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Sample records for vasectomy

  1. Vasectomy

    MedlinePlus

    Sterilization surgery - male; No-scalpel vasectomy; NSV; Family planning - vasectomy; Contraception - vasectomy ... term form of birth control. The procedure to reverse a vasectomy is a much more complicated operation. ...

  2. Vasectomy

    MedlinePlus

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

  3. Vasectomy reversal.

    PubMed

    Belker, A M

    1987-02-01

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

  4. Vasectomy reversal.

    PubMed

    Belker, A M

    1987-02-01

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

  5. Vasectomy reversal in humans.

    PubMed

    Bernie, Aaron M; Osterberg, E Charles; Stahl, Peter J; Ramasamy, Ranjith; Goldstein, Marc

    2012-10-01

    Vasectomy is the most common urological procedure in the United States with 18% of men having a vasectomy before age 45. A significant proportion of vasectomized men ultimately request vasectomy reversal, usually due to divorce and/or remarriage. Vasectomy reversal is a commonly practiced but technically demanding microsurgical procedure that restores patency of the male excurrent ductal system in 80-99.5% of cases and enables unassisted pregnancy in 40-80% of couples. The discrepancy between the anastomotic patency rates and clinical pregnancy rates following vasectomy reversal suggests that some of the biological consequences of vasectomy may not be entirely reversible in all men. Herein we review what is known about the biological sequelae of vasectomy and vasectomy reversal in humans, and provide a succinct overview of the evaluation and surgical management of men desiring vasectomy reversal.

  6. Complications of vasectomy.

    PubMed Central

    Awsare, Ninaad S.; Krishnan, Jai; Boustead, Greg B.; Hanbury, Damian C.; McNicholas, Thomas A.

    2005-01-01

    INTRODUCTION: Vasectomy is a common method of sterilisation. However, it is less popular than tubal ligation world-wide. It is also a frequent cause of litigation relating to its complications. This article reviews the early and late risks associated with the procedure. PATIENTS AND METHODS: Data collection was done using the internet to search Medline for obtaining evidence-based medicine reviews. Cross-references were obtained from key articles. Websites of government bodies and medical associations were searched for guidelines relating to vasectomy. DISCUSSION: Early complications include haematoma, wound and genito-urinary infections, and traumatic fistulae. Vasectomy failure occurs in 0-2% of patients. Late recanalisation causes failure in 0.2% of vasectomies. Significant chronic orchalgia may occur in up to 15% of men after vasectomy, and may require epididyectomy or vasectomy reversal. Antisperm antibodies develop in a significant proportion of men post-vasectomy, but do not increase the risk of immune-complex or atherosclerotic heart disease. Similarly, vasectomy does not enhance risk of testicular or prostate cancer. Vasectomy has a lower mortality as compared to tubal occlusion, but is still significantly high in non-industrialised countries because of infections. CONCLUSIONS: Vasectomy, though safe and relatively simple, requires a high level of expertise to minimise complications. Adequate pre-operative counselling is essential to increase patient acceptability of this method of permanent contraception. PMID:16263006

  7. Attracting men to vasectomy.

    PubMed

    Finger, W R

    1998-01-01

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

  8. Attracting men to vasectomy.

    PubMed

    Finger, W R

    1998-01-01

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

  9. Vasectomy failure and open-ended vasectomy.

    PubMed

    Schmidt, S S

    1985-10-01

    The author of this letter comments on the earlier exchange of letters on vasectomy failure. In the present author's opinion, vasectomy failures are most often caused by the inadequate creation of a barrier of fascia between the cut ends of the vas. The use of a magnifier makes it easier to spot and correct this error. The conventional electrosurgical unit is the worst cautery used due to the potential for current leakage between the wall of the vas and the fascia. The desiccating effect of cautery units using red hot wire makes this the unit of choice. At present, the open-end technique appears to be most effective, although the creation of a spermatic granuloma risks involvement of the spermatic nerve. Research is needed in terms of observations of the vas end in humans after open-end vasectomy and an explanation of the difference in spermatic granulomas between cases in which the end of the vas is sealed and those in which the testicular end of the vas is left open. It is speculated that this difference is due to the difference in time of development of these granulomas. Finally, it is recommended in cases of postoperative orchialgia that the vas be transected about 1 cm proximal to the vasectomy and be left open to reduce the pressure within the epididymis and create a low-pressure spermatic granuloma.

  10. Vasectomy - series (image)

    MedlinePlus

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

  11. Vasectomy offers many advantages.

    PubMed

    Finger, W R

    1997-01-01

    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

  12. How couples choose vasectomy.

    PubMed

    Schehl, M

    1997-01-01

    A study conducted by AVSC International between 1992 and 1995 found that couples around the world go through a highly similar decision-making process when they choose vasectomy as their family planning methods. Study findings are based upon in-depth, qualitative interviews with couples using vasectomy in Bangladesh, Mexico, Kenya, and Rwanda, where the prevalence of vasectomy is relatively low, and Sri Lanka and the US, where it is relatively high. 218 separate interviews were conducted with male and female partners. Concerns about the woman's health were cited by respondents in each country as reasons to cease childbearing and to opt for vasectomy as the means to achieving that end. Also, almost all respondents mentioned varying degrees of financial hardship as contributing to their decision to end childbearing. These findings highlight the concept of partnership in relationships and family planning decision-making, and demonstrate the importance of going beyond traditional stereotypes about gender roles in decision-making. Social influences and the potential risks of using other forms of contraception also contributed to the choice of using vasectomy. The decision-making process and lessons learned are discussed.

  13. No-scalpel vasectomy.

    PubMed

    Schlegel, P N; Goldstein, M

    1992-11-01

    Physicians in China have developed a new technique to perform vasectomies which improves men's acceptance of vasectomy. It is called no-scalpel vasectomy. Before performing the vasectomy, the surgeon should determine whether the patient is indeed interested in permanent sterilization. The surgeon should also gather information on patient's age, marital status, and medical history and perform a physical examination. Counseling should consist of clear, simple language to diminish any fears. The surgeon must inform the patient of alternative nonpermanent means of contraception and stress that vasectomy is essentially irreversible. 2 physicians recommend external spermatic fascia injection using 2-3 ml of 2% plain lidocaine to induce vasal nerve blockage. After properly fixing the vas deferens with a ring clamp, the surgeon pierces the scrotal skin, vas sheath, and vas deferens in the midline with a curved dissecting clamp held at a 45 degree angle from horizontal. The surgeon then rotates the clamp 180 degrees to prepare the vas for cutting. The surgeon cuts out a 1 cm segment and then occludes the ends of the vas. The vas is then returned to the scrotal sac via the same puncture hole. No sutures are needed for the puncture hole. The same procedure is followed for the other vas. Hands-on training requires 10-15 procedures to develop proficiency. The no-scalpel technique takes about 40% less time than conventional techniques. The complication rate for the no-scalpel technique is 0.4 events/100 procedures compared to 3.1/100 procedures for conventional techniques. Both the ring clamp and dissecting clamp were developed in China. These instruments are provided through a company in Georgia and through the Association for Voluntary Surgical Contraception (AVSC). AVSC helps medical institutions coordinate physician training of the no-scalpel technique.

  14. [Vasectomy and its difficulties].

    PubMed

    Mesnard, L; Lanson, Y

    1987-01-01

    There is an increasing demand for vasectomies due to personal convenience in the context of an ongoing rearrangement of roles and relationships for couples. French doctors remain divided in their attitudes when facing these demands, either because of personal convictions or due to the ambiguities of legislation and the insurance companies. A survey of vasectomies in various countries of the world is given. In the United States it is estimated that 15 million Americans have been vasectomized, more than 1 in 10 aged over 30, and some experts predict that voluntary sterilization will become more popular than oral contraception for couples of all ages. In many third world countries sterilization is considered the only effective solution to family planning. In China and South-Asian countries vasectomy is practiced and birth rates are almost down to European levels. In Spain, Greece, Portugal and Brazil vasectomy is illegal. In African countries it is considered unacceptable and a direct attack upon virility. In France no epidemiological studies have supplied even approximate figures. It has been found that 96% of vasectomized men (married or not) have lived with a partner for 5 years having an average age of 36-38 and 2.7 children. Liberal professions, managers and middle executives are overrepresented; employees and farmers are underrepresented. Before an operation most are well informed about concomitant problems. The prime motive is to limit the number of children. 10% to 20% mentioned a previous unwanted pregnancy due to failure of other contraceptive means. Various techniques for performing the operation and possible complications are described. PMID:3429891

  15. Noninvasive laser vasectomy

    NASA Astrophysics Data System (ADS)

    Cilip, Christopher Michael

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

  16. Vasectomy: clinical aspects and reversibility.

    PubMed

    Muangman, V

    1979-12-01

    Sterilization, which was originated in Thailand 35 years ago, was initially performed in Bangkok and in the large up-country towns only. Sterilization acceptors were the minority group of well educated families. Population in Thailand increased rapidly following World War 2, and the demand in sterilization has risen respectively. In 1950 the government decentralized the National Health Program, and both vasectomy and tubal ligation were accepted by the Thai. After the government announced their population policy in 1971, vasectomy was included in the plan and has become popular. During 1967-72 there were only 2588 vasectomy acceptors. After the government launched an intensive program, the numbers were augmented. In 1977 there were 15,000 vasectomy acceptors, and 107,000 tubal ligation acceptors--a ratio of 1:7. At Ramathibodi Hospital in Bangkok there were 536 vasectomy acceptors. In 1967-69 the National Family Planning Division was established and activities were motivated through health centers, i.e., hospitals, provincial health centers, hygiene centers, mother and child care centers, and so forth. The government set up a Mobile Vasectomy Unit in 1975 with the goal of performing vasectomy in the remote areas of the country. The National Family Planning Division, established in 1977, has encouraged private clinics throughout Thailand to perform sterilizations. The aim of vasectomy surgery is to block the passage of spermatozoa through the vas deferens. The standard technic of vasectomy consists of division of the vas at the level of upper scrotum and removal of 1 cm portion of the vas. Both ends of vas are tied with No. 3-0 black silk thread. Currently, there are more than 20 methods of vasectomy. The result of vasectomy can be divided into 4 categories: complication, changes from the obstruction of sperm passage, autoantibody, and result in physical and mental condition. The effects of vasectomy on postvasectomized Thai men were studied in 1976 and 1978. The

  17. Advertising increases demand for vasectomy.

    PubMed

    Mehta, M; Mckenzie, M

    1996-01-01

    The recent evaluation of a 2-year no-scalpel vasectomy (NSV) training program providing on-site, hands-on training for physicians working in 43 publicly funded health centers in 17 states found that demand for vasectomy in low-income and minority communities in the US increased following the implementation of innovative advertising strategies. The program also provided sites with surgical instruments, training materials, a press kit, and some help with public information activities. Participating clinics used a range of formal and informal advertising strategies, including radio and printed advertisements, to inform potential clients about vasectomy services. Many interested clients presented to clinics to undergo vasectomy once they had been made aware of the service and its availability. Several providers even stated that advertising caused the demand for vasectomy to exceed their capacity to provide services. The provision of low- or no-cost procedures helped to attract new clients. PMID:12321999

  18. One Thousand Vasectomies

    PubMed Central

    Barnes, Marian N.; Blandy, J. P.; England, H. R.; Gunn, George; Howard, Geraldine; Law, Barbara; Mason, Bridgett; Medawar, Jean; Reynolds, C.; Shearer, R. J.; Singh, M.; Stanley-Roose, Dorothy G.

    1973-01-01

    In a prospective study of 1,000 people treated by vasectomy at the Margaret Pyke Centre under local anaesthesia as outpatients minor sepsis occurred in 12 cases, an abscess in one, and haematoma needing drainage in seven. Spontaneous recanalization of the vasa occurred in six patients and an unsuspected third vas was found in one. Except in patients with recanalization or a third vas the semen was always free from motile spermatozoa within three months, but non-motile spermatozoa have so far persisted for up to 17 months in a few cases. PMID:4758395

  19. Vasectomy reversal: a clinical update.

    PubMed

    Patel, Abhishek P; Smith, Ryan P

    2016-01-01

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

  20. Vasectomy reversal: a clinical update

    PubMed Central

    Patel, Abhishek P; Smith, Ryan P

    2016-01-01

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

  1. Behavioral response to vasectomy.

    PubMed

    Vaughn, R L

    1979-07-01

    This article reviews the literature concerning the behavioral and psychological response of men and their wives to the vasectomy operation when used as a contraceptive technique. The data suggest that two primary changes may frequently be observed postoperatively. Individuals who have experienced anxiety in conjunction with intercourse because of a fear of contraceptive failure or pregnancy tend to report a decline in anxiety and a disinhibition of sexual arousal postoperatively. Also, test results suggest that behavoir patterns within the marital dyad are altered in some cases when the men adopt stereotyped masculine behavior, presumably to deny any suggestion that they are less masculine because of the operation. Ramifications of these findings as well as numerous other speculations, are considered, along with the suggestion that prescreening and postvasectomy counseling may help reduce negative response to the operation. PMID:454098

  2. Pain after vasectomy.

    PubMed

    McConaghy, P; Reid, M; Loughlin, V; Huss, B K

    1998-01-01

    We studied the influence of the timing of injection of bupivacaine into the vas deferens on the intensity and duration of scrotal pain following vasectomy. Forty-two patients undergoing vasectomy under general anaesthesia were randomly allocated to have the operation performed on either the left or the right side first. On the first side to be operated upon, 5 ml bupivacaine 0.5% was infiltrated along the line of the scrotal incision. The vas deferens was identified and 1 ml bupivacaine 0.5% was injected into its lumen, with 0.5 ml directed proximally and 0.5 ml directed distally. After completion of the procedure on that side, the operation continued on the other side. On this occasion, the same dose of bupivacaine was injected into the vas deferens after division and ligation, and subcutaneously along the scrotal incision after skin closure. Median [interquartile range] visual analogue pain scores on the first side to be operated upon were significantly lower than on the second side on day 1 (7 [1.5-19] vs. 11 [2.5-47]) (p < 0.01) and day 7 (0 [0-8.5] vs. 0 [0-18.8]) (p < 0.05) postoperatively. The median [interquartile range] duration of postoperative discomfort was less on the first side operated upon than on the second (3 [1-7] vs. 6 [2-7]) (p < 0.01). Although statistically significant differences occurred between the treatment groups, the actual differences were small and may not be clinically significant.

  3. REGULATORY T CELLS AND VASECTOMY

    PubMed Central

    Rival, Claudia; Wheeler, Karen; Jeffrey, Sarah; Qiao, Hui; Luu, Brian; Tewalt, Eric F; Engelhard, Victor H; Tardif, Stephen; Hardy, Daniel; del Rio, Roxana; Teuscher, Cory; Tung, Kenneth

    2013-01-01

    CD4+CD25+ regulatory T cells (Tregs) strongly influence the early and late autoimmune responses to meiotic germ cell antigens (MGCA) and the gonadal immunopathology in vasectomized mice. This is supported by the published and recently acquired information presented here. Within 24 hours of unilateral vasectomy (uni-vx) the ipsilateral epididymis undergoes epithelial cell apoptosis followed by necrosis, severe inflammation, and granuloma formation. Unexpectedly, vasectomy alone induced MGCA-specific tolerance. In contrast, uni-vx plus simultaneous Treg depletion resulted in MGCA-specific autoimmune response and bilateral autoimmune orchitis. Both tolerance and autoimmunity were strictly linked to the early epididymal injury. We now discovered that testicular autoimmunity in uni-vx mice did not occur when Treg depletion was delayed by one week. Remarkably, this delayed Treg depletion also prevented tolerance induction. Therefore, tolerance depends on a rapid de novo Treg response to MGCA exposed after vasectomy. Moreover, tolerance was blunted in mice genetically deficient in PD-1 ligand, suggesting the involvement of induced Treg. We conclude that pre-existing natural Treg prevents post-vasectomy autoimmunity, whereas vasectomy-induced Treg maintains post-vasectomy tolerance. We further discovered that vasectomized mice were still resistant to autoimmune orchitis induction for at least 12–16 months; thus, tolerance is long-lasting. Although significant sperm autoantibodies of low titers became detectable in uni-vx mice at seven months, the antibody titers fluctuated over time, suggesting a dynamic “balance” between the autoimmune and tolerance states. Finally, we observed severe epididymal fibrosis and hypo-spermatogenesis at 12 months after uni-vx: findings of highly critical clinical significance. PMID:24080233

  4. Vasectomy--an international appraisal.

    PubMed

    Johnson, J H

    1983-01-01

    Although an estimated 100 million couples who practice contraception have chosen sterilization as their accepted method, the overwhelming majority of the sterilizations were obtained by women even though vasectomy is known to be simpler, safer and cheaper than tubal ligation. In an effort to stimulate new interest in male sterilization an international meeting was held in Sri Lanka in 1982. 66 participants from 25 countries discussed problems related to the acceptance of vasectomy and the delivery of sterilization services. Yearly vasectomy figures have fluctuated widely and are attributed to new simplified female procedures, fluctuating government policies, erratic funding and male chauvinism. Machismo in Central and South America were of particular concern. The use of paramedics to perform vasectomies in areas where there are few overworked doctors was debated. It was concluded that quality services were essential and both physicians and paramedics may have to be used. In Africa neither the population nor the government is interested in male sterilization and contraception is considered woman's business. Several gynecologists are just beginning to introduce the male role in contraception. In Thailand, vasectomy is widely promoted and rewarded, and additional mass market techniques were suggested. Some countries have given cash payments for the procedure, but the conference participants were in favor of more indirect motivational methods. The conference concluded that promoting vasectomy will require more information, education and effort than female sterilization. In particular erroneous fears of castration and impotence must be overcome. Word of mouth communication was judged to be the best way of promoting the success of the procedure.

  5. Experiences of Vasectomy: A Phenomenological Study

    PubMed Central

    Hosseini, Habibollah; Abdi, Fatemeh

    2012-01-01

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

  6. Increasing the availability of vasectomy in public-sector clinics.

    PubMed

    Haws, J M; McKenzie, M; Mehta, M; Pollack, A E

    1997-01-01

    A program designed to improve the availability of vasectomy in public-sector clinics trained physicians at 43 facilities in no-scalpel vasectomy between 1993 and 1995. Among the 38 clinics that responded to a follow-up survey in 1996, the number of clinics providing vasectomies rose from 23 to 32, an increase of almost 40%, while the number of vasectomies performed rose by 18%. Seventeen of the 32 clinics performed more vasectomies after the training; 10 of the 17 had not previously provided the procedure. In-depth interviews with staff from seven sites that experienced large caseload increases and from seven that experienced decreases identified three elements for the successful establishment or expansion of vasectomy services-sufficient numbers of trained providers, funds to subsidize vasectomies for men who cannot afford them and activities to raise awareness about the availability of low-cost or free vasectomy. PMID:9258652

  7. Vasectomy

    MedlinePlus Videos and Cool Tools

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

  8. The safety of vasectomy: recent concerns.

    PubMed Central

    Farley, T. M.; Meirik, O.; Mehta, S.; Waites, G. M.

    1993-01-01

    Vasectomy has been accepted for family planning by approximately 42 million couples worldwide, the majority of whom live in developing countries. It is a highly reliable and safe contraceptive method, which has been extensively studied. Recently, however, renewed concerns have been raised about a possible effect between vasectomy and cancer of the prostate many years after the procedure has been performed. These concerns are based on research conducted in the USA, where there is a high and rising incidence of prostate cancer. This review discusses the evidence for this association and its potential impact in developing countries. The factors influencing the development and growth of prostate cancer are poorly understood and complicate any research into risk factors for the disease. Overall incidences of prostate cancer in some developed countries, such as the USA, are fifty times higher than in some developing countries, such as China. The majority of epidemiological studies on the relationship between vasectomy and prostate cancer have been based in the USA, but the findings are inconsistent and the reported associations weak. On the basis of currently available data, no changes in family planning policies with regard to vasectomy are warranted, but the concerns raised by these studies require that research into any possible association be undertaken in developing countries where vasectomy is widely practised. PMID:8324861

  9. Vasectomy reversal in the age of intracytoplasmic sperm injection.

    PubMed

    Pierpaoli, S; Mulhall, J P

    1998-11-01

    The advent of intracytoplasmic sperm injection has revolutionized the treatment of male infertility and offers an alternative to vasectomy reversal as a treatment option for post-vasectomy infertility. Issues including morbidity, cost and therapeutic outcomes are, however, important considerations for both treatment options. Vasectomy reversal should be considered the ideal option for couples less than 15 years since vasectomy, couples interested in more than one child, couples without in-vitro fertilization insurance coverage and couples with no interest in assisted reproductive techniques. Intracytoplasmic sperm injection may be considered as the primary option for those couples with an older female partner especially if bilateral vasoepididymostomy may be required.

  10. Incidence of sperm antibodies before and after vasectomy.

    PubMed Central

    Hunter, J; Logan, H; Greer, G

    1976-01-01

    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

  11. Should We Still be Performing Vasectomies?

    PubMed Central

    Smith, R. K. L. Percival

    1981-01-01

    Longterm safety of vasectomy has been questioned, based on the possibility of sperm antigens causing an antibody response. The point at which the antigens enter the circulation is unknown. Animal experiments have shown atherosclerosis as a result of antibody production, but evidence in man is still equivocal. Nonetheless, the family physician is obliged to inform patients of possible postoperative complications, but to avoid overinterpretation of a still controversial problem. PMID:20469361

  12. Computer simulation of vasectomy for wolf control

    USGS Publications Warehouse

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

    1997-01-01

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

  13. How should vasectomy be promoted in Guatemala?

    PubMed

    Piotrow, P T; Kincaid, D L

    1988-01-01

    In the article "Evaluation of a Communications Program to Increase Adoption of Vasectomy in Guatemala" by J.T. Bertrand et al (Stud Fam Plann 1987 Nov/Dec), the authors conclude that the use of a male promoter alone was 4 times more cost-effective in increasing the number of vasectomies than the use of radio alone because the costs of the radio program were 4 times higher. This conclusion is questionable for several reasons. 1) The district where the promoter was used alone was twice as large as the radio-only district. 2) In one of the promoter-only districts the same promoter worked throughout the program, but in the other, 3 different promoters had to be recruited and trained, due to high personnel turnover. 3) The initial costs of a radio program may be higher, but 1 program can be broadcast in all districts with little or no extra cost, whereas the costs of a promoter would have to be multiplied by the number of districts. 4) Although the promoter and the radio program produced approximately equal numbers of vasectomies, the radio messages reached over 70% of the people surveyed. Thus, on a national basis, radio broadcasts would be far more cost-effective than the use of salaried promoters in each district.

  14. Psychologic effects of vasectomy in voluntarily childless men.

    PubMed

    Brown, R A; Magarick, R H

    1979-07-01

    Forty-four childless men and 51 vasectomized parents were compared as to their childhood backgrounds, marital satisfaction, social/emotional adjustment, physical and emotional problems attributed to the vasectomy, and attitudes toward vasectomy as a means of birth control. The findings suggested that for young married men, firmly committed to childlessness and in agreement with their wives regarding the necessity of the operation, vasectomy appears to be as physically and psychologically safe as in married parents for at least a two-year period. There were differences in the childfree men and fathers in styles of adjustment, with the childfree reporting themselves to be more independent, mobile, and less tied to tradition; these differences were seen as being more related to choosing a childfree life style than to the choice of vasectomy as a contraceptive method. PMID:452223

  15. Vasectomy May Not Raise Prostate Cancer Risk After All

    MedlinePlus

    ... Vasectomy May Not Raise Prostate Cancer Risk After All Large study challenges previous research linking the procedure ... the results of the two studies are not all that different. Sometimes study results differ by chance." ...

  16. Factors influencing the declining trend of vasectomy in Sichuan, China.

    PubMed

    Nian, Cui; Xiaozhang, Liu; Xiaofang, Pan; Qing, Yang; Minxiang, Li

    2010-07-01

    Vasectomy was once the most common birth control method in both Sichuan Province, China and the world. However, since the 1990s the prevalence of vasectomy in Sichuan, has declined significantly compared to female sterilization in Sichuan and national prevalence of male/female sterilization during the same period. To explore possible reasons for this decline, 27 focus group discussions (FGDs) and 8 in-depth interviews (IDIs) were conducted in four strata of Sichuan. Procedures for qualitative data analysis were used. The findings reveal the decline in vasectomy in Sichuan Province is influenced by multiple factors, including shifts in demographics, changes in family planning working approach and people's perceptions of reproduction, lack of information and misunderstandings about vasectomy, the stereotype of male dominance, bias and preference of program and provider, and the impact of a market economy. Several implications arise from the study for future program development.

  17. Psychologic effects of vasectomy in voluntarily childless men.

    PubMed

    Brown, R A; Magarick, R H

    1979-07-01

    Forty-four childless men and 51 vasectomized parents were compared as to their childhood backgrounds, marital satisfaction, social/emotional adjustment, physical and emotional problems attributed to the vasectomy, and attitudes toward vasectomy as a means of birth control. The findings suggested that for young married men, firmly committed to childlessness and in agreement with their wives regarding the necessity of the operation, vasectomy appears to be as physically and psychologically safe as in married parents for at least a two-year period. There were differences in the childfree men and fathers in styles of adjustment, with the childfree reporting themselves to be more independent, mobile, and less tied to tradition; these differences were seen as being more related to choosing a childfree life style than to the choice of vasectomy as a contraceptive method.

  18. Liposarcoma of the cord presenting at vasectomy counselling.

    PubMed

    Milner, S M; Hawthorn, I E; Morgans, B T

    1989-06-01

    A case of liposarcoma of the cord is reported in a patient presenting for vasectomy. This paper discusses such tumours and illustrates the importance of a careful clinical examination during counselling.

  19. The unofficial vasectomy agent of East Pakistan. (Bangladesh).

    PubMed

    Quddus, A H; Ratcliffe, J W; Croley, H T

    1969-01-01

    This study was undertaken to inquire into the background of individuals known as "vasectomy agents." They act by bringing men into the East Pakistan (Bangladesh) Family Planning Clinics for vasectomy. Their activities have caused the number of vasectomies to rise beyond expectation. Although voluntary at first, they have recently been paid a fee for such services. Many also receive commissions from doctors or others. A total of 155 such agents were interviewed at 24 clinics in 3 districts of East Pakistan. 32 of the agents were women. The median age of all agents was 37.3 years. Of the 155 agents, 60% were engaged full-time in recruiting men for vasectomies. Some had brought in over 100 clients. Of the part-time agents, 37% were farmers, 31% in business, 22% in service employment, and 12% were day laborers. Of the 123 male agents, about 40% had undergone vasectomy themselves. Most agents were from low income groups. Their incomes from acting as agents had increased slightly. About 80% reported acting as agents for 1 year or less. Adequate information about the vasectomy operation seems to have been communicated to clients by the agents. The majority of clients had been concerned about the nature and implications of the vasectomy operation, particularly regarding the loss of sexual potency and their ability to continue working. Many agents encountered opposition from the general public and religious and village leaders. Negative rumors were circulated about the method. Since these agents have made a major contribution to the vasectomy program in East Pakistan, it is thought that they should be given official recognition. By registration, recruiting activities could be supervised. Improved monetary incentives would attract more and better persons. A training course, given by clinic physicians is recommended. In this way agents would be subject to evaluation by an interested and competent person. PMID:12305304

  20. Fertility options after vasectomy: a cost-effectiveness analysis.

    PubMed

    Pavlovich, C P; Schlegel, P N

    1997-01-01

    Calculations of cost per delivery for vasectomy reversal versus sperm retrieval-intracytoplasmic sperm injection (ICSI) under a wide variety of initial assumptions clearly indicate that vasectomy reversal is associated with lower costs per delivery and higher delivery rates. The data for the models on average postvasectomy infertility costs were derived from 6 specialized medical centers in the US in 1994; only men with female partners 39 years or younger were included. The overall vasectomy reversal pregnancy rate was 52%, with an estimated live delivery rate of 47%; for sperm retrieval and ICSI procedures, the mean weighted delivery rate per attempt was 33%. The average cost per delivery for vasectomy reversal (including pretreatment evaluation, surgeon's fee, anesthesia, ambulatory charges, complication costs, lost work costs, and delivery costs weighted for the number of procedures performed at each center) was US $25,475 (95% confidence interval, $19,609-31,339). In contrast, the cost per delivery after sperm retrieval and ICSI was US $72,521 (95% confidence interval, $63,357-81,685), with an average of $73,146 for percutaneous or testicular sperm retrieval and $71,896 for surgical epididymal sperm retrieval. Overall inpatient charges for delivery of a singleton gestation were $9845 ($37,947 for twin gestations and $109,765 for triplet gestations). Unless microsurgical epididymal sperm aspiration results improve dramatically or ICSI procedural costs and multiple gestation rates decrease, vasectomy reversal will remain the indicated treatment for men interested in fertility restoration after vasectomy.

  1. The quality of marriage before and after vasectomy.

    PubMed

    Howard, G

    1979-09-01

    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

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

    PubMed Central

    Reynolds, J. L.

    1998-01-01

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

  3. The effects of vasectomy on the perception of marital roles among married Filipino couples.

    PubMed

    Barrion, E

    1978-01-01

    Using a non-probability type of sampling a total of 20 men who underwent a vasectomy at the University of the Philippines PGH Medical Center and their wives were selected to be interviewed. The general objective of the study was to identify the effects of vasectomy on the perception of marital roles among married Filipino couples. The specific study objectives were to determine the effects of vasectomy on the perception of self-image of vasectomized Filipino males, to investigate the sexual problems that may arise after vasectomy, and to clarify misconceptions regarding vasectomy that may be brought up by the subjects. The following were included among the results: 1) before sterilizaiton, all the males were worried about their increasing family size, but after the operation 80% felt no need for further worry in this regard; 2) 10% of the men felt that the vasectomy had negatively affected their physical health; 3) 85% of the men felt that the surgical method did not affect their masculinity; 4) the majority of the couples felt no difference in their love for one another after the vasectomy as attested to by 75% of the husbands and 80% of the wives; 5) 25% of the females and 40% of the males reported increased sexual desire after the vasectomy; and 6) 55% of the males reported no change in the sexual satisfaction they derived from intercourse after the vasectomy. PMID:12261323

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  8. Demographic consequences, client satisfaction, and reasons for selecting sterilization among vasectomy and tubectomy clients in Bangladesh.

    PubMed

    Swenson, I; Khan, A R

    1982-06-01

    A follow-up study of vasectomy and tubectomy clients in Bangladesh showed that the mean ages of vasectomy clients and their wives were significantly higher than the mean ages of tubectomy clients. These findings suggest that the number of births averted by vasectomy is less than what might be expected from tubectomy. Between 20-60% of tubectomy clients stated that they (or their husbands) had previously used contraception, while only 2% of vasectomy clients indicated that they or their wives had previously used contraception. More than 95% of tubectomy clients, compared to less than 48% of vasectomy clients, were satisfied with having a sterilization procedure. A large proportion of dissatisfied vasectomy clients indicated that they had chosen vasectomy rather than some other method of contraception primarily because of financial incentives. The small percentage of dissatisfied tubectomy clients indicated that their concern was about possibly having a child die and not being able to replace that child. Less than 30% of vasectomy clients compared to more than 70% of tubectomy clients indicated that they had recommended the procedure to another man (woman). While more than 80% of tubectomy clients cited themselves, their husbands, or a close family member as the most influential person in their decision to have a tubectomy, vasectomy clients never mentioned their wives, rarely another family member, and in less than 1/2 the cases, themselves. This study suggests that client satisfaction with tubectomy in Bangladesh can be attributed to the desire to terminate childbearing. Positive responses of tubectomy clients appear to be consistent in spite of urban-rural, religious, and socioeconomic differences as measured by education of clients and their husbands' occupation. On the other hand, lack of satisfaction of vasectomy clients can be attributed to use of incentives, causing recruitment of clients who were not primarily motivated by a desire to terminate childbearing

  9. A study of characteristics of vasectomy acceptors at the Fertility Control Clinic, U.P. PGH Medical Center.

    PubMed

    Patacsil, G R

    1978-01-01

    The clinical records of 166 available vasectomy patients at the Fertility Control Clinic of the University of the Philippines, Philippines Medical Center were examined and in-depth interviews using the case study method were conducted with 10 vasectomy acceptors in an attempt to obtain the characteristics of vasectomy acceptors and to determine the persons most influential in the decision to accept vasectomy as well as the fears and problems relating to vasectomy. The demographic characteristics of age, educational achievement, occupation, residence, race, religion, marital status, total live births, and contraceptives used before vasectomy were gathered. The most probable acceptors of vasectomy are men in the 30-39 year age bracket, with high school education, an unskilled job, married, Catholic, father of 3-4 children, and wives who have used oral contraception. For 64% of the acceptors the reason for vasectomy was socioeconomic, according to clinic records. The in-depth interviews indicated the reasons for acceptance to be contraceptive failure and convenience. The mass media and "significant others" (such as friends; neighbors; associates; and the husband's manager) played a major role in the dissemination of vasectomy information. Husbands were the decision-makers in the family, particularly with regard to the choice of vasectomy. The nature of preoperative fears was related to possible side effects and the uncertain outcome of the procedure. The sexual relationship remained unchanged in regard to coital frequency, coital attitude, and behavior.

  10. Effects of vasectomy on medical and psychosocial aspects.

    PubMed

    Lee, H Y; Chon, K H; Moon, C O; Chung, M K; Kim, S K; Whang, N D; Lee, B K; Choi, S G; Kim, Y C; Cho, C H

    1970-01-01

    To understand the effects of vasectomy on men, 1080 men were interviewed an average of 3.7 years after having had this operation. These men were grouped according to whether they privately paid for their operation or received it through a government program. The average age of these subjects was 37.8 years, and they had an average of 4.7 children. Reasons for vasectomy included economic considerations and the desire to limit their family. This type of operation was selected due to its permanance and reliability. Many men were motivated by family counselors or by the mass media. 68% had discussed the operation with their wives. 16% of the men had fears of impotence after the operation. Most were operated under a local anesthesia, and were not hospitalized. 57% did not bother to stay at home in recovery. Pain was encountered by 25% during the operation. Sexual activity was resumed in 3 weeks, with little change reported in eating or sleeping habits. Coital frequency decreased from 1.92-1.70 times/week. 90% of the men said they would recommend the operation to others.

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

    PubMed

    Tan, Wei Phin; Levine, Laurence A

    2016-01-01

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

  12. Vasectomy reversal: new techniques and role in the era of intracytoplasmic sperm injection.

    PubMed

    Karpman, Edward; Williams, Daniel H; Lipshultz, Larry I

    2006-02-01

    The growing popularity of vasectomy as a primary form of birth control has also created an increasing demand for vasectomy reversal (VR). The advent of IVF with intracytoplasmic sperm injection after sperm retrieval has given couples an alternative to traditional VR. Although VR remains the most cost-effective and natural way to conceive after vasectomy, competing interests and market pressures have encouraged the development of this assisted reproductive technique (ART). The success of VR is dependent on several variables. The length of time since vasectomy and an individual surgeon's experience appear to be the most significant factors and are equally important. The success of this procedure is highly contingent on adherence to strict surgical principles of creating a water-tight, tension-free anastomosis, along with the appropriate decision whether to perform either a vasovasostomy or epididymovasostomy at the time of VR.

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

    PubMed Central

    Tan, Wei Phin; Levine, Laurence A

    2016-01-01

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

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

    PubMed

    1975-12-01

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

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

    PubMed Central

    Zhang, Xiao-Long; Yan, Jia-Jun; Pan, Shou-Hua; Pan, Jian-Gang; Ying, Xiang-Rong; Zhang, Guan-Fu

    2015-01-01

    Background: The relationship of vasectomy to prostate cancer has great public health significance. However, the results of observational studies were conflicting. To determine whether vasectomy is associated with the risk of prostate cancer, we performed a meta-analysis of cohort studies. Methods: A literature search was carried out using Pubmed, Embase, Cochrane Libraryl, and China National Knowledge Infrastructure (CNKI) between January 1966 and July 2013. Before meta-analysis, between-study heterogeneity and publication bias were assessed using adequate statistical tests. Fixed-effect and random-effect models were used to estimate summary relative risks (RR) and the corresponding 95% confidence intervals (CIs). Potential sources of heterogeneity were detected by meta-regression. Subgroup analyses and sensitivity analysis were also performed. Results: A total of nine cohort studies contributed to the analysis. There was heterogeneity among the studies but no publication bias. Pooled results indicated that vasectomy was not associated with a significant increase of total prostate cancer risk (RR = 1.07, 95% CI [0.79, 1.46]). When stratified the various studies by geographic location, we found a significant association between vasectomy and increased PCa risk among studies conducted in the USA (RR = 1.54, 95% CI [1.23, 1.93]), however, there was no significant association between vasectomy and PCa risk among studies conducted in non-USA countries (RR = 0.74, 95% CI [0.50, 1.09]). Furthermore, sensitivity analysis confirmed the stability of the results. Conclusions: In conclusion, the present meta-analysis of cohort studies suggested that vasectomy was not associated with increased risk of prostate cancer. More in-depth studies are warranted to report more detailed results, including stratified results by age at vasectomy, tumor grade, and tumor stage. PMID:26770392

  16. Unilateral absence of vas deferens: prevalence among 23,013 men seeking vasectomy

    PubMed Central

    Miller, Sarah; Couture, Sophie; James, Gareth; Plourde, Simon; Rioux, Jacky; Labrecque, Michel

    2016-01-01

    ABSTRACT Purpose: To determine the prevalence of unilateral absence of vas deferens (UAVD) in men with both testes seeking vasectomy. Materials and Methods: Computerized charts of 23,013 patients encountered between January 1994 and December 2013 in one university hospital and two community clinics of Quebec City, Canada, were searched. Pre-vasectomy consultation, operative reports and semen analysis results were reviewed to identify cases of UAVD. Cases were categorized as confirmed (unilateral vasectomy and success confirmed by semen analysis) or possible congenital UAVD further sub-categorized according to whether or not a scrotal anomaly was present. Results: Among 159 men identified as potentially having UAVD, chart review revealed that 47 had only one testicle, 26 had bilateral vasa, and four were misdiagnosed (post-vasectomy semen analysis [PVSA] showing motile sperm after unilateral vasectomy) leaving 82 men deemed cases of UAVD (0.36%, 95% confidence interval 0.28% to 0.43%). These were classified as confirmed (n=48, 0.21%) and possible (n=34, 0.15%; 22 without and 12 with scrotal anomalies) congenital UAVD. The misdiagnosis ratio of UAVD was low when scrotal content was otherwise normal (1:48), but higher if anomalies were present (3:12). Conclusions: Most surgeons who perform vasectomy will encounter cases of UAVD. In most suspected cases, it is safe and effective to proceed with unilateral vasectomy under local anesthesia while stressing the need for PVSA. Further studies or scrotal exploration may be considered in patient with prior scrotal surgery. PMID:27509370

  17. Psychosocial and medical effects of vasectomy in a sample of health plan subscribers.

    PubMed

    Janke, L; Wiest, W M

    The effects of vasectomy on psychosocial adjustment assessed by interviews, and on physical health assessed by physicians and other medical personnel, were examined by comparing 33 vasectomized men with a matched group of 33 non-vasectomized men in a pre-paid health plan. Consistent with favorable self-reports in earlier studies, the vasectomized men experienced no greater marital, job, or general living stress than the non-vasectomized men. In fact the psychosocial adjustment of the vasectomized men appeared superior to that of the non-vasectomized men, perhaps because of reduced anxiety about unwanted pregnancy. The hypothesis advanced by some investigators that vasectomized men exaggerate their masculinity in an overcompensating maneuver to reduce a perceived threat to their masculinity was not supported; instead, men volunteering for vasectomy exhibited as many masculine traits prior to the operation as after it. There was no evidence that vasectomy led to either impairment or enhancement of medical health.

  18. Not all births are "blessed events": legal perils of vasectomy.

    PubMed

    Benjamin, R

    1978-11-01

    Recent court decisions awarding damages for the costs involved in bearing and raising a child born after negligent vasectomy procedures should not deter the medical profession from performing sterilizations. Liability claims can be avoided by providing both the patient and his spouse with adequate counselling covering such topics as the irreversibility of sterilization and the possibility of sterilization failure and by having the patient sign a consent form describing the risks involved. In addition, all information provided over the phone should be recorded on the patient's chart. Recently the Minnesota Supreme Court awarded damages to a man whose wife became pregnant after he was inaccurately advised over the phone that his postoperative semen sample was free of sperm. The patient's medical chart did not contain a reference to the phone conversation; therefore, the validity of the claimants testimony could not be contested. The damage awards in most of these cases are small, and in some cases, including the one noted above, the amount of the awards are computed by subtracting the value of the child's aid and comfort to the parents from the costs involved in bearing and raising the child.

  19. Laparoscopic orchiectomy and contralateral vasectomy in a patient with an abdominal testicle: a case report.

    PubMed

    Childers, J M; Hicks, T H

    1992-05-01

    We present a case of a 38-year-old man with a unilateral intra-abdominal testicle and undesired fertility in whom orchiectomy and contralateral vasectomy were performed laparoscopically. Urologists have been using diagnostic laparoscopy in patients with nonpalpable testes to plan the definitive procedure when the testicle is present, and to avoid laparotomy in cases of testicular absence. This case of laparoscopic orchiectomy and vasectomy demonstrates that operative laparoscopy allows another subset of patients with cryptorchidism to avoid open laparotomy. PMID:1349045

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

    PubMed Central

    Loftsgaarden, Megan; Chukwudelunzu, Felix

    2015-01-01

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

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

    PubMed

    David, Manova; Loftsgaarden, Megan; Chukwudelunzu, Felix

    2015-12-01

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

  2. Vasectomy and Risk of Aggressive Prostate Cancer: A 24-Year Follow-Up Study

    PubMed Central

    Siddiqui, Mohummad Minhaj; Wilson, Kathryn M.; Epstein, Mara M.; Rider, Jennifer R.; Martin, Neil E.; Stampfer, Meir J.; Giovannucci, Edward L.; Mucci, Lorelei A.

    2014-01-01

    Purpose Conflicting reports remain regarding the association between vasectomy, a common form of male contraception in the United States, and prostate cancer risk. We examined prospectively this association with extended follow-up and an emphasis on advanced and lethal disease. Patients and Methods Among 49,405 US men in the Health Professionals Follow-Up Study, age 40 to 75 years at baseline in 1986, 6,023 patients with prostate cancer were diagnosed during the follow-up to 2010, including 811 lethal cases. In total, 12,321 men (25%) had vasectomies. We used Cox proportional hazards models to estimate the relative risk (RR) and 95% CIs of total, advanced, high-grade, and lethal disease, with adjustment for a variety of possible confounders. Results Vasectomy was associated with a small increased risk of prostate cancer overall (RR, 1.10; 95% CI, 1.04 to 1.17). Risk was elevated for high-grade (Gleason score 8 to 10; RR, 1.22; 95% CI, 1.03 to 1.45) and lethal disease (death or distant metastasis; RR, 1.19; 95% CI, 1.00 to 1.43). Among a subcohort of men receiving regular prostate-specific antigen screening, the association with lethal cancer was stronger (RR, 1.56; 95% CI, 1.03 to 2.36). Vasectomy was not associated with the risk of low-grade or localized disease. Additional analyses suggested that the associations were not driven by differences in sex hormone levels, sexually transmitted infections, or cancer treatment. Conclusion Our data support the hypothesis that vasectomy is associated with a modest increased incidence of lethal prostate cancer. The results do not appear to be due to detection bias, and confounding by infections or cancer treatment is unlikely. PMID:25002716

  3. "Suddenly, bang, one day there's commitment with a woman..." men, vasectomy and the life course.

    PubMed

    Terry, Gareth

    2014-09-01

    Research that investigates and theorises the male reproductive life course is extremely limited, and often reduced to examining problems, such as infertility. As a consequence, what we know about men's reproductive decision making is often extrapolated from theorisation of the female reproductive life course, or simplistic assumptions about masculine identity. This article analyses interview data from 34 men talking about their vasectomy decision-making processes in order to provide a lens through which to understand men making sense of their reproductive life course. Men who had children spoke of their vasectomy as resolving their lay understandings of the 'normal' life course, men who did not want their children to speak of resisting the normal life course, and men who had experienced or considered relationship dissolution spoke of resetting the life course.

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

    PubMed Central

    2016-01-01

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

  5. Scoring men: vasectomies and the totemic illusion of male sexuality in Oaxaca.

    PubMed

    Gutmann, Matthew C

    2005-03-01

    This paper discusses research on men's reproductive health and sexuality in Oaxaca, Mexico, and specifically why some men there choose to be sterilized. Men who opt for vasectomies do so after considering numerous cultural, historical, physiological, commercial, and other concerns. Men and women in Oaxaca negotiate certain cultural folk beliefs about supposed male sexual desires and practices before arriving at the decision to get the operation. Vasectomy as a method of birth control is chosen despite folk beliefs that take the form of a totemic illusion which treats male sexuality as naturalized, something fixed, and as entirely distinct from female sexuality. Among its many consequences, this totemic illusion serves to conceal inequalities in the sphere of reproductive health and sexuality in relation to contraception. PMID:16108204

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2013-12-01

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

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

    PubMed

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

    2013-12-01

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

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

    PubMed

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

    2015-12-01

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

  10. Abnormalities of sperm morphology in cases of persistent infertility after vasectomy reversal.

    PubMed

    Pelfrey, R J; Overstreet, J W; Lewis, E L

    1982-07-01

    Persistent infertility after vasectomy reversal by vasovasostomy may be due to irreversible changes in epididymal physiology, producing morphologic abnormalities of the sperm tail. Specimens from 29 men with persistent infertility following vasectomy reversal were analyzed and sperm motility and morphology were evaluated. the percentage of motile sperm was below normal in 23 specimens. Swimming speed evaluation on 20 specimens showed only 4 were below the normal range. In 19 of the 29 specimens, 10% or more of the sperm cells examined were characterized by a normal head and a coiled or shortened tail. Within this group, the percentage of sperm with tail abnormalities ranged from 2-64%, with a mean of 18.1%. The appearance of sperm tail abnormalities in conjunction with normal or high sperm concentrations suggests a disturbance of epididymal physiology. The epididymal environment is required for the final maturation of spermatazoa and the acquisition of normal motility and fertilizing ability. The study results suggest that these epididymal functions may be impaired in some men after vasectomy. A case report of a 32 year old man who had a vasectomy 7 years prior to referral to the evaluation group, and a successful vasovasostomy 2 years prior, revealed only 20% of the sperm evaluated in the initial specimen had the normal head and tail shape. His semen volume was 3.5 ml with a sperm concentration of 250 million/ml. 25% of the sperm were motile. Reexamination of the semen 8 times during the next year showed no significant changes. The cervical mucus penetration test showed no abnormalities of the sperm-cervical mucus interaction. When the motile sperm were spearated from the immotile cells and incubated with zona-free hamster eggs, all of the eggs were penetrated. Attempts were unsuccessful to isolate sufficient numbers of motile cells for artificial insemination, however, a normal pregnancy was conceived 1 year after the initial evaluation without additional therapy

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

    PubMed

    Heiderich, Elisabeth; Schildger, Bernd; Lierz, Michael

    2015-03-01

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

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

    PubMed

    Heiderich, Elisabeth; Schildger, Bernd; Lierz, Michael

    2015-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

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

  14. A comparison of abdominal and scrotal approach methods of vasectomy and the influence of analgesic treatment in laboratory mice.

    PubMed

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

    2012-10-01

    Vasectomized mice are needed in the production of genetically-modified animals. The BVAAWF/FRAME/RSPCA/UFAW Joint Working Group on Refinement recommended that vasectomy should be performed via an incision in the scrotal sac, rather than via laparotomy, arguing that the former could be less painful due to minimal tissue trauma. This study was undertaken to assess the validity of this recommendation. Mice underwent vasectomy via either abdominal or scrotal approach surgery. Mice were filmed for 15 min presurgery and at one, 24 and 48 h postsurgery. Data were obtained using automated behaviour recognition software (HomeCageScan). Meloxicam was administered either alone or combined with acetaminophen prior to surgery. A third group received only saline subcutaneously. Postsurgery behaviour changes were compared between groups at each time point. Exploratory behaviours such as rearing, walking and sniffing were most greatly reduced at one hour following surgery whereas the duration of grooming increased. By 48 h these changes had largely subsided. Results indicated mice undergoing scrotal approach surgery fared better at one hour postsurgery, but the magnitude of this was relatively insignificant compared with the overall effects of surgery. If the observed behaviour changes resulted from pain, results suggested there was no significant advantage of scrotal versus abdominal approach vasectomy. These and other recently obtained data on the effects of non-steroidal anti-inflammatory drugs (NSAIDs) in mice suggest considerably larger doses of these or more potent analgesics, more precise monitoring of surgical outcomes, or a combination of these factors are needed to determine the extent of pain experienced by mice undergoing vasectomy.

  15. Comparison of microscopic epididymal sperm aspiration and intracytoplasmic sperm injection/in-vitro fertilization with repeat microscopic reconstruction following vasectomy: is second attempt vas reversal worth the effort?

    PubMed

    Donovan, J F; DiBaise, M; Sparks, A E; Kessler, J; Sandlow, J I

    1998-02-01

    Since 1986, we have performed microscopic reconstruction in 18 men following failed microscopic vasectomy reversal. Between 1994 and 1996, nine couples have undergone microscopic epididymal sperm aspiration (MESA)/ intracytoplasmic sperm injection (ICSI) treatment for male infertility due either to congenital absence of the vas deferens (CAVD) or inoperable excurrent duct obstruction. We compared the cost efficiency of repeat vasectomy reversal to that for MESA combined with ICSI/in-vitro fertilization (ICSI/IVF). The cost of male partner procedures (vasectomy reversal, MESA) was based on physician and hospital charges, while the cost of ICSI/IVF included preparation of the female partner (medications and physician charges) and procedures (physician and hospital charges including oocyte retrieval, micromanipulation, and embryo transfer). Our cost examination does not include charges related to follow-up visits, prenatal monitoring, complications of pregnancy (i.e. miscarriage) or delivery in either group. Overall patency and pregnancy rates in the repeat vasectomy reversal group were 78 and 44% respectively. The cost per delivered baby (including multiple metachronos deliveries per couple) was $14892. Fertilization of oocytes has been achieved in 37/72 (51%) and pregnancies have occurred in 6/9 (67%) attempts and 5/9 (56%) report delivery. The average cost per pregnancy was $25637 and the average cost per delivered baby (or ongoing pregnancy) was $35570. The cost per delivery by MESA/ ICSI/IVF is 2.4 times the charges per delivery obtained through repeat vasectomy repair. Couples attempting to overcome infertility caused by vasal obstruction should be informed that vas reconstruction remains a cost effective means of re-establishing fertility even in men who have previously failed vasectomy reversal.

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

    PubMed

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

    1997-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

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

  18. How Is a Vasectomy Done?

    MedlinePlus

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

  19. What Are the Risks of Vasectomy?

    MedlinePlus

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

  20. Vasectomies are legal--even in Queensland.

    PubMed

    Gerber, P

    1987-01-19

    Consent by patients to voluntary sterilization frees surgeons from criminal responsibility for assault when such consent is given freely with the knowledge of the purpose and consequence of the procedure, and when the operation is performed with professional skill. However, it is considered unethical for surgeons to sterilize a married man or woman of child-bearing age unless they have satisfied themselves that the other party to the marriage has consented to the procedure.

  1. Coagulation changes following vasectomy: a study in primates.

    PubMed

    Kisker, C T; Alexander, N J

    1978-05-01

    Thirty vasectomized rhesus monkeys were tested for changes in coagulation factors that might reflect an increased incidence of thrombosis. The results of tests on these monkeys were compared with results of tests on 18 control rhesus monkeys; there were no significant differences between control and vasectomized animals for any of the parameters tested. One vasectomized animal had increased levels of fibrin monomer in his plasma on repeated samples, but no evidence of thrombosis on postmortem examination.

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

    MedlinePlus

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

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

    PubMed

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

    2015-08-01

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

  4. A Retrospective Review of Factors Associated with Vasovasostomies in United States Military Members

    PubMed Central

    Masterson, J.; Avalos, E.; Santomauro, M.; Walters, R.; Marguet, C.; L'Esperance, J.; Drain, D.

    2013-01-01

    Background Men seeking a vasectomy should receive counseling prior to the procedure that includes discussion of later seeking a reversal. We sought to determine demographic factors that may predispose patients to possibly later seek a vasectomy reversal. Methods All U.S. Military electronic health records were searched between 2000 and 2009 for either a vasectomy or vasovasostomy procedure code. Aggregate demographic information was collected and statistical analysis performed. Result A total of 82,945 patients had a vasectomy of which 4,485 had a vasovasostomy resulting in a vasovasostomy-to-vasectomy rate of 5.04%. The average age at vasovasostomy was 34.9±5.0, with an average interval of 4.1±2.2 years. Men undergoing a vasectomy at a younger age were more likely to have a vasovasostomy. Various religions did have statistically significant differences. Within ethnic groups, only Native Americans [OR=1.39 (95% CI 1.198-1.614)] and Asians [OR=0.501 (95% CI 0.364-0.690)] had statistically significant differences when compared to Caucasians. Men with more children at the time of vasectomy were more likely to have a vasovasostomy. Conclusion Younger men, Native Americans, and men with more children at vasectomy were more likely to undergo a vasovasostomy. The reason for these differences is unknown, but this information may assist during pre-vasectomy counseling. PMID:24917734

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

    ERIC Educational Resources Information Center

    Population Council, New York, NY.

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

  6. The impact of mass media advertising on a voluntary sterilization program in Brazil.

    PubMed

    Foreit, K G; de Castro, M P; Franco, E F

    1989-01-01

    The effect of magazine advertising on vasectomy acceptance was tested in São Paulo, Brazil. Four advertisements ran for ten weeks in eight magazines. Clinic performance doubled during the campaign and stabilized at 54 percent higher than baseline. The advertisements selectively attracted the target audience without bringing in large numbers of ineligible candidates, completely avoided negative reactions, and recruited men previously unexposed to vasectomy. The cost of the advertising campaign was offset by additional revenue generated by the increase in vasectomies performed. The results suggest that while interpersonal communications can maintain performance in voluntary sterilization programs, mass media promotion may be necessary for program growth.

  7. The impact of mass media advertising on a voluntary sterilization program in Brazil.

    PubMed

    Foreit, K G; de Castro, M P; Franco, E F

    1989-01-01

    The effect of magazine advertising on vasectomy acceptance was tested in São Paulo, Brazil. Four advertisements ran for ten weeks in eight magazines. Clinic performance doubled during the campaign and stabilized at 54 percent higher than baseline. The advertisements selectively attracted the target audience without bringing in large numbers of ineligible candidates, completely avoided negative reactions, and recruited men previously unexposed to vasectomy. The cost of the advertising campaign was offset by additional revenue generated by the increase in vasectomies performed. The results suggest that while interpersonal communications can maintain performance in voluntary sterilization programs, mass media promotion may be necessary for program growth. PMID:2497560

  8. New sterilization techniques accent ease, speed.

    PubMed

    1993-01-01

    New techniques are being developed for permanent male and female sterilization. The new methods are cheaper, easier to use, and effective. Vassoclude, a device under development by the Population Council, is used in the no-scalpel vasectomy technique. A pin hole created by the Vassoclude opens the way to apply a staple-like mechanism to place clips on the vas deferens. The method requires less manual dexterity than other tools, and there is no puncture hole. A new female method uses quinacrine hydrochloride pellets, which are inserted into the uterus with an IUD inserter. Permanent scarring of the fallopian tubes prevents pregnancy. The method is cheap, safe, and easy to use. The disadvantage is that multiple visits are required before the fallopian tubes are blocked. About 500,000 women currently use quinacrine worldwide. There have been few clinical trials. Most of the women live in Vietnam and Pakistan. Toxicological tests conducted by the US Food and Drug Administration and the World Health Organization have shown the product not to be safe. The Association for Voluntary Surgical Contraception reports that there are 140 million couples relying on female sterilization worldwide, while only 42 million men undergo vasectomies. In the US, reports are that 23% of American couples rely on tubal ligations, compared to 13% relying on vasectomy. 500,000 men underwent vasectomies in the US in 1991. Neither quinacrine nor the Vassoclude was available in the US in 1993. There is little interest in producing and marketing vasectomy tools, and studies continue to examine vasectomy's side effects or links with cancer, which discourages the choice of vasectomy as a contraceptive method.

  9. [Apropos of male sterilization].

    PubMed

    Madelenat, P

    1974-03-30

    A British survey of urologists showed that vasectomy is increasing as rapidly there as in the US. Despite restricting vasectomy to married men over 30 with 3 children, 6%-8% request reversal. Vasovasostomy is more likely to succeed if only a short segment of vas is removed, the cut ends are cauterized in the mucosa only, and the pericanular fascia is closed with a nonresorbable black suture to separate the ends of the vas. With good postoperative care the patient will be more satisfied with the operation. Vasovasostomy using a Teflon support is described. Most vasa can be recanalized, but 85% of patients are infertile, probably because the juxtadeferential inferior spermatic nerve was severed. Sperm banks seem to offer hope for vasectomy as a contraceptive method, but the lifetime of fertile sperm is only about 3 years. Of the intracannular devices, nylon threads and gold or stainless steel microvalves have been successful experimentally.

  10. A note on the effect of different methods of emasculation on gain in body weight in Indian buffalo (Bubalus bubalis) calves.

    PubMed

    Saxena, O P; Rao, G S

    1978-01-01

    The effect of Burdizzo, Russian and vasectomy methods of castration on the gain in body weight was studied over a period of 2 1/2 months in the buffalo calves of two age groups (1--1 1/2 years and 2 1/2--3 years). The gain in body weight (1--1 1/2 years age group) has been significantly greater (P less than 0.05) in the control animals (30.3 +/- 3.38 kg) as well as those emasculated by the vasectomy (31.3 +/- 1.4 kg) method in comparison to the other two methods. PMID:686390

  11. Presterilization Interviewing: An Evaluation

    ERIC Educational Resources Information Center

    Carey, Raymond G.

    1976-01-01

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

  12. Spaying and Neutering

    MedlinePlus

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

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

    PubMed

    Santiso, R

    1988-04-01

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

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

    ERIC Educational Resources Information Center

    Mihevc, Nancy T.; And Others

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

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

    PubMed

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

    2013-12-01

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

  16. Characteristics of family planning clients in Bangladesh.

    PubMed

    Swenson, I; Khan, A R

    1983-01-01

    The study objective was to establish a profile of family planning clients in Bangladesh to illustrate differences and similarities of the clients who obtain various types of contraceptives--oral contraceptives (OCs), injectables, tubal ligation, and vasectomy--in both urban and rural areas. The urban women receiving OCs attended the family planning clinics of 6 hospitals in Dacca during the 1974-77 period. The rural OC clients attended a government family planning clinic about 25 miles southeast of Dacca between 1975-77. Urban injectable clients all attended the family planning clinic of the model clinic in Dacca. Rural injectable clients attended the same family planning clinic in Matlab as did rural OC clients. Urban tubal ligation clients were randomly selected from 2 areas, Kalicakar and Kustia. Vasectomy clients were randomly sampled from the lists of vasectomy clients which attended mass vasectomy centers in Shibjuir and Shalna provinces 2 years prior to the survey follow-up. The higher mean ages of all rural contraceptive users, regardless of method, was consistent with their high parities and the small percentages of these women who desired more children. 15.6% of urban women choosing sterilization had never used contraception previously, but 93.2% of urban OC acceptors and 61.5% of the injectable clients were obtaining contraception for the 1st time. 62% of sterilization clients who had previously used contraception had been using OCs. Among the rural users of contraceptives, those using pills and vasectomy had the highest proportions of no prior use of contraception (94% and 95.7%, respectively). 42% of tubal ligation clients had never used contraception previously; 64.2% of the injectable clients indicated they had never used contraceptives. Among the OC acceptors the majority of previous users had IUDs inserted. Injectable and tubal ligation acceptors previously using contraception had primarily been OC users. In both the urban and rural areas the vast

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

    SciTech Connect

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

    1981-09-01

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

  18. Changing trends in conception control.

    PubMed

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

    1989-01-01

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

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

    PubMed

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

  20. Sterilization among currently married men in the United States, 1991.

    PubMed

    Forste, R; Tanfer, K; Tedrow, L

    1995-01-01

    Data from the 1991 National Survey of Men indicate that about 12% of married men aged 20-39 have had a vasectomy and about 13% are married to a woman who is sterilized. Multivariate analyses indicate that the likelihood of sterilization rises with husband's age, wife's age, duration of marriage and number of children. Black couples are significantly less likely than white couples to rely on sterilization, and interracial couples are less likely than same-race couples to be sterilized. The likelihood of reliance on vasectomy rather than tubal ligation also rises with husband's age, while black men are significantly less likely than white men to elect male over female sterilization. Use of male sterilization is strongly associated with having had a recent contraceptive failure while using a male method.

  1. Changing trends in conception control.

    PubMed

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

    1989-01-01

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

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

    PubMed

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

    1994-09-01

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

  3. Congenital disabilities and the law.

    PubMed

    Roth, Robert

    2007-06-01

    This article describes the evolution and stutter steps in the legal developments surrounding the controversial claims for "wrongful conception," "wrongful birth," and "wrongful life." These claims arise from negligence in a failed vasectomy/tubal ligation resulting in an unwanted pregnancy and from negligence in failing to perform or properly interpret genetic testing resulting in the inability of parents to make an informed decision whether to terminate a pregnancy where a child would be, and ultimately is, born with serious genetic defects.

  4. Why Bolivians are talking about gender roles.

    PubMed

    Eschen, A

    1998-01-01

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

  5. GP could not be liable for specialist's negligence.

    PubMed

    Gregory, D R

    1979-03-01

    Thomas Bushman and Mrs. Bushman sued Dr. John Hall of the Burns Medical Center when Mrs. Bushman became pregnant after her husband had undergong a vasectomy. The child was born healthy. The Bushmans sued Dr. Hall and the clinic to recover damages for wrongful pregnancy allegedly resulting from negligence in performing the vasectomy. The Circuit Court of Michigan entered judgment for the defendants on the jury verdict, and the Bushmans appealed. The Court of Appeals of Michigan held that an action could be rightfully maintained for wrongful pregnancy, but that damages would be limited to the pain, suffering, and discomfort of the wife as a result of the pregnancy, the cost of the vasectomy, the husband's loss of comfort, companionship, services, and consortium of his wife arising from the pregnancy and immediately following the birth, and medical expenses incurred as the result of the pregnancy. The Appeals Court found that the trial court erred in relying on Troppi v. Scarf. The original court approved the defense theory that any damages incurred by plaintiff-parents should be offset by the benefits of having a healthy child. Before the trial the Bushmans had dropped their allegation of damages for the cost of raising the child and sued only for wrongful pregnancy. Thus, the benefits rule applied in Troppi should not have applied to a case that was not confined to the issue of wrongful life.

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

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

    2016-01-01

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

  8. Post-obstruction rat sperm autoantigens identified by two-dimensional gel electrophoresis and western blotting.

    PubMed

    Flickinger, C J; Bush, L A; Williams, M V; Naaby-Hansen, S; Howards, S S; Herr, J C

    1999-05-01

    Although antisperm autoantibody responses to obstruction of the male reproductive system have been documented, information on the nature of the cognate sperm autoantigens has been limited. In the present study, the patterns of sperm autoantigens recognized by sera from rats after obstruction of the vas deferens or epididymis were studied by high resolution two-dimensional (2-D) gel electrophoresis and western blotting. Comparisons of patterns of autoantigens stained on 2-D western blots of sera from prepubertal vasectomy, prepubertal epididymal ligation and adult vasectomy groups revealed both similarities and differences. Sera from sham-operated animals showed no detectable reaction or much lighter staining of a small number of spots. Visualization of sperm autoantigens on 2-D western blots supported the hypothesis that there is a relatively small set of sperm proteins that can be regarded as dominant post-obstruction sperm autoantigens because they are recognized by multiple post-obstruction sera. The 2-D analysis revealed previously undetected distinctions in the autoantigens recognized after adult and prepubertal vasectomy, as well as variations with the site of obstruction. These differences in the response may be due in part to changes in antigens of spermatozoa in different parts of the tract and at different ages, as well as variations in exposure of sperm cell proteins to the immune system resulting from the sites of spermatic granulomas. Preparative 2-D gels and western blotting with post-obstruction sera are now being used to identify specific sperm autoantigens by microsequencing of selected proteins. PMID:10392780

  9. [Characteristics of candidates for surgical sterilization and factors associated with type of procedure].

    PubMed

    Vieira, Elisabeth Meloni; Fábio, Suzi Volpato; Gueleri, Wagner; Picado, Miriam Pinheiro; Yoshinaga, Elizabeth; de Souza, Luiz

    2005-01-01

    In 1999 the Municipal Health Department in Ribeirão Preto, São Paulo, Brazil, implemented the provision of surgical contraceptive methods according to prevailing legal requirements. This study aimed to characterize the candidates for surgical sterilization and study the variables associated with the type of procedure. A total of 95 candidate patient records were studied, and statistical logistic regression analysis and Fisher's exact test were performed considering a significance level of ? = 0.05. Most candidates had stable partners, low schooling, and low income, were satisfied with their number of children, and had already tried to limit the number of children using reversible contraceptives. Mean age was 34.2 years, 45.3% underwent female sterilization, 35.8% underwent vasectomy, and 18.9% did not submit to any procedure. The odds of a man older than 35 having a vasectomy were 6.1 times that of a younger man (OR = 6.1; 95%CI: 2.4-16.4). More married men submitted to vasectomy than men who cohabited (OR = 4.0; 95%CI: 1.5-12.4). Women with four or more children were more likely to undergo sterilization than those with fewer children (OR = 3.1; 95%CI: 1.1-8.5).

  10. 2016 Laboratory guidelines for postvasectomy semen analysis: Association of Biomedical Andrologists, the British Andrology Society and the British Association of Urological Surgeons.

    PubMed

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

    2016-07-01

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

  11. Myths and fallacies about male contraceptive methods: a qualitative study amongst married youth in slums of Karachi, Pakistan.

    PubMed

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

    2013-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2009-02-01

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

  13. Postpartum Care and Contraception in Obese Women.

    PubMed

    Maclean, Courtney C; Thompson, Ivana S

    2016-03-01

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

  14. Male contraception: history and development.

    PubMed

    Kogan, Paul; Wald, Moshe

    2014-02-01

    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.

  15. Voluntary and involuntary sterilization: medical, ethical, legal and religious aspects.

    PubMed

    Fasouliotis, S J; Schenker, J G

    1999-08-01

    Surgical voluntary sterilization has become one of the most widely used methods of contraception, with vasectomy and tubal sterilization being the most commonly employed techniques, associated with a low failure, morbidity, mortality, and long-term sequelae rate. As sterilization is related with the elimination of the possibility for procreation, a number of ethical, legal and religious issues have arisen, leading often to personal misjudgements, legal disputes, and failures in applying family planning. Involuntary sterilization is currently not practiced, except in cases of severely mentally retarded people, who are unable to appreciate the consequences of their acts or care for their children and who may have a high likelihood of propagating hereditary disease.

  16. Development of teaser bulls under field conditions.

    PubMed

    Morgan, Gregor L; Dawson, Lionel J

    2008-11-01

    A teaser bull is a term describing a bull whose reproductive system has been surgically altered to render him sterile. The purpose of such bulls is to aid in detection of cows in estrus to facilitate when to artificially inseminate. The bull is sterilized by either vasectomy or caudal epididymectomy. In addition to sterilization, other surgical options are described that prevent intromission and the spread of venereal disease. This article describes briefly some of those options. The procedures described are those preferred by the authors and can be performed in the field. Some of the pros and cons of these procedures are discussed.

  17. A comparison of ABAcard(®) p30 and RSID™-Semen test kits for forensic semen identification.

    PubMed

    Boward, Emily S; Wilson, Stacey L

    2013-11-01

    The screening and confirmatory tests available to a forensic laboratory allow evidence to be examined for the presence of bodily fluids. With the majority of evidence being submitted involving sexual assaults, it is important to have confirmatory tests for the identification of semen that are straightforward, quick, and reliable. The purpose of this study was to compare two commonly used semen identification kits utilized by forensic laboratories: ABAcard(®) p30 and Rapid Stain Identification of Human Semen (RSID™-Semen). These kits were assessed with aged semen stains, fresh and frozen post-vasectomy semen, post-coital samples collected on different substrates, post-vasectomy semen mixed with blood, saliva, and urine, a series of swabs collected at increasing time intervals after sexual intercourse, and multiple non-semen samples. The test kits were compared on the basis of sensitivity, specificity, and the cost and time effectiveness of each protocol. Overall, both semen identification tests performed well in the studies. Both kits proved specificity for identifying semen, however the ABAcard(®) p30 test surpassed the RSID™-Semen test in sensitivity, cost per test, and simplified test protocol.

  18. Acceptability of contraception for men: a review.

    PubMed

    Glasier, Anna

    2010-11-01

    Methods of contraception for use by men include condoms, withdrawal and vasectomy. Prevalence of use of a method and continuation rates are indirect measures of acceptability. Worldwide, none of these "male methods" accounts for more than 7% of contraceptive use although uptake varies considerably between countries. Acceptability can be assessed directly by asking about intended (hypothetical) use and assessing satisfaction during/after use. Since they have been around for a very long time, there are very few data of this nature on condoms (as contraceptives rather than for prevention of infection), withdrawal or vasectomy. There are direct data on the acceptability of hormonal methods for men but from relatively small clinical trials which undoubtedly do not represent the real world. Surveys undertaken among the male general public demonstrate that, whatever the setting, at least 25% of men - and in most countries substantially more - would consider using hormonal contraception. Although probably an overestimate of the number of potential users when such a method becomes available, it would appear that hormonal contraceptives for men may have an important place on the contraceptive menu. Despite commonly expressed views to the contrary, most women would trust their male partner to use a hormonal method.

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

    NASA Astrophysics Data System (ADS)

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

    2012-02-01

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

  20. Parthenogenesis in a Brazilian rainbow boa (Epicrates cenchria cenchria).

    PubMed

    Kinney, Matthew E; Wack, Raymund F; Grahn, Robert A; Lyons, Leslie

    2013-03-01

    A 22-year-old captive Brazilian rainbow boa (Epicrates cenchria cenchria) gave birth to four offspring after being housed with a vasectomized male. Sexual reproduction as a result of failed prior vasectomy, recanalization of the vas deferens, or prolonged sperm storage was ruled out using the clinical history, histopathology, and gross necropsy. Short tandem repeat (STR) DNA markers were genotyped in the male, female, and four offspring. None of the offspring possessed a diagnostic STR allele present in the potential sire. In addition, all offspring were homozygous at each STR locus evaluated, supporting parthenogenetic reproduction. This is the first report of parthenogenesis in a Brazilian rainbow boa and has implications for the conservation of reptiles maintained in captive breeding programs.

  1. [Studies on male sterilization techniques].

    PubMed

    Lee, H Y

    1975-06-01

    After a review of the theory, incidence in Korea, indications, complications, and operative technique of vasectomy, clinical observations on 2 procedures are given. Vas reanastomosis was performed on 185 men, aged 19-58, using general anesthesia. Ejaculates of 178 of the men showed 81% contained viable sperm. more than 10 years, 58%). Later pregnancies were reported by 35% of the men. Reversible vas occlusion by insertion of intravasal thread (IVT) was performed on 544 men under local anesthesia. Sperm passage was occluded in 96% of the men. After 9 months, 42 men had the IVT removed; 83% had viable sperm 1 month later. Advantages of the IVT technique are 1) simplicity of reversibility, 2) low cost, 3) no postoperative pain or discomfort, and 4) outpatient/local anesthesia procedure. A disadvantage is the lower success rate of vas occlusion due to luminal dilation around the IVT.

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

    PubMed Central

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

    2008-01-01

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

  3. Factors that determine prevalence of use of contraceptive methods for men.

    PubMed

    Ringheim, K

    1993-01-01

    Globally, men have not shared equally with women the responsibility for fertility regulation. While family planning efforts have been directed almost exclusively toward women, the lack of male involvement may also reflect the limited options available to men. Current methods for men are either coitus-dependent, such as the condom or withdrawal, or permanent, such as vasectomy. The 20-year history of social science research on male contraceptive methods is examined here in terms of the human and method factors related to the acceptability of hypothetical methods and the prevalence of use of existing methods. New male methods, particularly if reversible, may alter men's willingness to accept or share responsibility for the control of fertility. Research opportunities in the areas of gender, decision-making, communication, health education, and service delivery will be enhanced when methods for women and men are comparable.

  4. Attitudes of urban Sudanese men toward family planning.

    PubMed

    Khalifa, M A

    1988-01-01

    Using data from the Male Attitude Survey of 1985, this paper shows that Sudanese men play a major role in family planning decision-making. Attitudes regarding family planning issues are presented for 1,500 men aged 18 years and over, living in urban areas of Khartoum, the capital of Sudan. The decision not to practice family planning is found to be male-dominated, and husbands are responsible for providing contraceptives when family planning is practiced. Widespread misconceptions about vasectomy, along with a very low acceptance rate, exist among the men in the sample. It is concluded that the involvement of men in family planning programs will give these programs a better chance of success in the future. PMID:3176096

  5. A survey of China's birth control among women of child-bearing age.

    PubMed

    Qiu, S

    1983-12-01

    To further implement China's family planning policy of "prevention first, birth control first," a study of the current family planning situation was conducted. A survey of the birth control methods employed by women of childbearing age and by men was based on a nationwide randomized sampling of 1/1000. In the different age groups, ranging from 15-49 years old, IUD users accounted for over 50%, tubal sterilization 25%, and vasectomy 10%. The main IUD users were women in the 20-24 age group. Tubal sterilization was more prevalent among the women in the 35-39 age group. The use of oral contraceptives (OCs) was more common among younger women but accounted for less than 10% of the total. The survey was based on the replies to questionnaires from 172,788 married women of childbearing age; 120,022 of them practiced contraceptive methods for a birth control rate of 69.46%. The breakdown was as follows: IUD, 34.84%; tubal sterilization, 17.63%; vasectomy, 6.94%; OCs, 5.86%; condom users, 1.39%; and other methods (including chemical suppositories, rhythm, or safe period method and withdrawal before ejaculation), 2.78%. There was a higher percentage of OC users in urban areas, and a marked preference for IUDs in the rural communities. The rural birth control rate was 68.58%; the urban rate was 74.17%. The use of the IUD has priority in all the areas; its percentage approaches the national average level. The use of vasectomy as a birth control method varies considerably according to area as does the use of OCs, condom, and tubal sterilization. Rural minority groups prefer the IUD and OCs; tubal sterilization, the condom, and vasectomy are preferred by the Han nationality. The birth control rate differed according to the different occoupation groups: 77.85%, workers; 76.01%, farmers; 85.15%, cadres; 59.52%, housewives; and 66.67%, others. The birth control rate was higher among those who received a college education than the illiterates, but statistics did not show a

  6. Family planning in the People's Republic of China.

    PubMed

    1971-02-01

    China's goal is to reduce the current growth rate of 2 to 1% per annum by the year 2000. To do so all methods of family limitation are encouraged, such as raising the age of marriage, distribution of contraception, and induced abortion. The paramedical barefoot doctors have helped the spread of family planning by their ability to prescribe pills and insert IUDs. Sterilizations are performed, and there are monitary incentives for vasectomy of 20% of the mans monthly salary. Abortion is permitted during the first 3 months of gestation. The optimum age of marriage is considered 30 for men and 22 for women, and is promoted by propoganda means. The program began in the late 1950s and has been administered through the Ministries of Health, Propaganda, Culture, Commerce and the China Medical Association.

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

    PubMed

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

    2014-03-01

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

  8. Increased risk of prostate cancer following sexually transmitted infection in an Asian population.

    PubMed

    Chung, S D; Lin, Y K; Huang, C C; Lin, H C

    2013-12-01

    The relationship between sexually transmitted infections (STIs) and prostate cancer (PC) remains inconclusive. Moreover, all such studies to date have been conducted in Western populations. This study aimed to investigate the risk of PC following STI using a population-based matched-cohort design in Taiwan. The study cohort comprised 1055 patients with STIs, and 10 550 randomly selected subjects were used as a comparison cohort. Cox proportional hazards regression analysis revealed that the hazard ratio for PC during the 5-year follow-up period for patients with a STI was 1.95 (95% confidence interval 1.18-3.23), that of comparison subjects after adjusting for urbanization level, geographical region, monthly income, hypertension, diabetes, hyperlipidaemia, obesity, chronic prostatitis, history of vasectomy, tobacco use disorder, and alcohol abuse. We concluded that the risk of PC was higher for men who were diagnosed with a STI in an Asian population.

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

    PubMed Central

    Yuan, Yiming; Xin, Zhongcheng

    2016-01-01

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

  10. Social gradients in surgical sterilization rates: opposing patterns for males and females.

    PubMed

    Fransoo, Randall; Bucklaschuk, Jill; Prior, Heather; Burland, Elaine; Chateau, Daniel; Martens, Patricia

    2013-05-01

    Objectif : Cette étude avait pour but d’analyser les taux en population générale de stérilisation chirurgicale en fonction du sexe, du revenu, du groupe d’âge et du lieu de résidence (urbain, rural ou éloigné) au sein d’une population bénéficiant d’une assurance maladie universelle. Méthodes : L’étude s’est penchée sur les 1,2 million de résidents du Manitoba. Des données issues de dossiers exhaustifs de consultation hospitalière et médicale ont été utilisées pour calculer les taux de vasectomie et de ligature des trompes chez les membres de la population dont l’âge se situait entre 20 et 55 ans. Des analyses ont été menées au moyen d’une modélisation linéaire généralisée, en utilisant les données administratives du Manitoba Centre for Health Policy. Résultats : Les taux de stérilisation chez les deux sexes (P < 0,001) présentaient des gradients significatifs liés au revenu; toutefois, les tendances étaient opposées chez les hommes et les femmes. Les taux de ligature des trompes atteignaient leur apogée dans les régions à faible revenu et étaient inversement proportionnels au revenu, tandis que les taux de vasectomie atteignaient leur plus bas niveau dans les régions à faible revenu et étaient proportionnels au revenu. Ces taux variaient également de façon considérable en fonction de l’âge et du lieu de résidence (urbain, rural ou éloigné). Conclusion : Ces résultats sont potentiellement troublants, en raison du fait que la ligature des trompes est une intervention plus effractive, associée à plus de risques et plus coûteuse que la vasectomie. On serait donc en droit de s’attendre à ce qu’elle soit moins courante que la vasectomie dans tous les groupes, et non seulement dans les groupes des régions à revenu élevé. Ces résultats donnent des taux d’intervention en population générale uniques, lesquels ne sont pas assujettis aux biais qui peuvent affecter les études fond

  11. Evaluation of Canada goose sterilization for population control.

    USGS Publications Warehouse

    Converse, Kathryn A.; Kennelly, James J.

    1994-01-01

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

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

    PubMed

    Simbar, M

    2012-03-01

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

  13. Robotic instrumentation: Evolution and microsurgical applications

    PubMed Central

    Parekattil, Sijo J.; Moran, Michael E.

    2010-01-01

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

  14. Paternal contribution: new insights and future challenges.

    PubMed

    Krawetz, Stephen A

    2005-08-01

    It has been widely held that all that fathers essentially contribute to the next generation is half their genome. However, recent progress towards understanding biological processes such as sperm maturation and fertilization now indicates that the paternal contribution has been underestimated. To tackle some of the misconceptions surrounding the paternal contribution, the factors that are actually delivered by the sperm at fertilization and their potential developmental functions will be discussed using data from humans and animal models. Although still in their infancy, the practical applications of using sperm RNAs have already emerged in reproductive medicine as markers that are indicative of successful vasectomy. They are also beginning to appear in the forensic sciences and, within the next decade, might appear in the environmental sciences.

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

    PubMed

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

    2014-03-01

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

  16. Men targeted for family planning in Zambia.

    PubMed

    Chirambo, K

    1992-08-01

    80% of women using contraception in Zambia use oral contraceptives (OCs), yet they often complain about side effects. 66% of people polled at family planning (FP) clinics prefer OCs and 30% chose condoms. Nevertheless only 10% of the 60% of married couples familiar with FP use contraception. This contributes to Zambia having 1 of the highest annual population growth rates in the world (3.4%). The Planned Parenthood Association of Zambia (PPAZ) thinks that if males become more knowledgeable about FP, the population growth would slow down. At least 60% of men in Zambia approve of their wives using FP, yet they are slow to use male contraception. They say condoms reduce sensation and wives often consider condoms a nuisance. The AIDS epidemic forces men to rethink their views toward condom use, however. Those 30% of men who do use condoms are more likely to use them with their girlfriends or women with whom they are unfamiliar. So they are not using them for FP purposes. Men fear vasectomy because they perceive it to cause impotence. Considerable education to counter this myth is needed to increase the number of vasectomies. Besides some men prefer their wives be sterilized rather than themselves because if the men lose all their children they can have other children with other wives. PPAZ aims programs at men in order to expand their participation and nurture their influence in FP matters. It has a male counseling program serving rural villages along the railroad lines which begin in the northern copper belt and end in urban areas in the south to promote birth spacing. It is working with companies to include FP services in their clinics so men can learn more about FP. FP specialists in Zambia foresee an increase in male support of FP as they realize the difficulty of supporting large families during the economic crises.

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

    PubMed

    Williams, J R

    1992-08-01

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

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

    PubMed

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

    2014-01-01

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

  19. Developments in male contraception.

    PubMed

    Bialy, G; Alexander, N J

    1992-01-01

    Relevant research efforts in male contraception involve: 1) hormonal approaches to block sperm production by inhibiting the hypothalamic-pituitary-gonadal axis, 2) disruption of sperm production by drugs that act directly on the testes, 3) interruption of sperm transport, and 4) alteration of secretions of the accessory sex glands and their subsequent effect on the spermatozoa. Both agonistic and antagonistic synthetic analogs of the hypothalamic gonadotropin releasing hormone (GnRH) factor cost too much and lack an effective mode of administration. Recent studies indicate that over 90% of Chinese and Indonesian men can develop complete azoospermia following either a testosterone or a progestin and an androgen combination treatment. Vaccines that utilize GnRH and follicle stimulating hormone as the active antigens have been introduced in clinical studies in the US and India. Drugs such as sulfasalazine, pyrimethamine, nitrofurane, and bis(di-chloracytal) diamines reduce male fertility but side effects make them unacceptable. Dinitropyrroles, halopropanedils, chlorosugars, and indazole carboxylic acids have been tried in laboratory animals. Gossypol rendered men infertile in large-scale clinical studies conducted in China but synthesis of safer analogs has not succeeded. Extracts of another plant, tripterigium wilfordii, are used in China as a popular herbal medicine. Vasectomy has improved with no-scalpel vasectomy and by the novel technique of blocking the vas with cured in situ polymeric plugs. Preliminary data suggest that men prefer condoms made from polyurethane as opposed to latex rubber increasingly used to protect against AIDs and sexually transmitted diseases. The antifungal agents, imidazoles, have spermicidal activity and synthetic variants may reduce undesirable side effects. Research on male-oriented methods has intensified during the last 10-15 years, but a new product is not likely to appear in the next 5-10 years.

  20. Pilot programs increase men's involvement.

    PubMed

    Finger, W R

    1992-08-01

    The UN Population Fund contends that it is the need for family planning (FP) information and services instead of lack of interest that prevents men from participating more in FP. 3 pilot projects in Pakistan, Zimbabwe, and Colombia have acted on this belief. In geographically isolated Mardan, Pakistan, the all male Urban Community Developing Council (UCDC) started a community education project to involve men in FP. 5 UCDC member form 1 community educator team of which there are 60. The teams visit families in Mardan. In 1988, 1 team reported that some men in the households wanted a women to inform their wives about FP. Eventually UCDC located enough women free to be members on 40 teams. In 4 years, contraceptive prevalence among married couples rose from 9% to 21%. Initially the methods tended to be temporary methods but are now longer lasting methods (IUDs, sterilization, injectables, and even a few vasectomies). Other community groups donate about US$541/month to the project. In 1988, the Zimbabwean National Family Planning Council (ZNFPC) began its national education/male motivation project which included sending messages via popular radio soap opera, discussions, and leaflet distribution. The program reached many rural men since they tend to have radios. In 1 year, more men were taking part in decisions about FP (25-35%). ZNFPC has learned it needs to design 2 campaigns to promote condom use: 1 for single and 1 for married men. PROFAMILIA in Colombia began its 1st male clinic in 1985 in Bogota. By 1992, it had 8 male clinics. The key to its success is attractive clinics, low cost vasectomy, individualized care, wide range of services such as condom distribution and treatment of sexually transmitted diseases, and Saturday hours. Despite the 3 projects' successes, they face many obstacles that need to be addressed.

  1. Acceptability of a transdermal gel-based male hormonal contraceptive in a randomized controlled trial☆, ☆☆, ★

    PubMed Central

    Roth, Mara Y.; Shih, Grace; Ilani, Niloufar; Wang, Christina; Page, Stephanie T.; Bremner, William J.; Swerdloff, Ronald S.; Sitruk-Ware, Regine; Blithe, Diana L.; Amory, John K.

    2014-01-01

    Objective Fifty percent of pregnancies in the United States are unintended despite numerous contraceptive methods available to women. The only male contraceptive methods, vasectomy and condoms, are used by 10% and 16% of couples, respectively. Prior studies have shown efficacy of male hormonal contraceptives in development, but few have evaluated patient acceptability and potential use if commercially available. The objective of this study is to determine if a transdermal gel-based male hormonal contraceptive regimen, containing testosterone and Nestorone® gels, would be acceptable to study participants as a primary contraceptive method. Study Design As part of a three-arm, 6-month, double-blind, randomized controlled trial of testosterone and nestorone gels at two academic medical centers, subjects completed a questionnaire to assess the acceptability of the regimen. Of the 99 men randomized, 79 provided data for analysis. Results Overall, 56% (44/79) of men were satisfied or extremely satisfied with this gel-based method of contraception, and 51% (40/79) reported that they would recommend this method to others. One third of subjects (26/79) reported that they would use this as their primary method of contraception if it were commercially available today. However, men with concerns about sexually transmitted disease were significantly less satisfied than men without such concerns (p=0.03). Conclusions A majority of the men who volunteered to participate in this trial of an experimental male hormonal contraceptive were satisfied with this transdermal male hormonal contraceptive. If commercially available, a combination of topical nesterone and testosterone gels could provide a reversible, effective method of contraception that is appealing to men. Implications A substantial portion of men report they would use this transdermal male contraceptive regimen if commercially available. This method would provide a novel, reversible method of contraception for men, whose

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

    PubMed

    1992-01-01

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

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

    PubMed

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

    2014-09-15

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

  4. The "filarial dance" is not characteristic of filariasis: observations of "dancing megasperm" on high-resolution sonography in patients from nonendemic areas mimicking the filarial dance and a proposed mechanism for this phenomenon.

    PubMed

    Adejolu, Margaret; Sidhu, Paul S

    2011-08-01

    The objective of this series was to show that the sonographic appearance described as the "filarial dance" is not characteristic of filariasis but occurs in nonendemic areas as a manifestation of epididymal obstruction. An experienced observer documented cases after initial observation of the filarial dance in routine clinical practice using high-frequency linear array transducers. The filarial dance was described as excessive to-and-fro movement of echogenic particles within a prominent epididymis and graded 1 to 4 according to the extent and distribution of the abnormality. The country of birth, exposure to filarial infection or travel to a filarial-endemic area, previous scrotal surgery including vasectomy, any previous or current scrotal inflammatory disease, and any congenital testicular abnormalities were recorded. Over a 10-year period, sonographic appearances consistent with the filarial dance were observed in 18 patients (bilateral in 6). The mean patient age was 47.7 (range, 28-91) years. The abnormality was graded in the 24 affected testes as follows: grade 1, n = 3; grade 2, n = 8; grade 3, n = 8; and grade 4, n = 5. No patient had a history of filariasis or travel to an endemic area. Six of 18 patients (33.3%) had bilateral vasectomies; 5 (27.8%) had a history of epididymo-orchitis in the ipsilateral testis; 3 (16.7%) had previous scrotal surgery; and 4 (22.2%) had no relevant urologic history. We have described a sonographic appearance identical to the filarial dance in men with no history of filarial infection. Most had previous scrotal surgery or infection, suggesting that the filarial dance may not always be due to movement of filarial worms. The unifying condition in patients with filariasis and our patients is lymphatic obstruction, likely the underlying cause of the appearance in both groups.

  5. AVSC helps Rwanda prepare for expansion of services.

    PubMed

    Gold, M

    1992-03-01

    The Association for Voluntary Surgical Contraception (AVSC) is aiding efforts to develop an effective national family planning policy in Rwanda, a country were fertility remains extremely high. If present trends continue, Rwanda's population of 7.5 million will reach 10 million by the year 2000. Currently, only 1% of couples use a modern contraceptive method. Concerned over population growth and economic developments, the Rwandan government has set the goal of increasing the use of modern contraceptive methods to 15%. The National Office of Population (ONAPO), established in 1981, has launched a serious effort to increase the availability of contraceptive methods. AVSC has joined this effort, working to make available voluntary sterilization and Norplant services. AVSC has established 3 training centers in the country. As part of a 2-year project, AVSC plans to train 4 teams (each team consisting of 1 surgeon and 1 assistant) to perform minilaparotomy under general anesthesia. This procedure is well-suited to the Rwandan context. Performed under local anesthesia, minilaparotomy involves a small abdominal incision through which the physician gains access to the fallopian tubes. The procedure takes about 20 minutes. The client experiences little or no discomfort, and the woman is able to return home within a few hours. So far 425 Rwandan women have undergone the procedure. Vasectomy, another procedure supported by AVSC, has also begun to gain demand. In a 12-month period, 93 vasectomies were performed in Rwanda, more than have been performed in any other African country. In May, Rwanda will host a national seminar on Norplant. And soon, AVSC, ONAPO, and the Population Council will begin a project to introduce Norplant in 10 different sites.

  6. [The problem of overpopulation in Asia].

    PubMed

    Knaus, J P

    1981-06-01

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

  7. Iran rebuilds family planning services.

    PubMed

    Butta, P

    1993-07-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

    Traitongyoo, T

    1985-10-01

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

  10. [Male contraception].

    PubMed

    Demoulin, A

    1984-04-01

    have not been demonstrated. Among irreversible methods, many workers have sought an active or passive mehtod of immunizing against paregnancy, but no usable results have yet been obtained. Vasectomy is a simple and easy surgical procedure which is well accepted in some countries, although in most countries the responsibility for contraception is assumed by the women. Vasectomy has 1 advantage over female sterilization: sperm may be preserved in a bank for several years.

  11. Choosing a contraceptive. What's best for you?

    PubMed

    Anthony, J

    1994-04-01

    New types of contraception approved for use in the US include two long-lasting, hormone-based contraceptives, Depo-Provera and Norplant, and the female condom. The female condom is made of polyurethane, which is thinner, stronger, and a better conductor of heat than latex. Its inner ring fits over the cervix and the outer ring protects the labia and the base of the penis. Its typical-use and perfect-use failure rates are 21-26% and around 5%, respectively. One injection of Depo-Provera blocks ovulation for 3 months. Irregular periods are common with Depo-Provera use. Fertility may not return for 6-12 months after discontinuation. Depo-Provera may protect against endometrial cancer. The 6-capsule system Norplant is inserted subdermally in the arm and releases levonorgestrel for up to 5 years. Since its arrival on the US market, more than 900,000 women have used Norplant. Contraindications to Norplant are liver disease, blood clots, inflammation of the veins, history of breast cancer, or breast feeding in the first 6 weeks postpartum. More than 600,000 US women undergo sterilization annually. 25% of all heterosexually active, fertile women of reproductive age and 60% of these women ages 35-44 have had a tubal ligation. Vasectomy is less risky than tubal ligation. Both vasectomy and tubal sterilization are more than 99% effective. Oral contraceptives (OCs) suppress ovulation. 28% of US women of reproductive age use OCs. OCs are more than 99% effective. OCs appear to increase the risk of blood clots, heart attack, and stroke for smokers over 35. Health benefits of OCs include protection against ovarian cancer, endometrial cancer, pelvic inflammatory disease, ovarian cysts, and benign breast tumors. Barrier methods keep sperm from joining the egg. Latex condoms protect against sexually transmitted diseases (STDs). IUDs interfere with sperm transport and egg fertilization. In the US, there is a perception that IUD use is unsafe. Women with new or multiple partners should

  12. Evidence based contraceptive choices.

    PubMed

    Scott, Alison; Glasier, Anna

    2006-10-01

    People who attend for contraceptive advice have usually formulated an idea of the type of contraceptive that will suit them best. They may wish to use a method that is long, short or medium acting. These are defined as follows: Long-acting method requires renewal no more frequently than every 3 months (e.g. injectable or intrauterine). Short-acting method used daily or with every act of intercourse (e.g. pills, condoms) Medium-acting method requires renewal weekly or monthly (e.g. ring, patch). For men the choice is limited to condoms or vasectomy. Some women do not wish to use hormonal preparations or have an intrauterine device (IUD) or implant inserted. There may also be cultural influences making certain methods of contraception unacceptable. Each of these factors influences the final decision of which method of contraception is decided upon. In addition to taking a full medical and sexual history to identify any risks to the individual's health, which might be increased by a particular contraceptive, time must be spent discussing the options available. It is important to ensure that there is a full understanding of the advantages and disadvantages of each method. The most successful contraceptive method is likely to be the one that the woman (or man) chooses, rather than the one the clinician chooses for them. Access for women to contraception can be improved by having convenient clinic times and service developments such as nurse prescribing and Patient Group Directions.

  13. Scrotal abscess: Varied etiology, associations, and management

    PubMed Central

    Ramareddy, Raghu S.; Alladi, Anand

    2016-01-01

    Aim: To report a series of scrotal abscess, a rare problem, their etiology, and management. Materials and Methods: A retrospective study of children who presented with scrotal abscess between January 2010 and March 2015, analyzed with respect to clinical features, pathophysiology of spread and management. Results: Eight infants and a 3-year-old phenotypically male child presented with scrotal abscess as a result of abdominal pathologies which included mixed gonadal dysgenesis (MGD) [1]; three anorectal malformations with ectopic ureter [1], urethral stricture [1], and neurogenic bladder [1]; meconium peritonitis with meconium periorchitis [2], ileal atresia [1], and intra-abdominal abscess [1]; posturethroplasty for Y urethral duplication with metal stenosis [1] and idiopathic pyocele [1]. Transmission of the organism had varied routes include fallopian tube [1], urethra ejaculatory reflux [4], hematogenous [2], and the patent process of vaginalis [2]. Two of the nine required extensive evaluation for further management. Treating the predisposing pathology resolved scrotal abscesses in eight of nine patients, one of whom, required vasectomy additionally. Idiopathic pyocele responded to needle aspiration and antibiotics. Conclusion: Scrotal abscess needs a high index of suspicion for predisposing pathology, especially in infants. Laparoscopy is safe and effective in the management of the MGD and ectopic ureter. PMID:27695207

  14. Family planning methods: new guidance.

    PubMed

    1996-10-01

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

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

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-08-01

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

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

    PubMed Central

    Yong, Hwanyul

    2014-01-01

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

  17. Scrotal abscess: Varied etiology, associations, and management

    PubMed Central

    Ramareddy, Raghu S.; Alladi, Anand

    2016-01-01

    Aim: To report a series of scrotal abscess, a rare problem, their etiology, and management. Materials and Methods: A retrospective study of children who presented with scrotal abscess between January 2010 and March 2015, analyzed with respect to clinical features, pathophysiology of spread and management. Results: Eight infants and a 3-year-old phenotypically male child presented with scrotal abscess as a result of abdominal pathologies which included mixed gonadal dysgenesis (MGD) [1]; three anorectal malformations with ectopic ureter [1], urethral stricture [1], and neurogenic bladder [1]; meconium peritonitis with meconium periorchitis [2], ileal atresia [1], and intra-abdominal abscess [1]; posturethroplasty for Y urethral duplication with metal stenosis [1] and idiopathic pyocele [1]. Transmission of the organism had varied routes include fallopian tube [1], urethra ejaculatory reflux [4], hematogenous [2], and the patent process of vaginalis [2]. Two of the nine required extensive evaluation for further management. Treating the predisposing pathology resolved scrotal abscesses in eight of nine patients, one of whom, required vasectomy additionally. Idiopathic pyocele responded to needle aspiration and antibiotics. Conclusion: Scrotal abscess needs a high index of suspicion for predisposing pathology, especially in infants. Laparoscopy is safe and effective in the management of the MGD and ectopic ureter.

  18. Robotic assisted andrological surgery

    PubMed Central

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

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

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

    PubMed Central

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

    2010-01-01

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

  20. Leaving machismo behind.

    PubMed

    Eschen, A; Castano, F

    1999-01-01

    A study, which was conducted in Colombia's five largest cities, determined men's, women's, and health care provider's knowledge, attitudes, and needs regarding sexual and reproductive health services for men. Data were collected through 60 focus groups, 720 surveys of service users and nonusers, 45 interviews with health care staff, and 5 couple's life histories. The study found that, due to the inadequate service facilities offered to men, it was difficult for men to achieve the goal of being responsible about their own and their partner's sexual and reproductive health. Only 9 of the 14 health care facilities surveyed rendered services such as vasectomy, health care promotion or prevention, and educational programs aimed at men. According to providers, one reason for lack of services is the low utilization rate even if such services are available. In addition, existing services focus on disease management rather than preventive protocols. The AVSC will work with health care facilities, the Ministry of Health, and health insurance companies in establishing sexual and reproductive health services for men in Bogota, Cali, and Medellin.

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

    USGS Publications Warehouse

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

    1996-01-01

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

  2. Men's absence in family planning clinics.

    PubMed

    De Souza, L

    1990-12-01

    Few men are found in family planning centers. The author describes how the changing role of fatherhood and the typically female-oriented focus of family planning centers do not endear men to seek out clinic services. Men will not frequent a family planning clinic which focuses exclusively upon gynecological and contraceptive services, but they may go to centers which offer services related to pregnancy, sexological problems, and where information may be obtained on vasectomy and AIDS. Men and boys rarely visit family planning centers on their own initiative, but instead usually with a partner and at her request often when a specific problem must be resolved. Four family planning counselors and one midwife working in family planning clinics in Francophone Switzerland believe that male participation should be encouraged, particularly among adolescents, but without placing undue pressure upon men. They suggest sex education courses emphasizing family planning, providing a gender neutral clinic environment, developing relevant printed media with an eye to male participation, offering clinic hours adapted to men's working hours, encouraging men to express their feelings and desires during contraceptive and other counseling sessions, developing clinic sessions specially for STDs and AIDS, and improving the socioeconomic status of family planning counselors and personnel in the interest of bringing more men into the field professionally.

  3. Robotic assisted andrological surgery.

    PubMed

    Parekattil, Sijo J; Gudeloglu, Ahmet

    2013-01-01

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

  4. Sperm-related antigens, antibodies, and circulating immune complexes in sera of recently vasectomized men.

    PubMed Central

    Witkin, S S; Zelikovsky, G; Bongiovanni, A M; Geller, N; Good, R A; Day, N K

    1982-01-01

    Sera from 35 men were collected before and at timed intervals subsequent to vasectomy and examined for the presence of (a) antibody reactive with human spermatozoa, (b) sperm-related antigen, and (c) circulating immune complexes (CIC). Fewer than 10% of the men examined were ever positive for antisperm antibodies. However, sperm-related antigens were elevated in the sera of 18, 18, and 26% of the mean at 2 wk, 2 mo, and 4 mo postvasectomy, respectively. CIC were detected in the sera of some vasectomized men by three different assays. The CIC in patients' sera were precipitated with polyethylene glycol, dissociated, and the individual CIC components identified by an enzyme-linked immunosorbent assay. Most, but not all, of the CIC contained antigen reactive with antisperm immunoglobulin (Ig)G and some also contained complement components C3 and/or Clq. IgA was identified in some of the CIC positive for IgG and sperm antigen and two men had IgM-containing CIC. Analysis of the CIC by sucrose gradient centrifugation revealed them to be heterogeneous in size. PMID:7085887

  5. [Bioethics in Peru].

    PubMed

    Zuloaga, R L

    1990-01-01

    Bioethics has still not acquired an identity of its own in Peru. The Ethics Committee of the Peruvian Medical School and the National AIDS Commission are review committees that deal with ethical problems arising in practice. Doubts regarding quality control of the drugs being tested have been raised in research on human subjects. Questions related to reproduction are very important. There is a high incidence of adolescent pregnancies, and illegal abortions result in many deaths and hospitalizations of women in serious condition. Birth control methods, such as vasectomy, conflict with attitudes about manhood in Peruvian society. Euthanasia is prohibited by the Ethical Code of the Peruvian Medical School, and legislation penalizes assisted suicide. Organ transplantation is hindered by concerns over early declaration of death. Handicapped children are often rejected by society owing to an absurd belief in the possibility that disorders such as Down's syndrome are contagious. The Ministry of Health requires state hospitals to accept AIDS patients, but instances of rejection are still reported.

  6. [Informed consent in health legislation of Mexico].

    PubMed

    López-de la Peña, X A

    1996-01-01

    This paper deals with informed consent in Mexican Health Legislation in the context of a contract regulated by the Mexican Civil Code, in which a patient capable of making a thoughtful decision agrees to a specific plan of medical management and has received sufficient information, in a clear and explicit manner so that he/she can make a decision and in consequence agrees, or does not agree, to a course of action and to its consequences, under the Nuremberg Code. In Mexico, informed consent has recently been incorporated into health care legislation, and is basically oriented toward the field of medical research, while in other medical procedures, a legal authorization, and not an informed consent form is required, as with surgical procedures such as definitive fertility control (e.g. vasectomy or fallopian tube ligation). We emphasize the necessity of the adding of informed consent to Mexican health legislation in general, substituting it for other terms to legalize medical action, such as authorization, permission, dispositioned compliance, acceptance or approval-all of which have an essentially different and limited connotation, and are not Patient's Rights legal protector mechanisms, from our point of view. PMID:9011521

  7. The use of epididymal spermatozoa in assisted reproduction.

    PubMed

    McLachlan, R I

    1998-01-01

    The use of epididymal spermatozoa in assisted reproduction (ART) permits fertility in men with surgically irremediable obstructive azoospermia. When used for conventional IVF (sperm-oocyte co-culture), epididymal spermatozoa show reduced fertilization and pregnancy rates (compared with ejaculated spermatozoa from men with a range of spermatogenic disorders) as evidence of their functional immaturity. However, when used with intracytoplasmic sperm injection (ICSI) either fresh or frozen-thawed epididymal spermatozoa produce ART success rates similar to those of ejaculated spermatozoa. The clinical place of epididymal sperm retrieval for ICSI has come under review as a result of data showing similarly good outcomes with testicular spermatozoa obtained by needle aspiration. In Australia ICSI using epididymal or testicular spermatozoa is an increasingly favoured option for vasectomy-related infertility and in other types of obstructive azoospermia for a number of reasons including better pregnancy outcomes, the less invasive nature of the procedures and less expense involved; however, this cost-benefit analysis will vary in other health systems.

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

    PubMed

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

    2006-04-01

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

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

    PubMed

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

    2008-11-01

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

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

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-07-01

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

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

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-08-01

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

  12. [Voluntary surgical sterilization in Greater Metropolitan Campinas, São Paulo State, Brazil, before and after legal regulation of the procedure].

    PubMed

    Carvalho, Luiz Eduardo Campos de; Osis, Maria José Duarte; Cecatti, José Guilherme; Bento, Silvana Ferreira; Manfrinati, Márcia B

    2007-12-01

    This cross-sectional study compared the provision of surgical sterilization in public health services in Greater Metropolitan Campinas, São Paulo State, Brazil, and the characteristics of women and men who underwent sterilization before and after its legal regulation. Structured and pre-tested questionnaires were applied to 398 women, 15 directors of municipal family planning programs, and 15 coordinators of basic health units. Eight municipalities in Greater Metropolitan Campinas provided tubal ligation and nine performed vasectomy. Approximately half reported following the guidelines of the prevailing family planning legislation. There were no significant differences before or after legal regulation in terms of the characteristics of women and men sterilized or the waiting time for surgery. Most tubal ligations were still performed in combination with cesarean sections (the additional payment for sterilization had decreased, but the difference was not significant). There is strong evidence that in Greater Metropolitan Campinas the changes expected from legal regulation of surgical sterilization did not materialize. Although progress has been made, several distortions still need to be corrected.

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

    PubMed

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

    2006-04-01

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

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

    NASA Astrophysics Data System (ADS)

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

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

  15. Contraception and family planning at the extreme of reproductive life - climacteric.

    PubMed

    Di Bella, Zsuzsanna Ilona Katalin de Jármy; Bianchi, Ana Maria Homem de Mello; Araujo, Fabio Fernando de; Sartori, Marair Gracio Ferreira; Girão, Manoel João Batista Castello

    2016-01-01

    Menopause is an endocrine phenomenon characterized by gradual estrogen decline. This is a stage in a woman's life in which contraception is extremely important as the risks associated with pregnancy and childbirth increase, both maternal issues associated with higher incidence of comorbidities and issues related to fetal abnormalities, mitochondrial abnormalities, or genetic syndromes. On the other hand, there is a growing number of women who have postponed motherhood and need effective contraception, but without prolonging the return to fertility. Long-acting reversible contraceptives (LARCs), low-dose oral hormonal contraceptives and non-oral contraceptives are preferred. The levonorgestrel-releasing intrauterine system is a very good alternative that can maintain endometrial protection after menopause. Definitive methods such as tubal ligation and vasectomy are options for couples that already have their offspring. In this review, we present evidence for contraceptive indication and the effects of hormonal methods on climacteric including options for contraception, control of bleeding during perimenopause and of climacteric symptoms, as well as the transition from such methods to hormone therapy if indicated. PMID:27656856

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

    NASA Astrophysics Data System (ADS)

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

    2015-07-01

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

  17. Pakistan seminar.

    PubMed

    1970-02-01

    Public participation in the national family planning programme and the promotion of population education were the main topics discussed at the national conference of the Family Planning Association of Pakistan held at Cokilla in December. The Conference was opened by the Governor of East Pakistan, Vice-Admiral S.M. Ahsan. The Minister of Health, Dr. A.M. Malik, presided at the first session when delegates and visitors were welcomed by Begum Manzoor Quadir, President of the Pakistan Association. Experience in India, Cylon and Nepal, as well as in Pakistan was examined in relation to public participation in national programmes. At the session concerned with the promotion of a population education programme special attention was paid to a new element in the education programme, the proposals for teaching the elements of responsible parenthood and population dynamics to school children and young people. Mrs. Sarwat Rahman and Mrs. Fatema Iftekhar, members of the Pakistan Association who recently attended a prototype course in family life education at IPPF headquarters in London, addressed the conference on certain approaches to the education of young people that they consider particulary suitable for Pakistan. Dr. Malcolm Potts, Medical Secretary of the IPPF, also took part in the session on population education. He subsequently addressed meetings of doctors in three towns in East Pakistan as well as visiting urban and rural projects of the Pakistan Association and saw vasectomy clinics at work.

  18. [Choosing contraception].

    PubMed

    Gonzalez Velez, A C

    1998-06-01

    The development of contraception has allowed women to think about and experience motherhood not as their destiny but as an option. Humans have always been interested in controlling their fertility. Writings unearthed in the 18th century demonstrated the interest of the ancient Egyptians and Greeks in fertility control. The oral contraceptive (OC) pill, developed in the 1950s by Pincus and Rock, has allowed millions of women to avoid unwanted pregnancy. Since 1960, when the oral contraceptive Enovid was first marketed in the US, over 200 million women throughout the world have used OCs. Modern formulations have low hormone doses, which has minimized side effects. OCs now have an effectiveness of 98%. The method is controlled by the woman, permitting autonomous decisions about pregnancy. Currently, in Colombia, 12.9% of women in union use OCs, 25.7% are sterilized, 11.1% each use IUDs and traditional methods, 4.3% use condoms, 2.5% use injectables, 1.4% use vaginal tablets, 0.7% each use Norplant and vasectomy, and 1.8% use other methods. 27.8% use no method. OCs can be used as an emergency method in case of rape, an unexpected sexual encounter, or failure of another method. When used as a postcoital method, OCs must be taken within 72 hours of unprotected sexual intercourse.

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

    PubMed

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

    1981-08-01

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

  20. Robotic-assisted laparoscopic surgery: recent advances in urology.

    PubMed

    Autorino, Riccardo; Zargar, Homayoun; Kaouk, Jihad H

    2014-10-01

    The aim of the present review is to summarize recent developments in the field of urologic robotic surgery. A nonsystematic literature review was performed to retrieve publications related to robotic surgery in urology and evidence-based critical analysis was conducted by focusing on the literature of the past 5 years. The use of the da Vinci Surgical System, a robotic surgical system, has been implemented for the entire spectrum of extirpative and reconstructive laparoscopic kidney procedures. The robotic approach can be applied for a range of adrenal indications as well as for ureteral diseases, including benign and malignant conditions affecting the proximal, mid, and distal ureter. Current evidence suggests that robotic prostatectomy is associated with less blood loss compared with the open surgery. Besides prostate cancer, robotics has been used for simple prostatectomy in patients with symptomatic benign prostatic hyperplasia. Recent studies suggest that minimally invasive radical cystectomy provides encouraging oncologic outcomes mirroring those reported for open surgery. In recent years, the evolution of robotic surgery has enabled urologic surgeons to perform urinary diversions intracorporeally. Robotic vasectomy reversal and several other robotic andrological applications are being explored. In summary, robotic-assisted surgery is an emerging and safe technology for most urologic operations. The acceptance of robotic prostatectomy during the past decade has paved the way for urologists to explore the entire spectrum of extirpative and reconstructive urologic procedures. Cost remains a significant issue that could be solved by wider dissemination of the technology.

  1. Sterilisation.

    PubMed

    Parsons, A D

    1985-05-01

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

  2. Review and appraisal of the World Population Plan of Action [WPPA].

    PubMed

    1984-01-01

    This article summarizes the major points covered in the document, "Review and Appraisal of the World Population Plan of Action," with special emphasis on demographic factors pertaining to Asia and the Pacific. This document, which will be a focus for deliberations at the International Conference on Population, includes 6 major chapters: 1) socioeconomic development and population; 2) development of population policies; 3) population trends, prospects, goals, and policies; 4) promotion of knowledge; 5) role of national governments and the international community; and 6) monitoring, review, and appraisal of the World Population Plan of Action. Each chapter synthesizes major trend over the 1974-84 decade and projects possible future trends. The variation in fertility levels within the developing world are now as large as those previously found between developed and developing regions. For example, kfertility declined by 44% in East Asia but only by 14% in South Asia in the 1970-75 to 1980-85 period. Recent increases in contraceptive practice have primarily involved methods employed by women. Despite the relative safety and cost-effectiveness of vasectomy, many more women than men have been voluntarily sterilized. a common feature in most developing countries over the past decade has been rising female labor force participation andequalization of the school enrollment of males and females. Governments are increasingly aware of the link between demographic goals and implementation of population and development programs has been recognized. In general, family planning has become integrated with other development programs. Effective service approaches have included integration of family planning with maternal and child health services, community centered primary health care, community based distribution and marketing of contraceptives, and use of paraprofessional personnel. The rapid increase in the school age population is projected to be among the most important

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

    PubMed

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

    1998-10-01

    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.

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

    PubMed

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

    2015-01-01

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

  5. Male contraception: an overview of the potential target events.

    PubMed

    Tulsiani, Daulat R P; Abou-Haila, Aïda

    2008-06-01

    The contraceptive options available to men have not changed in several decades and are still limited to the non-surgical methods of the use of a condom, a timely withdrawal, or a surgical procedure that removes a segment of the vas deferens (vasectomy). The first two approaches have relatively higher failure rates whereas the last approach is largely irreversible and may not be suitable for younger men. Thus, providing a safe, effective and readily available contraception for men has remained an unfulfilled goal. In this article, we intend to review the current status of the research and development on male contraceptives. It is apparent that the scientific community in the past few decades has witnessed impressive progress in understanding the basics of male physiology, the knowledge necessary for developing new contraceptive methods for men. We will highlight various new and improved strategies for the regulation of fertility in males. The diverse approaches that are at various stages of development and/or in clinical trials include: 1) administration of hormones, herbal extracts or chemicals to suppress/arrest sperm production in the testes (spermatogenesis); 2) interference with the delivery of spermatozoa during ejaculation by targeted blockage of vas deferens with plugs or chemicals (polymers) that prevent flow of sperm through the vas duct; 3) active or passive immunization of males with well characterized antigens/antibodies which are intended to block sperm function; and 4) administration of site-directed antagonists to block specific sperm function(s) necessary for normal fertilization. All these approaches do not involve surgery and are reversible. Our intention is to discuss the current status of various approaches which show promising results in clinical trials, particularly in China and India, the world's most populous nations.

  6. Ethical issues in male sterilization in developing countries.

    PubMed

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

    1995-11-01

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

  7. Statistics.

    PubMed

    1993-02-01

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

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

    PubMed

    Andrews, D J

    1996-01-01

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

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

    PubMed

    1985-01-01

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

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

    PubMed

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

    2015-07-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

    Merrill, J

    1992-09-01

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

  13. An overview of male infertility in the era of intracytoplasmic sperm injection.

    PubMed

    Kim, E D

    2001-02-01

    As a result of the technological advance provided by intracytoplasmic sperm injection (ICSI) in 1992, the evaluation and treatment of the infertile male has changed significantly. Many men who were previously thought to be irreversibly infertile have the potential to initiate their own biologic pregnancy. However, not all men having impaired semen parameters are ideal candidates for ICSI for numerous reasons including a lack of addressing the underlying problem causing the male infertility, unknown genetic consequences, and cost-effectiveness issues. In this era of ICSI, the fundamental approach to the male with suspected subfertility is unchanged and is based on a history, physical examination, and focused laboratory testing. The urologist should approach the patient with an intent to identify remediable causes of subfertility given the specific clinical situation. For instance, should a gentleman have his varicocele repaired or vasectomy reversed, or should he proceed directly with ICSI? If no factors can be improved in a timely manner, then ICSI should be considered using the available sperm. Examples of recent advances include the diagnosis and treatment of ejaculatory duct obstruction, indications and techniques for performing testis biopsy, and techniques for sperm harvesting. Potential genetic causes should be diagnosed and discussed with the patient. Cystic fibrosis gene mutations, karyotype abnormalities, and Y-chromosome microdeletions all have recently been identified as causative for male infertility in otherwise phenotypically normal men. While the long-term genetic consequences for these offspring are largely undefined, recent studies suggest that serious birth defects are not significantly increased in ICSI babies. An understanding of these advances by all physicians is important as we progress into the 21st century.

  14. Evaluation of human sperm function after repeated freezing and thawing.

    PubMed

    Bandularatne, Enoka; Bongso, Ariff

    2002-01-01

    Sperm storage via freezing has been useful for men who have difficulty masturbating during assisted reproductive technology (ART) programs and before impotency caused by chemotherapy, vasectomy, and other procedures. Studies were undertaken to evaluate the extent of cryoinjury to sperm after repeated freezing and thawing. The results showed that normozoospermic and oligozoospermic sperm survived after 3 repeated freeze-thaw cycles. The inclusion of seminal plasma did not seem to protect human sperm during freezing and thawing. There were no significant differences in recovery percentages for motile, vital, and morphologically normal sperm between slow and rapid freezing methods in thaws 1, 2, and 3 of normozoospermic and oligozoospermic unwashed (u), washed (w), and washed + seminal plasma (ws) samples. However, there were significant percentage drops in the recovery of motile and vital sperm between each thaw (ie, first to second thaw, and second to third thaw) using both slow and rapid freezing for u, w, and ws samples (P < .01). There were also no significant differences in percentage recovery of motile, vital, and morphologically normal sperm between u, w, and ws samples during thaws 1 to 3 in the normozoospermic and oligozoospermic groups. Sperm were capable of fertilizing hamster oocytes microinjected with single sperms after 3 freeze-thaw cycles as evidenced by the formation of 2 distinct pronuclei and 2 polar bodies in 22.2% and 17.2% of normozoospermic and oligozoospermic samples, respectively. The numbers of normal vital motile sperm after 3 serial freeze-thaw cycles are adequate for bringing about fertilization via intracytoplasmic sperm injection in ART programs. Thus, leftover washed sperm in laboratories that perform in vitro fertilization can be frozen, thawed, and refrozen several times without loss of the sperms' ability to fertilize. This approach has tremendous benefits for men who have difficulty producing sperm and for those with low and

  15. Testicular obstruction: clinicopathological studies.

    PubMed Central

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

    1990-01-01

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

  16. Advances in Male Contraception

    PubMed Central

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

    2008-01-01

    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

  17. Male contraception: a clinically-oriented review.

    PubMed

    Kanakis, George A; Goulis, Dimitrios G

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2011-03-01

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

  20. Indian women cry foul.

    PubMed

    1993-01-01

    Thirteen organizations in Bombay issued a position statement on women's reproductive health and family planning as part of a national Planned Parenthood Foundation 1990's meeting on new contraception. The statement asserted that women needed to have an understanding of their bodies, wanted contraceptives that would not harm physiological functions, and desired men's and women's joint responsibility for reproduction. Women's groups voiced a concern about women gaining awareness of their ability to control their own health and contraception. The Indian government has been concerned with population control since 1952 and has stressed reducing the birth rate rather than providing for people's needs. The Indian government has followed the advice of Western nations and promoted the IUD during the 1960s, vasectomies during the 1970s, female sterilization during the 1980s, and long acting contraceptives during the 1990s. Government policy after the 1970s that focused on women's methods was viewed as coercive. Women's groups such as Stree Shakti Sanghatana, Saheli, and Chingari and the Andhra Pradesh Civil Liberties Union protested the Indian's governments promotion of injectable contraceptives such as NET-EN which were considered hazardous to women's health. Women's groups asked for legislative action, which helped to focus discussion and debate on the issues of the side effects of contraception. The concern was raised that people needed to be made aware of the issues and that the NET-EN campaign was only a dialogue among experts. Women's groups have focused on creating understanding about family planning rather than on simplistic labeling of harmful contraception. Demands should be put in a positive framework that redefines couple relationships, explores a variety of expressions of sexuality, and asserts the primacy of women's decision making about reproduction.

  1. The enter-educate approach.

    PubMed

    Piotrow, P T; Coleman, P L

    1992-03-01

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

  2. As the Third World turns.

    PubMed

    Hagerman, E

    1991-01-01

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

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

    PubMed

    1985-10-01

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

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

    PubMed

    1993-10-27

    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

  5. Importance of male fertility control in family planning.

    PubMed

    Tulsiani, Daulat R P; Abou-Haila, Aida

    2014-01-01

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

  6. Bhorletar: the sustainable village.

    PubMed

    Rowley, J

    1993-01-01

    The village of Bhorletar, in the middle hills of Nepal, is run by an elected Village Development Committee (VDC). It consists of 9 wards with a total of 3000 people. The village center is growing fast, with 35 new houses built in the last year. Bhorletar is 1 of 8 villages selected by the National Planning Commission and the World Conservation Union (IUCN) to develop and test a system of local environmental planning. The effort is a central part of the National conservation Strategy, which began in 1983. The task of drawing up environmental plans for Bhorletar and 7 other villages was begun in 1990 with the help of 2 nongovernmental organizations and the IUCN planning team. This included drawing up land use maps on forest patches, trees species, landslides, cropping patterns, and hazard-prone areas. Finally, an environmental plan based on this profile was defined by the villagers themselves and approved in meetings. Each village selected its own activities and was granted project funds to supplement the work of men and women from the village. These activities included community forest conservation; improved fuel-wood stoves; new latrines; protective dams and afforestation; improved roads; vegetable gardens and marketing; and a new health post. There is no health post in Bhorletar, and the nearest hospital is a 7 hours' walk away. Contaminated water, poor diet, and a polluted environment are the main causes of a child death rate of around 100 per 1000. Most of the women and girls were too busy with household and farming chores to attend the planning meetings or school. According to the profile, 99 men and only 5 women were practicing family planning. The only family planning commonly available has been an annual vasectomy camp. Women find sterilization services almost impossible to obtain, though they are increasingly using Depo-Provera injections at a health center in the adjoining village. Bhorletar's experience, and that of the 7 other villages, has proved that

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed

    Elmendorf, M

    1980-01-01

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

  9. [Promotion of family planning services: experience of Ruhengeri].

    PubMed

    Binyange, M

    1990-12-01

    among men has led to 21 vasectomies and 18 scheduled future operations. An association to promote voluntary sterilization was created in October 1990 with 36 founding members. In the prefecture as a whole, the proportion of fertile-aged women in union using contraception increased from 7.6% in January to 16.5% in August. The steady increase in acceptance of family planning can be traced directly to promotional activities during 1990 in Ruhengeri. PMID:12283852

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

    PubMed Central

    Yasin, Ahmad Lotfi; Basha, Walid Salim

    2016-01-01

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

  11. [Medico-legal risks of human voluntary sterilization].

    PubMed

    Le Quinquis, P; Chevrant-Breton, O

    1986-01-01

    There has been no legislation in France explicitly authorizing voluntary sterilization, so that a practitioner carrying out a voluntary surgical sterilization runs a theoretical risk of lawsuit. Concern about the legal status of voluntary sterilization stems from 2 articles in the French penal code, article 16 which forbids the crime of castration, defined as the intentional complete and definitive amputation or removal of an organ necessary for procreation; and article 309 which forbids voluntary assault and battery resulting in death or inability to work for 8 days, or a lesser incapacity if the violence was premeditated. Vasectomy and tubal ligation differ from castration in that they do not involve removal or mutilation of the genital organs. Article 309 has been applied to a sterilization case only once. The criminal chamber of the Court of Cassation, France's highest appeals court, ruled in 1937 that the consent of the victim had no effect on penal responsibility, since individuals have no right to violate on their own persons the rules of public order by undergoing corporal injuries unjustified by medical need. There has been no penal judgment since 1937 in a voluntary sterilization case. In a 1983 judgment, the Court of Cassation upheld the responsibility of a surgeon for not informing a 28-year-old mother of 5 of the possibility of failure of the sterilization operation he performed on her. The patient found herself pregnant once again less than 1 month after the operation. Had she been informed of the possibility of pregnancy, she might have taken further precautions to avoid it. The court established a causal link between the problems created by the pregnancy and the fault of the physician in not providing adequate information. The court's decision was of interest because it included tubal ligation among surgical interventions condoned by the common law of medical responsibility, thereby implying acceptance of voluntary sterilization. The plaintiff

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

    PubMed Central

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

    2011-01-01

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

  13. Bhorletar: the sustainable village.

    PubMed

    Rowley, J

    1993-01-01

    The village of Bhorletar, in the middle hills of Nepal, is run by an elected Village Development Committee (VDC). It consists of 9 wards with a total of 3000 people. The village center is growing fast, with 35 new houses built in the last year. Bhorletar is 1 of 8 villages selected by the National Planning Commission and the World Conservation Union (IUCN) to develop and test a system of local environmental planning. The effort is a central part of the National conservation Strategy, which began in 1983. The task of drawing up environmental plans for Bhorletar and 7 other villages was begun in 1990 with the help of 2 nongovernmental organizations and the IUCN planning team. This included drawing up land use maps on forest patches, trees species, landslides, cropping patterns, and hazard-prone areas. Finally, an environmental plan based on this profile was defined by the villagers themselves and approved in meetings. Each village selected its own activities and was granted project funds to supplement the work of men and women from the village. These activities included community forest conservation; improved fuel-wood stoves; new latrines; protective dams and afforestation; improved roads; vegetable gardens and marketing; and a new health post. There is no health post in Bhorletar, and the nearest hospital is a 7 hours' walk away. Contaminated water, poor diet, and a polluted environment are the main causes of a child death rate of around 100 per 1000. Most of the women and girls were too busy with household and farming chores to attend the planning meetings or school. According to the profile, 99 men and only 5 women were practicing family planning. The only family planning commonly available has been an annual vasectomy camp. Women find sterilization services almost impossible to obtain, though they are increasingly using Depo-Provera injections at a health center in the adjoining village. Bhorletar's experience, and that of the 7 other villages, has proved that

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

    PubMed

    Keeny, S M

    1974-05-01

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

  15. Role of planned parenthood for enrichment of the quality of life in Sri Lanka.

    PubMed

    Chinnatamby, S

    1990-12-01

    The story of the Sri Lankan Family Planning movement is told from its inception in 1953, prompted by a visit by Margaret Sanger 1952. The Family Planning Association of Sri Lanka was founded with the health of women and children, and both contraception and infertility treatment as its policies. The first clinic, called the "Mothers Welfare Clinic," treated women for complications of multiparity: one woman was para 26 and had not menstruated in 33 years. The clinic distributed vaginal barriers, spermicides and condoms, but the initial continuation rate was 5% year. Sri Lanka joined the IPPF in 1954. In 1959, after training at the Worcester Foundation, and a personal visit by Pincus, the writer supervised distribution of oral contraceptives in a pilot project with 118 women for 2 years. Each pill user was seen by a physician, house surgeon, midwife, nurse and social worker. In 1958 Sweden funded family planning projects in a village and an estate that reduced the birth rate 10% in 2 years. The Sri Lankan government officially adopted a family planning policy in 1965, and renewed the bilateral agreement with Sweden for 3 years. In 1968 the government instituted an integrated family planning and maternal and child health program under its Maternal and Child Health Bureau. This was expanded in 1971 to form the Family Health Bureau, instrumental in lowering the maternal death rate from 2.4/1000 in 1965 to 0.4 in 1984. During this period IUDs, Depo Provera, Norplant, and both vasectomy and interval female sterilizations, both with 1 small incision under local anesthesia, and by laparoscopic sterilization were adopted. Remarkable results were being achieved in treating infertile copies, even from the beginning, often by merely counseling people on the proper timing of intercourse in the cycle, or offering artificial insemination of the husband's semen. Factors contributing to the success of the Sri Lankan planned parenthood program included 85% female literacy, training of

  16. The use of contraception among abortion applicants.

    PubMed

    Krishnamoni, D; Jain, S C

    1985-01-01

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

  17. [Colombia. Prevalence, Demography and Health Survey 1990].

    PubMed

    1991-06-01

    Colombia's 1990 Survey of Prevalence, Demography, and Health (EPDS) was intended to provide data on the total population and on the status of women's and children's health for use in planning and in formulating health and family planning policy. 7412 household interviews and 8647 individual interviews with women aged 15-49 years were completed. This document provides a brief description of the questionnaire, sample design, data processing, and survey results. More detailed works on each topic are expected to follow. After weighing, 74.8% of respondents were urban and 25.2% rural. 3.2% were illiterate, 36.6% had some primary education, 50.2% had secondary educations, and 9.9% had high higher educations. Among all respondents and respondents currently in union respectively, 98.2% and 997% knew some contraceptive method, 94.1% and 97.9% knew some source of family planning, 57.6% and 86.0% had ever used a method, and 39.9% and 66.1% were currently using a method. Among all respondents and respondents currently in union respectively, 52.2% and 78.9% had ever used a modern method and 33.0% and 54.6% were currently using a modern method. Among women in union, 14.1% currently used pills, 12.4% IUDs, 2.2% injectables, 1.7% vaginal methods, 2.9% condoms, 20.9% female sterilization, .5% vasectomy, 11.5% some tradition method, 6.1% periodic abstinence, 4.8% withdrawal, and .5% others. Equal proportions of rural and urban women were sterilized. The prevalence of female sterilization declined with education and increased with family size. Modern methods were used by 57.5% of urban and 47.7% of rural women, 44.0% of illiterate women, 51.8% of women with primary and 57.8% with secondary educations. Among women in union, 10.9% wanted a child soon, 19.7% wanted 1 eventually, 3.6% were undecided, 42.6% did not want 1, 21.4% were sterilized, and 1.2% were infertile. Among women giving birth in the past 5 years, the proportion having antitetanus vaccinations increased from 39% in 1986

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

    PubMed

    Shen, G

    1984-08-01

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