Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Vasectomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2002

Vasectomy and the risk of prostate cancer: a meta-analysis examining vasectomy status, age at vasectomy, and time since vasectomy.

The aim of this study was to conduct a quantitative review of prostate cancer studies to pool relative risk (RR) estimates on the association between prostate cancer and vasectomy, in an attempt to determine whether there is an association, and if so, its magnitude. Random-effects models were examined along with a linear model for time since vasectomy. The pooled RR estimate was 1.37 (95% CI=1.15-1.62) based on five cohort studies and 17 case-control studies. The RR estimate varied by study design with the lowest risk for population-based case-control studies. No difference was seen in risk by age at vasectomy. A linear trend based on the 16 studies reporting time since vasectomy suggested an 10% increase for each additional 10 y or a RR of 1.32 (95% CI=1.17-1.50) for 30 y since vasectomy. When null effects were assumed for the six studies not reporting information, the linear RR for the 22 studies was 1.07 (1.03-1.11) and 1.23 (1.11-1.37) for 10 and 30 y since vasectomy, respectively. These results suggest that men with a prior vasectomy may be at an increased risk of prostate cancer, however, the increase may not be causal since potential bias cannot be discounted. The overall association was small and therefore could be explained by bias. The latency effect shown here for time since vasectomy should be examined further.

Age Factors↗
PubMed2002

[Vasectomy. A prospective, randomized trial of vasectomy with bilateral incision versus the Li vasectomy].

INTRODUCTION: Studies have shown that the Li vasectomy can match the effectiveness of and reduce the duration of operation and rate of complications compared to standard vasectomy with bilateral incision. MATERIALS AND METHODS: A prospective, randomised trial was conducted to compare the Li vasectomy with the standard vasectomy with bilateral incision. Data regarding effectiveness, time of operation, the patient's pain and discomfort, and peroperative and postoperative complications were recorded. Overall, 99 patients were entered in the trial, 51 with vasectomy with bilateral incision, 48 with the Li vasectomy. RESULTS: No significant difference was found between the two methods with regard to effectiveness, time of operation, the patient's pain and discomfort, and peroperative and postoperative complications. Overall, vasectomy was inadequate in 5%, haematoma was found in 13%, infection in 9%, and scrotal pain or painful ejaculation in 9%. DISCUSSION: The Li vasectomy can be learned and practiced under routine conditions by residents in training with the same effectiveness and the same rate of complications as standard vasectomy with bilateral incision. The total morbidity was at the same level as in previous Danish studies, but higher than in the international studies with the Li vasectomy.

Adult↗
PubMed2005

Simply modified no-scalpel vasectomy (percutaneous vasectomy)--a comparative study against the standard no-scalpel vasectomy.

BACKGROUND AND PURPOSE: The simply modified no-scalpel vasectomy (SMNSV; percutaneous vasectomy) technique was reported to simplify the standard no-scalpel vasectomy (SNSV) procedure. In this report, we introduce our experiences with SMNSV in comparison with the SNSV. MATERIALS AND METHODS: Between July 1999 and June 2002, 417 men were prospectively randomized to be vasectomized at the Taipei Medical University Hospital: 215 acceptors underwent the SNSV and the remaining 202 received the SMNSV. Using the no-scalpel vasectomy instruments in a percutaneous fashion, the sharp no-scalpel hemostat punctures the skin directly instead of fixating the vas to the skin with the use of a ring clamp, as done in SNSV. The vas is then grasped with the ringed instrument instead of piercing the vas and performing the supination maneuver, as described for SNSV. The intraoperative conditions of each group were recorded. The postoperative pain and life conditions were self-reported. The pain level was assessed using a 10-cm visual analogue scale under various situations. RESULTS: The time required for the SMNSV technique was less than that for the SNSV technique (p < .05). There were no significant differences between the two groups with respect to incision length, postoperative pain, pain at coitus, time of return to work, time of resuming intercourse, self-reported satisfaction in sexual life, postoperative psychological status, postoperative body weight change and postoperative complications (p > .05 for all items). CONCLUSIONS: The simply modified vasectomy technique simplifies the SNSV technique. It combines the minimally invasive nature of SNSV with the simplicity of classical vasectomy while conserving many comparable advantages.

Activities of Daily Living↗
PubMed2000

Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation.

PURPOSE: The cause of the post-vasectomy pain syndrome is unclear. Some postulated etiologies include epididymal congestion, tender sperm granuloma and/or nerve entrapment at the vasectomy site. To our knowledge nerve proliferation has not been evaluated previously as a cause of pain. Vasectomy reversal is reportedly successful for relieving pain in some patients. We report our experience and correlate histological findings in resected vasal segments with outcome to explain the mechanism of pain in these patients. MATERIALS AND METHODS: We retrospectively reviewed the records of 13 men who underwent vasectomy reversal for the post-vasectomy pain syndrome. We compared blinded histological evaluations of the vasal ends excised at vasectomy reversal in these patients with those of pain-free controls who underwent vasectomy reversal to reestablish fertility. Controls were matched to patients for the interval since vasectomy. Histological features were graded according to the degree of severity of vasitis nodosum, chronic inflammation and nerve proliferation. RESULTS: Mean time to pain onset after vasectomy was 2 years. Presenting symptoms included testicular pain in 9 cases, epididymal pain in 2, pain at ejaculation in 4 and pain during intercourse in 8. Physical examination demonstrated tender epididymides in 6 men, full epididymides in 6, a tender vasectomy site in 4 and a palpable nodule in 4. No patient had testicular tenderness on palpation. Unilateral and bilateral vasovasostomy was performed in 3 and 10 of the 13 patients, respectively. Postoperatively 9 of the 13 men (69%) became completely pain-free. Mean followup was 1.5 years. We observed no differences in vasectomy site histological features in patients with the post-vasectomy pain syndrome and matched controls, and no difference in histological findings in patients with the post-vasectomy pain syndrome who did and did not become pain-free postoperatively. CONCLUSIONS: No histological features aid in identifying a cause of pain or provide prognostic value for subsequent pain relief. Vasectomy reversal appeared to be beneficial for relieving pain in the majority of select patients with the post-vasectomy pain syndrome.

Adult↗
PubMed1997

Vasectomy reversal for treatment of the post-vasectomy pain syndrome.

PURPOSE: The post-vasectomy pain syndrome is a rare but troublesome complication of vasectomy. We report our experience with 32 patients who underwent vasectomy reversal for relief of the post-vasectomy pain syndrome. MATERIALS AND METHODS: The records of 32 patients undergoing vasovasostomy or epididymovasostomy for the post-vasectomy pain syndrome were evaluated for characteristics of symptoms, previous therapy, interval from vasectomy, success of surgery and duration of relief. RESULTS: Of 32 men who underwent vasectomy reversal for the post-vasectomy pain syndrome between 1980 and 1994, 24 had relief of symptoms after the initial procedure. Of 8 men with recurrent pain 6 underwent a second reversal procedure, and 3 of them subsequently had relief of symptoms. Overall, 27 of 32 men had resolution of pain. CONCLUSIONS: In our experience vasectomy reversal has a high rate of success for relief of the post-vasectomy pain syndrome. It does not preclude other forms of surgical therapy and it should be considered in the treatment of the post-vasectomy pain syndrome.

Adult↗
PubMed2002

Vasectomy reversal performed 15 years or more after vasectomy: correlation of pregnancy outcome with partner age and with pregnancy results of in vitro fertilization with intracytoplasmic sperm injection.

OBJECTIVE: To document a contemporary series of vasectomy reversals performed in men 15 years or more after vasectomy and to correlate the results with spousal age and results of ICSI for obstructive azoospermia. SETTING: University referral center for male infertility. DESIGN: Retrospective analysis of a single surgeon's experience compared with reported ICSI results. PARTICIPANT(S): One hundred seventy-three men who had vasectomy reversal 15 years or more after vasectomy. INTERVENTION(S): Reversal of vasectomy by vasovasostomy or epididymovasostomy. MAIN OUTCOME MEASURE(S): Correlation of pregnancy results after vasectomy reversal with spousal age and published ICSI results. RESULT(S): Pregnancy rates for the intervals of 15-19 years, 20-25 years, and >25 years after vasectomy were 49%, 39%, and 25%, respectively. For spousal age <30 years, 30--35 years, 36-40 years, and >40 years, pregnancy rates were 64%, 49%, 32%, and 28%, respectively. The overall pregnancy rate was 43%, which is similar to the pregnancy rate of 40% for ICSI in obstructive azoospermia. Sixty-two percent of the men required a unilateral or bilateral epididymovasostomy. CONCLUSION(S): Spousal age is an important predictive factor after vasectomy reversal among men who have reversal 15 years or more after vasectomy. Pregnancy rates after vasectomy reversal compare favorably with those obtained with ICSI.

Adult↗
PubMed1990

No-scalpel vasectomy at the King's birthday vasectomy festival.

No-scalpel vasectomy was developed to increase acceptability of vasectomy by elimination of the fear of the incision. Although this method has been used for over 8,000,000 men, the technique is largely unknown in developed countries. During the King's birthday vasectomy festival no-scalpel vasectomy was compared with standard incisional vasectomy in 1203 patients. An average of 57 procedures per day could be done by each physician with the no-scalpel method, compared to 33 procedures with the standard method (p less than 0.001). The complication rate was 0.4/100 procedures for no-scalpel vasectomy compared with 3.1/100 for standard vasectomy (p less than 0.001). No-scalpel vasectomy is a rapid and economic alternative to standard vasectomy, with fewer complications and increased patient acceptability.

Constriction↗
PubMed2004

Effect of time since vasectomy and maternal age on intracytoplasmic sperm injection success in men with obstructive azoospermia after vasectomy.

OBJECTIVE: To determine the effects of time since vasectomy and maternal age on intracytoplasmic sperm injection (ICSI) outcome in azoospermic men after vasectomy. DESIGN: Retrospective analysis. SETTING: Assisted conception unit. PATIENT(S): Thirty-seven azoospermic men (after vasectomy) who were undergoing 56 cycles of ICSI. INTERVENTION(S): Surgical sperm retrieval and standard ICSI protocol. The ICSI cycles were analyzed in four groups, according to years since vasectomy, and were reanalyzed in three groups, according to maternal age. MAIN OUTCOME MEASURE(S): Fertilization rate, implantation rate, clinical pregnancy rate, and live-birth rate (LBR) per ET. RESULT(S): No effect of time since vasectomy was seen on any outcome. The highest fertilization rate and LBR were found in the group with the longest time interval. These findings could not be explained by differences in either patient characteristics or stimulation regimes. When reanalyzed by maternal age, there was an improvement in implantation rate and LBR with decreasing maternal age. Live birth rates of 38.5%, 22.7%, and 11.8% were achieved for maternal ages of <32, 32-37, and >38 years, respectively. Logistic regression confirmed a statistically significant effect on outcome of maternal age but not time since vasectomy. CONCLUSION(S): Our data suggest that maternal age, and not interval since vasectomy, remains the principal determinant of ICSI success in men with obstructive azoospermia after vasectomy.

Adult↗
PubMed2003

Percutaneous vasectomy: a simple modification eliminates the steep learning curve of no-scalpel vasectomy.

PURPOSE: We report a simplified method to avoid the most difficult step of no-scalpel vasectomy, while maintaining its minimally invasive advantages. MATERIALS AND METHODS: Using the no-scalpel vasectomy instruments in percutaneous fashion we perform vasectomy in the office setting without fixation of the vas to skin using the ring clamp. The sharp no-scalpel hemostat punctures the skin. The vas is then grasped with the ringed instrument instead of piercing the vas and performing the supination maneuver, as described for no-scalpel vasectomy. RESULTS: Percutaneous vasectomy was performed in 573 men by a single surgeon. In the 35 consecutive cases recently reviewed average operative time was 9.3 minutes with an additional 67 seconds added when a resident performed the procedure on 1 side in 15 cases. As determined by the knuckle of vas pulled through a puncture, average incisional length was 8.4 mm. Patients reported complete recovery in an average of 8.9 days. No major complications occurred. A single case of recanalization (0.17%) was successfully corrected by repeat percutaneous vasectomy. CONCLUSIONS: Percutaneous vasectomy is a minimally invasive option for permanent male sterilization that avoids the difficult aspects of no-scalpel vasectomy.

Ambulatory Surgical Procedures↗
PubMedDate not supplied

Ultrastructural features of the vas deferens from patients undergoing vasectomy and vasectomy reversal.

Despite more than 30 million vasectomies, the ultrastructural features of the epithelium of the vas deferens (VD) of healthy fertile men, as well as the effects of vasectomy at both proximal (testicular) and distal (abdominal) regions of the VD relative to the initial site of incision, have yet to be fully elucidated. In the present study, the VD from 22 fertile men undergoing vasectomy and 7 vasectomized men undergoing vasectomy reversal were examined by light and transmission electron microscopy. In fertile men, aside from cellular organelles involved in endocytosis and merocrine secretion, the epithelial principal cells showed protrusions of their apical cytoplasm between adjacent microvilli, referred to as "apical blebs." The latter contained solely numerous ribosomes/polysomes and few endoplasmic reticulum (ER) cisternae, unlike the presence of lysosomes, lipofuscin granules, mitochondria, and the Golgi apparatus in the apical principal cell cytoplasm, suggesting the segregation of organelles within blebs. Many apical blebs presented a bulbous extremity with a thin stalklike attachment connecting them to the apical principal cell surface, while others appeared to be isolated and well removed from it, suggesting that blebs are capable of detaching and being liberated into the lumen. We hypothesize that apical blebs represent a type of secretion, referred to as "apocrine secretion." In men undergoing vasectomy reversal, the VD proximal (testicular) to the vasectomy site showed a reduction in the size of principal cells and their microvilli and in the number of apical blebs. In contrast, the lumen of the VD distal (abdominal) to the vasectomy site was virtually abolished, with the epithelium reduced to a flattened layer of cells showing a paucity of organelles and no apical blebs, suggesting that these cells become undifferentiated in the absence of seminal fluids. Taken together, these data may explain, in part, the decreased pregnancy rate noted after vasectomy reversal despite a patent anastomosis.

Adult↗
PubMed1976

Vasectomy and vasovasostomy. I. Timing of histologic changes in immature and mature dog testis after vasectomy.

The effects of vasectomy on the development and maintenance of spermatogenesis was studied using immature and mature dog testes. Bilateral vasectomy in immature dogs delayed the development of advanced spermatocytes, spermatids, and spermatozoa for about 3 months postsurgery. Spermatogenesis appeared to be recovered to control levels by 4 months postvasectomy. Spermatogenesis in mature dogs was also altered after bilateral vasectomy. Decreased numbers of advanced spermatocytes as well as maturation arrest was observed by 3 weeks postvasectomy. Seminiferous tubule cell layers quickly decreased to one to three layers as the lumina became occluded with sloughed cells by 3 to 6 weeks postvasectomy. Recovery in terms of the numbers of spermatocytes, spermatids, and spermatozoa was evident by 13 weeks postvasectomy, although occasional dog testes did not recover and appeared to be more sensitive to vasectomy-induced damage. It thus appears that vasectomy temporarily inhibits both the development and maintenance of spermatogenesis in immature as well as mature dog testes. Spermatogenesis does recover but may be maintained at somewhat lower levels after vasectomy. Changes are rapid in onset and take several weeks to be reversed. Some dog testes appear to be more sensitive to the damage and it may be irreversible in these testes.

Animals↗
PubMed2003

[Vasectomy today: a review of 1,275 vasectomies in 10 years].

We report on a large series of 1,275 patients who underwent outpatient vasectomy performed by a single urological surgeon within a 10-year period. In addition, the results of a prospective questionnaire-based study on 217 patients regarding their opinions and motivation, and the financial aspects of the vasectomy are discussed. The mean age was 37.0+/-5.9 years. A total of 98.4% of the patients had an uneventful postoperative course. The average duration of sick leave was 2.2+/-0.21 days. During the study period, the length of sick leave dropped significantly from 2.63 (1990/91) to 1.1 days (1998/99; P=0.001). Efficacy was documented with azoospermia rates of 96.6% and 98.5% in patients who presented for two and three sperm examinations, respectively. A vast majority of patients (94.6%) felt that the procedure should be covered by their health insurance, although 88.1% stated they would also pay by themselves. A minority of patients (0.7%: 9/1,275) subsequently considered vasectomy reversal. The wish to reverse the vasectomy was significantly associated with a younger patient age. In conclusion, outpatient vasectomy provides a safe and reliable form of contraception at low cost. Overall satisfaction in appropriately counselled patients is very high. Based on these findings, further attempts to propagate vasectomy as a timely form of contraception are medically and socioeconomically recommended.

Adolescent↗
PubMed1997

A cross-sectional study of vasectomy, time since vasectomy and prostate cancer.

Past studies of the association of vasectomy and prostate cancer have reported inconsistent results. Our objective was to investigate whether vasectomy and time since vasectomy are associated with a higher risk of prostate cancer. We conducted a cross-sectional study on unduplicated records of >95 000 participants in a longitudinal study (1993-1995) of prostate cancer screening conducted during Prostate Cancer Awareness Week. Vasectomy was reported by 28%, and there were 2530 biopsies. (chi)(2) tests and logistic regression analyses were used and found that vasectomy and an increased length of time since vasectomy are not associated with a higher risk of prostate cancer.

Journal Article↗
PubMed1983

Immunoglobulin in seminal fluid of fertile, infertile, vasectomy and vasectomy reversal patients.

We measured the concentrations of IgG, IgA, and IgM, in the seminal fluid of 16 fertile men, 77 men of infertile marriages, 21 men who had undergone vasectomy reversal and 5 men who had undergone vasectomy only. The lower limits of sensitivity of the assay was 0.04 mg./dl. IgG (mean concentration 3.29 mg./dl., range 0.48 to 15.41 mg./dl.) and IgA (mean concentration 1.11 mg./dl., range 0.05 to 19.11 mg./dl.) were measureable in all specimens, but IgM (range 0.04 to 0.76 mg./dl.) was measureable in only 20 per cent. Intrasubject variability of IgG and IgA concentrations expressed as the coefficients of variation of serial determinations ranged from 18 to 40 per cent and 29 to 52 per cent, respectively. Discrepancies between the presence or absence of measurable IgM in serial determinations were unusual. The mean concentrations of seminal fluid IgG and IgA in the fertile group were not significantly different from the other patient groups. However, IgM was measurable in only 13 per cent of specimens from the fertile patients but in 62 per cent of specimens from the vasectomy reversal patients (p = 0.003). This suggests disruption of the blood-genital tract barrier following vasectomy and continuing after vasectomy reversal.

Adult↗
PubMed2004

A novel instrument-independent no-scalpel vasectomy - a comparative study against the standard instrument-dependent no-scalpel vasectomy.

An instrument-independent no-scalpel vasectomy (IINSV) technique is reported. This technique does not use the standard specific instruments, but comparatively retains the advantages of minimally invasive instrument-dependent no-scalpel vasectomy (IDNSV). Between July 1999 and June 2002, 449 men were prospectively randomized to be vasectomized at two hospitals in Taipei. Of those who accepted, 215 underwent IDNSV at one hospital and the remaining 234 underwent IINSV at the other. The intra-operative conditions of each group were recorded. The postoperative pain and life conditions were self-reported through a questionnaire that had been carefully designed prior to the operations, in which the pain level was assessed using a 10-cm visual analogue scale under varying situations. Men vasectomized using the IINSV method experienced less operation time and postoperative complications (haematomas, infections and granulomas) (p < 0.05). There were no significant differences between the two groups with respect to incision length, postoperative pain, pain at coitus, time of return to work, time of resuming intercourse, self-reported satisfaction in sexual life, postoperative psychological status, postoperative body weight change and vasectomy failure as evidenced by sperm analysis (p > 0.05 for all items). Thus, the IINSV technique can offer an alternative option for vasectomists whenever the specific instruments of standard no-scalpel vasectomy are unavailable. The IINSV technique shortens the operation time and reduces the incidence of operative complications when compared with the IDNSV technique, while still retaining the advantages of minimally invasive vasectomy.

Adult↗
PubMed1994

Vasectomy and vasectomy reversal.

Vasectomy remains the safest method of birth control and there is much to commend it in the setting of a stable family relationship. However, some aspects of this operation have been wrongly presented in an attempt to widen its popularity and increase public acceptance. A simple procedure it may be but it is not totally free of complications; sometimes the operation has to be repeated and rarely it may reverse spontaneously even after the most stringent precautions. The family planning officer who counsels a prospective candidate and the surgeon who undertakes the procedure must ensure that these facts are understood by the patient with crystal clarity and that this fact is duly recorded on a signed and witnessed permission slip. Any organization which includes vasectomy in its programme of family planning should include advice and referral for vasectomy reversal in exactly the same way that the pill may be stopped or a coil can be removed. Fertility can be successfully restored by vasovasostomy in 50% of men who wish to have their vasectomies reversed, which often is due to a change in circumstances beyond their direct control.

Aftercare↗
PubMed1977

Comparison of allergic aspermatogenesis with that induced by vasectomy. II. In vitro studies of cell-mediated immunity to sperm after vasectomy in man and guinea-pig.

Transformation of peripheral blood leucocytes was shown to be a valid assay for cell-mediated immunity to sperm in male guinea-pigs immunized with homologous epididymal sperm (ES) in FCA. A heat-treated extract of ES (BES) was used for culture. Possible developement of cell-mediated immunity to sperm after vasectomy was investigated in patients and guinea-pigs, by culture of blood leucocytes before and at intervals after operation. Patients' leucocytes were cultured with a heat-treated extract of human seminal sperm (BHS); guinea-pigs' leucocytes were cultured with BES. These cultures showed no evidence of specific stimulation of leucocytes by sperm extract, up to 1 year after vasectomy in patients, or up to 6 months in guinea-pigs. Similarly, no evidence of delayed hypersensitivity could be demonstrated by skin tests with BES in animals vasectomized 1 year previously. We consider that this study establishes that cell-mediated immunity to sperm does not develop in either man or guinea-pigs, up to 1 year after conventional vasectomy.

Animals↗
PubMed1979

Epididymal extravasation following vasectomy as a cause for failure of vasectomy reversal.

Twenty-eight men undergoing vasectomy reversal who were found to have no sperm in the proximal vas fluid on one or both sides underwent microscopic epididymal exploration. In 33 of 39 cases so explored, normal sperm were found in the epididymal fluid of the corpus, despite absence of sperm in the vas fluid. Epididymal histology distal to this site revealed extensive interstitial sperm granulomas resulting from rupture of the epididymal duct. Testicular biopsy revealed normal spermatogenesis. Secondary epididymal obstructions were noted when there was copious fluid in the vas deferens proximal to the vasectomy site as well as when there was scanty fluid. It is concluded that persistent azoospermia after an accurate microscopic vasovasostomy results from the secondary epididymal obstruction induced by rupture of the epididymal duct related to the pressure increase after vasectomy.

Adult↗