partly contribute to the increasing rates of testicular cancer observed in the past few decades. PMID:7912596



Iran rebuilds family planning services.  


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

Butta, P



Family planning programs during last one decade in Korea.  


The public and private family planning programs in Korea are described and their progress in population control during the 1960's is discussed. A goal of a natural increase rate of 2% per year by 1971 was set in 1961 when the rate was 3%. It was estimated that 45% of the married couples of childbearing age would have to actively practice family planning to meet that goal, and 2370 family planning workers are participating now in the program throughout the country. The family planning program operates as part of the already existing national health service network. All fmaily planning services are provided free or with only a nominal charge at most. Intrauterine devices, oral contraceptives, condoms and vasectomies are the most common contraceptive methods chosen, in that order. A 1968 survey on abortion which is illegal in Korea showed 30% of urban women and 15% of rural women had had at least 1 induced abortion. In 1970 it was estimated that 1.8 million IUD insertions and 146 thousand vasectomies had been performed, 276,000 women had been started on oral contraceptives, and 163,000 condoms had been distributed. Numerous problems have been encountered by the Korean family planning program including inadequate financing and political power, association with a generally poor maternal health service, lack of follow-up and statistical evaluating, and unnecessary bureaucratic procedures. Professionally, trained family planning workers have a high attrition rate. Ever-greater numbers of young Korean women are now entering their childbearing period which increases the challenge to the family planning program, along with the problems of an increasingly heterogeneous urban society. Reducing family size to only 2 children conflicts with deep-seated cultural traditions, and even if the motivation exists, present contraceptive technology remains inadequate. In partial response to these problems, increasing emphasis is being placed on paramedical personnel and a mass media educational campaign. Improved organization, a greater supply of well-trained workers, and well-controlled field and clinical studies are needed to improve Korea's family planning program. PMID:5161482

Yang, J M



Sperm Recovery and IVF after Testicular Sperm Extraction (TESE): Effect of Male Diagnosis and Use of Off-Site Surgical Centers on Sperm Recovery and IVF  

PubMed Central

Objective Determine whether testicular sperm extractions and pregnancy outcomes are influenced by male and female infertility diagnoses, location of surgical center and time to cryopreservation. Patients One hundred and thirty men undergoing testicular sperm extraction and 76 couples undergoing 123 in vitro fertilization cycles with testicular sperm. Outcome Measures Successful sperm recovery defined as 1–2 sperm/0.5 mL by diagnosis including obstructive azoospermia (n?=?60), non-obstructive azoospermia (n?=?39), cancer (n?=?14), paralysis (n?=?7) and other (n?=?10). Obstructive azoospermia was analyzed as congenital absence of the vas deferens (n?=?22), vasectomy or failed vasectomy reversal (n?=?37) and “other”(n?=?1). Sperm recovery was also evaluated by surgical site including infertility clinic (n?=?54), hospital operating room (n?=?67) and physician’s office (n?=?11). Treatment cycles were evaluated for number of oocytes, fertilization, embryo quality, implantation rate and clinical/ongoing pregnancies as related to male diagnosis, female diagnosis, and use of fresh or cryopreserved testicular sperm. Results Testicular sperm recovery from azoospermic males with all diagnoses was high (70 to 100%) except non-obstructive azoospermia (31%) and was not influenced by distance from surgical center to laboratory. Following in vitro fertilization, rate of fertilization was significantly lower with non-obstructive azoospermia (43%, p?=?<0.0001) compared to other male diagnoses (66%, p?=?<0.0001, 59% p?=?0.015). No differences were noted in clinical pregnancy rate by male diagnosis; however, the delivery rate per cycle was significantly higher with obstructive azoospermia (38% p?=?0.0371) compared to diagnoses of cancer, paralysis or other (16.7%). Women diagnosed with diminished ovarian reserve had a reduced clinical pregnancy rate (7.4% p?=?0.007) compared to those with other diagnoses (44%). Conclusion Testicular sperm extraction is a safe and effective option regardless of the etiology of the azoospermia. The type of surgical center and/or its distance from the laboratory was not related to success. Men with non-obstructive azoospermia have a lower chance of successful sperm retrieval and fertilization. PMID:23922817

Omurtag, Kenan; Cooper, Amber; Bullock, Arnold; Naughton, Cathy; Ratts, Valerie; Odem, Randall



The etiology of prostate cancer: what does the epidemiology suggest  

SciTech Connect

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.

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



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


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

Moriyama, Kazutaka; Kikuch, Ichiro; Ishii, Norihisa



The lipopolysaccharide co-receptor CD14 is present and functional in seminal plasma and expressed on spermatozoa  

PubMed Central

CD14 is a 54 000-molecular weight (MW) glycolipid-anchored membrane glycoprotein, expressed on myeloid cells, which functions as a member of the lipopolysaccharide (LPS) receptor complex. Soluble forms of CD14 have been reported in plasma, cerebrospinal fluid, amniotic fluid and breast milk. In plasma and breast milk, soluble CD14 has been implicated as a regulator of T- and B-cell activation and function. Expression of CD14 in the male reproductive system has not previously been investigated. We here show that soluble CD14 is present in seminal plasma at levels comparable to those in serum. Spermatozoa expressed CD14 on their membranes, as demonstrated by fluorescence microscopy and flow cytometry. Post-vasectomy, the levels of seminal plasma CD14 (spCD14) were much reduced, implying an origin distal to the point of transection of the vas deferens. Ultracentrifugation analyses demonstrated that spCD14 was not associated with lipid complexes, indicating that it lacks the glycolipid anchor. Purified spCD14 mediated activation by LPS of CD14-negative cells. These findings suggest that CD14 may play a hitherto unexplored role in immune defence and cell activation in the male reproductive tract. PMID:11722646

Harris, Claire L; Vigar, Miriam A; Rey Nores, Julia E; Horejsi, Vaclav; Labeta, Mario O; Morgan, B Paul



Clinical features and therapeutic strategies of obstructive azoospermia in patients treated by bilateral inguinal hernia repair in childhood.  


Childhood inguinal herniorrhaphy is one common cause of seminal tract obstruction. Vasovasostomy (VV) can reconstruct seminal deferens and result in appearance of sperm and natural pregnancy in some patients. Secondary epididymal obstruction caused by a relatively long-term vasal obstruction is a common cause of lower patency compared with VV due to vasectomy in adults. From July 2007 to June 2012, a total of 62 patients, with history of childhood inguinal herniorrhaphy and diagnosed as obstructive azoospermia were treated in our center. The overall patency rate and natural pregnancy rate were 56.5% (35/62) and 25.8% (16/62), respectively. 48.4% (30/62) of the patients underwent bilateral VV in the inguinal region, with a patency rate of 76.7% (23/30) and a natural pregnancy rate of 36.7% (11/30), respectively. 30.6% (19/62) of the patients underwent bilateral VV and unilateral or bilateral vasoepididymostomies due to ipsilateral epididymal obstruction with the patency and natural pregnancy rate decreasing to 63.2% (12/19) and 26.3% (5/19). 21.0% (13/62) of the patients merely underwent vasal exploration without reconstruction due to failure to find distal vasal stump, etc. Our study indicate that microsurgical reanastomosis is an effective treatment for some patients with seminal tract obstruction caused by childhood inguinal herniorrhaphy. PMID:24994783

Chen, Xiang-Feng; Wang, Hong-Xiang; Liu, Yi-Dong; Sun, Kai; Zhou, Li-Xin; Huang, Yi-Ran; Li, Zheng; Ping, Ping



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

SciTech Connect

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.

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



Induction of Contraception by Intraepididymal Sclerotherapy  

PubMed Central

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.

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



Male contraception: another Holy Grail.  


The idea that men should participate in family planning by playing an active role in contraception has become more acceptable in recent years. Up to the present the condom and vasectomy have been the main methods of male contraception. There have been and continue to be efforts to develop an acceptable hormonal contraceptive involving testosterone (T) suppression. However the off target affects, delivery of the analogs and the need for T replacement have proven difficult obstacles to this technology. Research into the development of non-hormonal contraception for men is progressing in several laboratories and this will be the subject of the present review. A number of promising targets for the male pill are being investigated. These involve disruption of spermatogenesis by compromising the integrity of the germinal epithelium, interfering with sperm production at the level of meiosis, attacking specific sperm proteins to disrupt fertilizing ability, or interfering with the assembly of seminal fluid components required by ejaculated sperm for acquisition of motility. Blocking contractility of the vas deferens smooth muscle vasculature to prevent ejaculation is a unique approach that prevents sperm from reaching the egg. We shall note the lack of interest by big pharma with most of the support for male contraception provided by the NIH. PMID:24368213

Murdoch, Fern E; Goldberg, Erwin



Clinical features and therapeutic strategies of obstructive azoospermia in patients treated by bilateral inguinal hernia repair in childhood  

PubMed Central

Childhood inguinal herniorrhaphy is one common cause of seminal tract obstruction. Vasovasostomy (VV) can reconstruct seminal deferens and result in appearance of sperm and natural pregnancy in some patients. Secondary epididymal obstruction caused by a relatively long-term vasal obstruction is a common cause of lower patency compared with VV due to vasectomy in adults. From July 2007 to June 2012, a total of 62 patients, with history of childhood inguinal herniorrhaphy and diagnosed as obstructive azoospermia were treated in our center. The overall patency rate and natural pregnancy rate were 56.5% (35/62) and 25.8% (16/62), respectively. 48.4% (30/62) of the patients underwent bilateral VV in the inguinal region, with a patency rate of 76.7% (23/30) and a natural pregnancy rate of 36.7% (11/30), respectively. 30.6% (19/62) of the patients underwent bilateral VV and unilateral or bilateral vasoepididymostomies due to ipsilateral epididymal obstruction with the patency and natural pregnancy rate decreasing to 63.2% (12/19) and 26.3% (5/19). 21.0% (13/62) of the patients merely underwent vasal exploration without reconstruction due to failure to find distal vasal stump, etc. Our study indicate that microsurgical reanastomosis is an effective treatment for some patients with seminal tract obstruction caused by childhood inguinal herniorrhaphy. PMID:24994783

Chen, Xiang-Feng; Wang, Hong-Xiang; Liu, Yi-Dong; Sun, Kai; Zhou, Li-Xin; Huang, Yi-Ran; Li, Zheng; Ping, Ping



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

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 PGF2? 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

Yong, Hwanyul



Anita: a Mayan peasant woman copes.  


This is a case history of Anita, Mayan woman aged 38, who lives in the small village of Can Cun in the Yucatan, Mexico. She has had 10 pregnancies and 7 living children. She nearly died with her last birth. She has a good relationship with her children. She worked several jobs and sold illegal alcohol to put her son, Emiliano, through school. She is close with her married daughter, aged 17. She herself was married at 17. Because of previous bad pregnancies Anita would like to have no more children. Her husband, Demetrio was interested in a vasectomy but couldn't believe he would have the strength to work after the operation. He, like many Mayan men, practiced coitus interruptus and rhythm. When Anita finally went to the family planning clinic, under the auspices of the author, she chose oral contraceptives, but she never actually used them. Many Mayan women seldom get a period because they are always lactating. Some women would rather be pregnant then menstruating. The husband opposes schooling for his children because he needs them to help him work their crops of beans and corn. Sending children to school creates hardship because cash is needed for living expenses. PMID:538802

Elmendorf, M



Genome-wide promoter methylation profile of human testis and epididymis: identified from cell-free seminal DNA  

PubMed Central

Background DNA methylation analysis is useful for investigation of male fertility in mammals, whereas the reliance on tissues limits the research on human. We have previously found the presence of high concentration of cell-free seminal DNA (cfsDNA) in human semen. We proposed that some testis and epididymis-specific methylated promoters could be detected in human cfsDNA, and thus hold promise as noninvasive epigenetic biomarkers for male infertility, of which most cases are caused by defects in testicular sperm production or epididymal sperm maturation. Results The ejaculate of successfully vasectomized men does not contain any secretion from testis and epididymis. Here we compared genome-wide promoter methylation profiles in cfsDNA between health donors and post-vasectomy men. Promoters of 367 testis and epididymis-specific hypomethylated genes and 134 hypermethylated genes were identified. Subsequent validation by Methyl-DNA immunoprecipitation and MethyLight analysis confirmed the result of promoter microarray. Gene Ontology analysis revealed many genes involved in male reproduction. Conclusion We detected the testis and epididymis-specific methylated promoters in human cfsDNA, which may be used for noninvasive epigenetic biomarkers for the study and diagnosis of male infertility. PMID:23622456



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


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

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



Robotic assisted andrological surgery  

PubMed Central

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

Parekattil, Sijo J; Gudeloglu, Ahmet



Thai family planner uses humor, good sense.  


This article is a proflie of Khun Mechai, a leader in the Thai family planning field who was instrumental in creating the community-based contraceptive distribution program which began in 1973 with the 1st in a series of grants from the International Planned Parenthood Federation (IPPF). The community-based distribution program is active in some 16,000 villages and neighborhoods throughout Thailand. The Community-Based Family Planning Service (CBFPS) was established in 1974 with Khun Mechai as secretary general to coordinate the efforts of the nationwide network. The CBFPS has been linked with a massive, humorous, and creative campaign of "desensitization": Khun Mechai passes out condoms at official dinners, and honors the king's birthday with an annual free vasectomy marathon. As a result of his efforts, family planning is no longer a taboo topic and no longer the exclusive province of government bureaucrats and medical professionals. Khun Mechai's basic concern is in improving access to family planning services by overcoming physical and sociocultural distance and by providing an acceptable method of service delivery. All family planning activities of the Population and Community Development Association, the CBFPS parent organization, are voluntary. Links have been created between family planning and personal and community betterment to help motivate acceptance. Khun Mechai became acquainted with the country' development needs as a young economist with the National Economic and Social Development Board. His family planning activities grew out of his conviction that rapid, unplanned population growth is Thailand's and the world's single most serious problem. An incremental approcah with insistence on individual and local responsibility for development is essential to his philosphy and personality. PMID:12266279

Cantlay, C



Barriers to male involvement in contraceptive uptake and reproductive health services: a qualitative study of men and women's perceptions in two rural districts in Uganda  

PubMed Central

Background Spousal communication can improve family planning use and continuation. Yet, in countries with high fertility rates and unmet need, men have often been regarded as unsupportive of their partner’s use of family planning methods. This study examines men and women’s perceptions regarding obstacles to men’s support and uptake of modern contraceptives. Methods A qualitative study using 18 focus group discussions (FGDs) with purposively selected men aged 15–54 and women aged 15–49 as well as eight key informant interviews (KIIs) with government and community leaders was conducted in 2012 in Bugiri and Mpigi Districts, Uganda. Open-ended question guides were used to explore men and women’s perceptions regarding barriers to men’s involvement in reproductive health. All FGDs and KIIs were recorded, translated, and transcribed verbatim. Transcripts were coded and analyzed thematically using ATLAS.ti. Results Five themes were identified as rationale for men’s limited involvement: (i) perceived side effects of female contraceptive methods which disrupt sexual activity, (ii) limited choices of available male contraceptives, including fear and concerns relating to vasectomy, (iii) perceptions that reproductive health was a woman’s domain due to gender norms and traditional family planning communication geared towards women, (iv) preference for large family sizes which are uninhibited by prolonged birth spacing; and (v) concerns that women’s use of contraceptives will lead to extramarital sexual relations. In general, knowledge of effective contraceptive methods was high. However, lack of time and overall limited awareness regarding the specific role of men in reproductive health was also thought to deter men’s meaningful involvement in issues related to fertility regulation. Conclusion Decision-making on contraceptive use is the shared responsibility of men and women. Effective development and implementation of male-involvement family planning initiatives should address barriers to men’s supportive participation in reproductive health, including addressing men's negative beliefs regarding contraceptive services. PMID:24597502



Noninvasive laser coagulation of the canine vas deferens, in vivo  

NASA Astrophysics Data System (ADS)

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.

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



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


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

Andrews, D J



Looking ahead in India.  


India and China contain more than 40% of the world's population, yet in India it is painfully clear that the political commitment necessary to tackle India's greatest problem is not there in full measure. India's present per capita income is less than $300, and nearly 65% of the people live below the poverty line. The average Indian woman produces 5 children; even if the Indian government's efforts to reduce family size to 2 children is successful by the year 2040, India will have a population of 2.5 billion. The possibility that India will succeed in reducing average family size to 2 children appears remote. 30 years ago, India became the 1st developing country to formally make family planning a matter of national policy. In the early years of the national family planning programs, practitioners had access mostly to sterilization and condoms. Over the years, theIndian government persuaded the US and other western donors to give $2 billion to population control programs. Still, the population continues to grow annually at the rate of 2.1%. Government statistics reflect the ups and downs of national population control policies; thenumber of new family planning users increased from 4.3 million in 1974-1975 to 12.5 million in 1976-1977, due largely to a dramatic increase in vasectomies. Tge number of new contraceptive users fell to 4.5 million after the "emergency" was lifted in 1977. The present Indian generation is far more receptive culturally as well as sociologically to the concept of population control than most other developing countries. What is needed now is renewed political committment by the Gandhi adminiostration. India cannot afford to replicate the Chinese way of tackling overpopulation without inflicting human abuses and without undermining its painstakingly cultivated democratic system. PMID:12340887

Gupte, P



Advances in Male Contraception  

PubMed Central

Despite significant advances in contraceptive options for women over the last 50 yr, world population continues to grow rapidly. Scientists and activists alike point to the devastating environmental impacts that population pressures have caused, including global warming from the developed world and hunger and disease in less developed areas. Moreover, almost half of all pregnancies are still unwanted or unplanned. Clearly, there is a need for expanded, reversible, contraceptive options. Multicultural surveys demonstrate the willingness of men to participate in contraception and their female partners to trust them to do so. Notwithstanding their paucity of options, male methods including vasectomy and condoms account for almost one third of contraceptive use in the United States and other countries. Recent international clinical research efforts have demonstrated high efficacy rates (90–95%) for hormonally based male contraceptives. Current barriers to expanded use include limited delivery methods and perceived regulatory obstacles, which stymie introduction to the marketplace. However, advances in oral and injectable androgen delivery are cause for optimism that these hurdles may be overcome. Nonhormonal methods, such as compounds that target sperm motility, are attractive in their theoretical promise of specificity for the reproductive tract. Gene and protein array technologies continue to identify potential targets for this approach. Such nonhormonal agents will likely reach clinical trials in the near future. Great strides have been made in understanding male reproductive physiology; the combined efforts of scientists, clinicians, industry and governmental funding agencies could make an effective, reversible, male contraceptive an option for family planning over the next decade. PMID:18436704

Page, Stephanie T.; Amory, John K.; Bremner, William J.



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

NASA Astrophysics Data System (ADS)

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.

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



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

NASA Astrophysics Data System (ADS)

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.

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



Population policy forum. Men, the Church, and pleasure.  


I applaud Marge Berer's initial proposal on feminist population police, demonstrating that feminists are capable of construction as well as criticism. Such creative efforts, while partial, are what keep the conversation going and us in it. Several points deserve to be highlighted as they point toward much needed changes in public policy. One is the need to shift the overwhelming burden of reproduction from women alone to society in general and men in particular. This is not to give an inch on women;s moral agency and primary decision making. To the contrary, it is to insist that male birth control be an integral part of all population policies in action as well as in regulations. Rates of tubal ligations and vasectomies in most countries show that women assume more than a fair share, men doing comparative little. Another important element is the role of religion as a shaper of social policy, the Catholic church worldwide being the prime example of how sex education, birth control, and abortion are regulated as much be theology as by law. Feminist s ignore this reality in our peril, though dealing head on with it, as some religious professions have found out, is also dangerous. The fact that the majority of women of childbearing age in the US ignore the church's pronouncements and use contraception shows that the ideological strangle hold is slipping. We can loosen it further. A related, though perhaps less politically correct, concern in such a feminist proposal is the place of sexual pleasure for its own sake. While public policy is not typically concerned with such matters, education is needed for women to feel entitled to separate sex from procreation, to enjoy the full range of sexual activities for which reproduction is but 1 possible outcome. This, after all, is a major feminist achievement that deserves to made available without delay] PMID:12178839

Hunt, M E



[Male contraception].  


Except for condoms, male contraception is very slightly utilized in France. Several male experimental methods are under study. A synthetic luteinizing hormone-releasing hormone (LHRH) analog has been used successfully in women and offers promise in men of blocking LHRH and thus blocking spermatogenesis. Several nonsteroid substances such an hypertensives and adrenaline would suppress follicle stimulating hormone and luteinizing hormone release, but are too toxic for use. The combination of 40 mcg ethinyl estradiol and 20 mg of methyltestosterone inhibits gonadotropin release and produces azoospermia in men, but at the risk of loss of libido, constant gynecomastia, and testicular atrophy. Several combinations of androgens and progestins have been evaluated. Percutaneous testosterone and medroxyprogesterone acetate appears to be the most effective, with good metabolic tolerance and maintenance of libido and sexual performance. Injections of inhibine, a testicular factor that controls secretion of follicle stimulating hormone by feedback, offer promise of suppressing spermatogenesis without affecting other systems. Numerous substances are known to inhibit spermatogenesis but are to toxic for use or entail an unacceptable loss of libido. Gossypol has been employed as a contraceptive by the Chinese for its action in inhibiting protein synthesis, but it is known to have serious secondary effects. Among male methods currently in use, the condom had a Pearl index of .4-1.6 in the most recent British studies. Coitus interruptus can seriously interfere with sexual pleasure and has a failure rate of 25-30%. Vasectomy is safe, effective, and easy to perform, but is not a reversible method. The combination of 20 mg of medroxyprogesterone acetate in 2 daily doses and 100 mg of testosterone applied in an abdominal spray has given very promising results in 2 small studies in France and merits further development and diffusion. PMID:3648976

Demery, A



As the Third World turns.  


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

Hagerman, E



Effectiveness of Norplant implants among Thai women in Bangkok.  


The purpose of the study was to evaluate the efficacy, acceptability, side effects and continuation rates of the implant system in Thai women. A five-year clinical study of 308 women receiving Norplant-6 implants in Bangkok was conducted. Acceptors' mean age was 29 years, and mean number of children was about two. More than half of the users (63%) finished primary school. The cumulative continuation rates for Norplant implants at first, second, third, fourth and fifth years were, respectively, 98%, 91%, 83%, 78% and 71%. Eight out of a total of eleven pregnancies occurred in the fourth and fifth year of use. The cumulative pregnancy rate was 1.1% for the third year, 2.0% for the fourth year and 4.2% for the fifth year. Desire for future pregnancy was the leading cause for termination of Norplant implants use. The five-year cumulative termination rate for planned pregnancy was 9.2%. Disruption of menstrual rhythm, particularly increased bleeding, was the other main reason for termination; however, the prevalence of menstrual irregularities appeared to diminish with time. The cumulative termination rate for menstrual irregularities in the fifth year of the study was 4.4%. The complaints of "other medical reasons" for removal of Norplant implants were acne, severe headache, and chloasma. The five-year cumulative termination rate for other personal reasons was 7.9%. These personal reasons were husband having vasectomy, husband objection and divorce. It can be seen from this five-year study that Norplant implants are well accepted by Thai women. However, the efficacy in preventing pregnancy was not acceptable during the fourth and fifth year of use in this study, which was different from results of other international studies. PMID:8631187

Chompootaweep, S; Kochagarn, E; Sirisumpan, S; Tang-usaha, J; Theppitaksak, B; Dusitsin, N



Experience of Thai women in Bangkok with Norplant-2 implants.  


A prospective study of the Norplant-2 contraceptive subdermal implant system was conducted in Bangkok, Thailand. The objective of the study was to evaluate the efficacy, adverse effects, and overall acceptability of Norplant-2 implants. A total of 140 women were enrolled in a 3-year clinical trial. The mean age was 29 years. Of all the acceptors, 70% had completed primary school. The continuation rates at years 1, 2, and 3 were, respectively, 94%, 89%, and 83%. No accidental pregnancies occurred throughout the 3 years of use in this study. Personal reasons were the leading cause for termination of Norplant-2 implant use. The 3-year cumulative termination rate for personal reasons was 7.2%. These personal reasons were divorce, husband having vasectomy, and moving away from the study area. The other leading cause for termination was medical reasons; acne, headache, and pain at the implant site were the complaints. The termination rate for medical reasons in year 3 of the study was 4.6%. Prolonged menstrual flow was the other main reason for termination. The 3-year cumulative termination rate for menstrual irregularities was 3.8%. In this study, the cumulative termination for planned pregnancy at the end of the year 3 was only 1.6%. The incidence of difficult removals was 8%. Breakage of the rods on removal was encountered in the majority of these cases. The study findings presented suggest that the Norplant-2 implants are highly effective with high continuation rates. The Norplant-2 system could become another choice of long acting reversible contraception for Thai women. PMID:9866003

Chompootaweep, S; Kochagarn, E; Tang-Usaha, J; Theppitaksak, B; Dusitsin, N



Expression of Glycogen synthase kinase 3-? (GSK3-?) gene in azoospermic men  

PubMed Central

Background: The Wnt/?- The Wnt/?-catenin signaling pathway is involved in many developmental processes in both fetal and adult life; its abnormalities can lead to disorders including several types of cancers and malfunction of specific cells and tissues in both animals and humans. Its role in reproductive processes has been proven. Objective: This study was designed to evaluate the expression of the key regulator of this signaling pathway GSK3-? and its presumed role in azoospermia. Materials and Methods: WNT3a protein concentration and GSK3-? gene expression levels were measured and compared between two groups of infertile men. The test groups consisted of 10 patients with obstructive and 10 non-obstructive azoospermia. The control group was selected among healthy men after vasectomies that were willing to conceive a child using a testicular biopsy technique. Samples were obtained by testicular biopsy and screened for the most common mutations (84, 86 and 255) in the SRY region before analyzing. GSK3-? gene expression was assessed quantitatively by real time-PCR. Results: The WNT3a protein concentration had no significant difference between the two test groups and controls. Expression of GSK3-? was down-regulated in non-obstructive azoospermia (3.10±0.19) compared with normal (7.12±0.39) and obstructive azoospermia (6.32±0.42) groups (p=0.001). Conclusion: Down-regulation of GSK-3? may cause to non-obstructive azoospermia. Regulation and modification of GSK-3? gene expression by drugs could be used as a therapeutic solution. PMID:25031575

Nazarian, Hamid; Ghaffari Novin, Marefat; Jalili, Mohammad Reza; Mirfakhraie, Reza; Heidari, Mohammad Hassan; Hosseini, Seyed Jalil; Norouzian, Mohsen; Ehsani, Nahid



Statistics on population and family planning in China, 1988-1990.  


The State Family Planning Commission of the Planning and Statistical Department in China has published its 1988-90 population and family planning statistics. The table lists these statistics by year and percentage change between years. The data are reported as numbers and rates or proportions. The population of China increased from 1.096 to 1.143 billion between 1988-90. The largest increase occurred between 1989-90 (31.42% vs. 15.77% [1988-89]). The death rate declined slightly between 1988-89 (.08%), but increased somewhat between 1989-90 (.17%). The birth rate increase, but only slightly (.05% [1988-89] and .23% [1989-90]). The percentage of 1st parity births fell between 1988-89 (.3%), but rose between 1989-90 (.9%). The opposite occurred for 2nd parity births (0.2% and -2.1%, respectively). The total fertility rate fell consistently from 2.52 in 1988 to 2.35 in 1989 and to 2.31 in 1990. There was no change in the number of women of childbearing age between 1988-89, but between 1989-90, the number increased by 10 million. Yet the number of married women of childbearing age did not increase at all between 1988-90. The number of people adopting contraception increased 8.34% between 1988-89 and 10.32% between 1989-90. Likewise the contraceptive prevalence rate also rose (6% [1988-89] and 5% [1989-90]). Contraceptive prevalence was highest for IUDs (about 40%), female sterilization (around 37%), and vasectomy (1.5%). The number of people agreeing to have only 1 child increased during the time period (1.32% [1988-89] and 2.42% [1989-90]). Accordingly, so did the percentage of people agreeing to have only 1 child (o.6% [1988-89] and 1.5% [1989-90]). PMID:12285209



Family planning and maternal and child health services.  


Considerable effort has been made in the area of family planning in the State of Punjab. Family planning personnel has been recruited and trained at the State Family Planning Training and Research Center in Kharar; supplies of Nirodh, IUDs, oral contraceptives, and hospital equipment along with transportation facilities have been made available; and there has been some building construction. The State Health Education Bureau has worked to produce publicity material and has also used the mass media to create awareness of family planning among the people. As many as 120 rural and 49 urban Family Welfare Planning Centers are providing family planning services along with 856 subcenters in rural areas. 1123 other institutions are also doing family planning work in addition to the efforts of 34 mobile sterilization and IUD units attached to the District Family Planning Bureau and the contributions of some voluntary organizations. Although the state has adopted the cafeteria approach to family planning and the focus is on provision of family planning services on routine days in the various institutions to well-motivated couples, mass family planning camps for vasectomy, tubal ligations, and IUD insertions have been held with considerable success. Additionally, the State has integrated family planning programs with maternal and child health care in order to provide a totality of service. This precedes the total integration of this national program w ith general health services. Punjab has done well in achieving its targets for 1974-1975. Sterilization targets were set at 38,300 and 36,460 sterilizations, 95.2% of the target, were performed. IUD targets were 27,000, and the number achieved was 39,637 or 109.4%. The conventional contraceptive user target was 99,800, and 151,976 or 152.3% of the target figure became conventional contraceptive users. PMID:12307760

Singh, A



Hope springs from tragedies in African Sahel.  


Helping to pave the way for family planning in Muslim societies is a change in attitude about family size. Once regarded as an economic asset, the large family is recognized by more and more people as a handicap. Family Health International (FHI) and collaborating scientists in Africa are embarking on several studies to provide family planning information to the governments of Niger, Sudan, and Mali. 1 research priority for 1985 in Nepal is a study of vanguard acceptors to determine the characteristics of the 1st acceptors of family planning services and the contraceptive needs of potential users. Also a pregnancy surveillance study will be conducted in Niamey to collect obstetric information that will allow for the design of programs to improve the quality of deliveries and reduce unwanted pregnancies. FHI plans to support a contraceptive technology seminar to be held in 1986 and, later, a training program hosted by the Universite de Niger to enhance research methodology skills. FHI supported a survey in Sudan conducted by Dr. Mutassin Mustafa and Dr. Mona Khalifa of the Sudan Fertility Control Association (SFCA) to assess male attitudes toward family planning. A previous survey using a quota sample indicated there was strong support for family planning, particularly vasectomy, among Sudanese men. The current study, using a random sample, will determine if those findings can be repeated. Clinical trial of progestogen-only pills is ongoing in Sudan. Future plans include a clinical trial of the Copper T 380 A IUD and a comparative study of standard versus low-dose pills. FHI will provide technical assistance to evaluate a training program on family planning skills and knowledge for midwives. A workshop is planned for August 1985 on research methodology. Since 1979, FHI has collaborated with the Malian government and L'Association Malienne pour la Protection et la Promotion de la Famille (AMPPF). The importance of breastfeeding on birth spacing was found in a study that monitored prenatal care, pregnancy, and childbirth in a maternity care facility. Women who breastfed had birth intervals more than twice as long as women who did not breastfeed. A multicenter surveillance study of Malian women hospitalized for treatment of incomplete abortion revealed that abortion was being used mostly by young, unmarried women to postpone a 1st birth. A recent study of the Copper T 200 showed a larger number of expulsions than expected, and FHI will help AMPPF train midwives to improve IUD insertion skills to reduce the number of expuslions. 2 OC studies are being conducted with FHI assistance. PMID:12340327



RESEARCHNOTE Quinacrine Pellet Method of Nonsurgical Female Sterilization in Iran: Preliminary Report on a Clinical Trial  

E-print Network

For a study of the safety, efficacy and acceptability of female sterilization with quinacrine pellets in a private-practice setting, data on 760 women who obtained the procedure in Tehran between September 7990 and April 1994 were evaluated. Three-fourths of the women were monitored for at least one year, and more than ha/f were monitored for more than two years. By the end of the study period, two women had become pregnant, for a gross pregnancy rate of 7.2%; neither pregnancy was ectopic. Within the first two months after the procedure, about half of the women reported complications or side effects, which were minor and easily treatable; after the first two months, the only side effect reported was delayed menses. The cost of sterilization with quinacrine pellets is one- 70th that of surgical sterilization. However, knowledge about the method is not widespread within the medical community in Iran. After the 1979 Islamic Revolution in Iran, the new government altered the 1967 fertility control policy, and the pace of population growth accelerated rapidly. In 1986, the population growth rate was 3.8 % (3.4 % when refugees from Afghanistan are excluded)-substantially higher than the 1976 rate of 2.7%, and one of the highest rates in the world.’ More recently, in response to social and economic pressures, the government has once again become very concerned with the issue of population growth. The Ministry of Health has taken various steps to promote family planning, from erecting billboards with messages discouraging people from having large families, to providing free oral contraceptives. Modern contraceptives are available in Iran and are used by roughly half of women in both urban and rural areas. Among urban women, 19 % use the pill, 11 % each have undergone voluntary sterilization and use the IUD, 8 % rely on the condom and 2? & are protected by their husband’s vasectomy; in rural areas, 27 % use the pill, 11 % have had a tubal occlusion, 4-5’h use the IUD or condom and 1 % have Sheitaneh Soroodi-Moghaddam is a family planning specialist in private practice in Tehran, Iran.

Sheitaneh Soroodi-moghaddam


Evaluating patient values and preferences for thromboprophylaxis decision making during pregnancy: a study protocol  

PubMed Central

Background Pregnant women with prior venous thromboembolism (VTE) are at risk of recurrence. Low molecular weight heparin (LWMH) reduces the risk of pregnancy-related VTE. LMWH prophylaxis is, however, inconvenient, uncomfortable, costly, medicalizes pregnancy, and may be associated with increased risks of obstetrical bleeding. Further, there is uncertainty in the estimates of both the baseline risk of pregnancy-related recurrent VTE and the effects of antepartum LMWH prophylaxis. The values and treatment preferences of pregnant women, crucial when making recommendations for prophylaxis, are currently unknown. The objective of this study is to address this gap in knowledge. Methods We will perform a multi-center cross-sectional interview study in Canada, USA, Norway and Finland. The study population will consist of 100 women with a history of lower extremity deep vein thrombosis (DVT) or pulmonary embolism (PE), and who are either pregnant, planning pregnancy, or may in the future consider pregnancy (women between 18 and 45 years). We will exclude individuals who are on full dose anticoagulation or thromboprophylaxis, who have undergone surgical sterilization, or whose partners have undergone vasectomy. We will determine each participant's willingness to receive LMWH prophylaxis during pregnancy through direct choice exercises based on real life and hypothetical scenarios, preference-elicitation using a visual analog scale (“feeling thermometer”), and a probability trade-off exercise. The primary outcome will be the minimum reduction (threshold) in VTE risk at which women change from declining to accepting LMWH prophylaxis. We will explore possible determinants of this choice, including educational attainment, the characteristics of the women’s prior VTE, and prior experience with LMWH. We will determine the utilities that women place on the burden of LMWH prophylaxis, pregnancy-related DVT, pregnancy-related PE and pregnancy-related hemorrhage. We will generate a “personalized decision analysis” using participants’ utilities and their personalized risk of recurrent VTE as inputs to a decision analytic model. We will compare the personalized decision analysis to the participant’s stated choice. Discussion The preferences of pregnant women at risk of VTE with respect to the use of antithrombotic therapy remain unexplored. This research will provide explicit, quantitative expressions of women's valuations of health states related to recurrent VTE and its prevention with LMWH. This information will be crucial for both guideline developers and for clinicians. PMID:22646475



As it is in heaven? John Paul II listened to God and misunderstood the message.  


This articles focuses on John Paul II's 1993 Veritatis Splendor, an 1798 page encyclical letter to the Church's bishops on the crisis in the Catholic Church of family limitation and the implications for the laity and society. The communication states that a flexible interpretation of theology must be abandoned. Paul VI's 19963 Humanae Vitae is reportedly affirmed. John XXIII's spiritualism and concern with conscience is ignored. This encyclical is identified as not spoken "ex cathedra" or from the throne, which would have made the pronouncement true, unarguable forever, and subject to excommunication for those disobeying. Pope John Paul II is said to be preparing another encyclical on life issues and sexuality. Reference is made in this encyclical to devices that are acceptable to use to gauge a safe period for copulation without impregnation. The devices include the rectal thermometer and the calculator for determining the infertile days in the natural cycle. Veritatis Splendor's position on fertility is viewed as an issue of loyalty to the Church and not as an honest evaluation of the moral implications of artificial birth control. This encyclical comes closer to "ex cathedra" than the Humanae Vitae, which banned the birth control pill, IUD, spermicides, hormonal implants, vasectomies, and tubal ligation. Liberal Catholic theologians are reported to have interpreted Paul VI's statement that "God illuminates from within the hearts of the faithful and invites their assent," as a validation of dissent. Pope John Paul II closes the door to dissent in this proclamation. The Church also closes the door to free will for people to decide for themselves. The Jesuits, with different notions of divine will, are described as potentially concluding that the denial of free will and individual reason for the sake of Papal supremacy must be the work of the devil himself. For good Catholics this encyclical is interpreted as potentially forcing even stronger opposition to the Vatican's teachings and continued adherence to the dictates of their own conscience. A God who gave men and women the power of his reason would not allow the Pope, however infallible, to take this away. Among nonreligious thinkers the Catholic posture is viewed as very wrong on birth control. Divisions within the Church are expected to increase. PMID:12345270



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

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

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



Directions and potentials of contraceptive research.  


The current status of birth control methods is reviewed. No fundamentally new practical birth control agent is in sight for the immediate future which would be more effective than presently employed procedures. The present climate of hypercaution and virulent consumerism penalizes the imaginative approach and encourages minor and safe modifications of existing methods. The scientific community does not lack theoretical leads, but those theories may not be put into practice. Special emphasis is given in this review to the reversible fertility control agents that will be needed during the next decade or 2, notably in developing countries. In the area of abortion, abortifacients, and related agents, the development of chemical abortifacients, preferably administered orally or intravaginally should get very high priority. Chemical agents for abortion fall into 2 classes: 1) those which interfere with embryonic development, and 2) those which lead to expulsion of the embryo or fetus, e.g. prostaglandins. Although there are many publications and books written about ovulation inhibitors, relatively little work has been devoted to developing new steroidal ovulation inhibitors. For fertility control in developing countries, IUDs offer the singular advantage of a 1-shot administration. The development of the copper T IUD is important. Preliminary clinical studies have indicated that the addition of copper results in much lower pregnancy rate and the T shape results in a lower bleeding and expulsion rate. The Food and Drug Administration may extend the time interval between clinical studies and eventual public use of the copper T because it carries a metal. It is not likely that a male pill will be developed in the near future. For males, major advances in vasectomy techniques which would quarantee reversibility upon demand would constitute a significant forward step. For females, recent clinical studies indicate that sterilization can be produced through occlusion of their fallopian tubes by the intrauterine installation of quinacrine. A variety of methods which could interfere with the viability or passage of sperm once it enters the vagina are unlikely to result in practical fertility control agents before the end of this decade. PMID:4788233

Djerassi, C



[Children and bankers in Bangladesh].  


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 source of security is to have many children, a significant proportion of whom will not survive. In rural Bangladesh, where chronic hunger and unemployment are rife, the incentives and the pressures of family planning and health workers were sufficient to persuade many persons to undergo sterilization. Payment of commissions to workers to promote sterilization has discouraged them from supplying adequate information about sterilization for fear of losing clients. Population from other donors and wide publicity about the abuses in the sterilization program and the high rates of regret among women undergoing sterilization only for the incentives have led to some modifications, but the World Bank has continued to exert pressure on the Bangladeshi government to develop fertility-control programs. The damaging effects of World Bank population programs can also be seen in Indonesia, Nepal, and other developing countries. PMID:12284143

Hartmann, B