Jump to content

Vasectomy

From Wikipedia, the free encyclopedia

Vasectomy
Background
TypeSterilization
First use1899 (experiments from 1785)[1]
Failure rates (first year)
Perfect use0.10%[2]
Typical use0.15%[2]
"Vas-Clip" nearly 1%
Usage
Duration effectPermanent
ReversibilityPossible
User remindersA negative semen specimen is required to verify no sperm.[3]
Clinic reviewAll
Advantages and disadvantages
STI protectionNo
BenefitsNo need for general anesthesia. Lower cost and less invasive than tubal ligation for females.
RisksTemporary local inflammation of the testes, long-term genital pain.

Vasectomy is an elective surgical procedure that results in male sterilization, often as a means of permanent contraception. During the procedure, the male vasa deferentia are cut and tied or sealed so as to prevent sperm from entering into the urethra and thereby prevent fertilization of a female through sexual intercourse. Vasectomies are usually performed in a physician's office, medical clinic, or, when performed on a non-human animal, in a veterinary clinic. Hospitalization is not normally required as the procedure is not complicated, the incisions are small, and the necessary equipment routine.

There are several methods by which a surgeon might complete a vasectomy procedure, all of which occlude (i.e., "seal") at least one side of each vas deferens. To help reduce anxiety and increase patient comfort, those who have an aversion to needles may consider a "no-needle" application of anesthesia while the 'no-scalpel' or 'open-ended' techniques help to accelerate recovery times and increase the chance of healthy recovery.[4]

Due to the simplicity of the surgery, a vasectomy usually takes less than 30 minutes to complete. After a short recovery at the doctor's office (usually less than an hour), the patient is sent home to rest. Because the procedure is minimally invasive, many vasectomy patients find that they can resume their typical sexual behavior within a week, and do so with little or no discomfort.

Because the procedure is considered a permanent method of contraception and is not easily reversed, patients are frequently counseled and advised to consider how the long-term outcome of a vasectomy might affect them both emotionally and physically. The procedure is not typically encouraged for young single childless people as their risk of later regret is higher as chances of biological parenthood are thereby permanently reduced, often completely.[citation needed] A vasectomy without the patient's consent or knowledge is considered forced sterilization.

Medical uses

[edit]

A vasectomy is done to prevent fertility in males. It ensures that in most cases the person will be sterile after confirmation of success following surgery. The procedure is regarded as permanent because vasectomy reversal is costly and often does not restore the male's sperm count or sperm motility to prevasectomy levels. Those with vasectomies have a very small (nearly zero) chance of successfully impregnating someone, but a vasectomy does not protect against sexually transmitted infections (STIs).[5]

After vasectomy, the testes remain in the scrotum where Leydig cells continue to produce testosterone and other male hormones that continue to be secreted into the bloodstream.

When the vasectomy is complete, sperm cannot exit the body through the penis. Sperm is still produced by the testicles but is broken down and absorbed by the body. Much fluid content is absorbed by membranes in the epididymis, and much solid content is broken down by the responding macrophages and reabsorbed via the bloodstream.[citation needed] After vasectomy, the membranes must increase in size to absorb and store more fluid; this triggering of the immune system causes more macrophages to be recruited to break down and reabsorb more solid content.[citation needed] Within one year after vasectomy, sixty to seventy percent of those vasectomized develop antisperm antibodies.[6] In some cases, vasitis nodosa, a benign proliferation of the ductular epithelium, can also result.[7][8] The accumulation of sperm increases pressure in the vas deferens and epididymis. The entry of the sperm into the scrotum can cause sperm granulomas to be formed by the body to contain and absorb the sperm which the body will treat as a foreign biological substance (much like a virus or bacterium).[9]

Efficacy

[edit]
Risks of vasectomy
Frequency Risk
1 in 1400 Unwanted pregnancy (failure of vasectomy)[10]
1 in 11 For comparison: unwanted pregnancy w/ typical use of pill[2]
1 in 6 For comparison: unwanted pregnancy w/ typical use of condom[2]
1 in 40 Infection after surgery[11]
1 in 7 Pain at 7 months after vasectomy[12]
1 in 110 Pain at 7 months affecting quality of life[12]

Vasectomy is the most effective permanent form of contraception available to males. (Removing the entire vas deferens would very likely be more effective, but it is not something that is regularly done.[13]) In nearly every way that vasectomy can be compared to tubal ligation it has a more positive outlook. Vasectomy is more cost effective, less invasive, has techniques that are emerging that may facilitate easier reversal, and has a much lower risk of postoperative complications.

Early failure rates, i.e. pregnancy within a few months after vasectomy, typically result from unprotected sexual intercourse too soon after the procedure while some sperm continue to pass through the vasa deferentia. Most physicians and surgeons who perform vasectomies recommend one (sometimes two) postprocedural semen specimens to verify a successful vasectomy; however, many people fail to return for verification tests citing inconvenience, embarrassment, forgetfulness, or certainty of sterility.[14] In January 2008, the FDA cleared a home test called SpermCheck Vasectomy that allows patients to perform postvasectomy confirmation tests themselves;[15] however, compliance for postvasectomy semen analysis in general remains low.

Late failure, i.e. pregnancy following spontaneous recanalization of the vasa deferentia, has also been documented.[16] This occurs because the epithelium of the vas deferens (similar to the epithelium of some other human body parts) is capable of regenerating and creating a new tube if the vas deferens is damaged and/or severed.[17] Even when as much as five centimeters (or two inches) of the vas deferens is removed, the vas deferens can still grow back together and become reattached—thus allowing sperm to once again pass and flow through the vas deferens, restoring one's fertility.[17]

The Royal College of Obstetricians and Gynaecologists states there is a generally agreed-upon rate of late failure of about one in 2000 vasectomies—better than tubal ligations for which the failure rate is one in every 200 to 300 cases.[18] A 2005 review including both early and late failures described a total of 183 recanalizations from 43,642 vasectomies (0.4%), and 60 pregnancies after 92,184 vasectomies (0.07%).[10]

Complications and patient concerns

[edit]

Short-term possible complications include infection, bruising and bleeding into the scrotum resulting in a collection of blood known as a hematoma.[19] A study in 2012 demonstrated an infection rate of 2.5% postvasectomy.[11] The stitches on the small incisions required are prone to irritation, though this can be minimized by covering them with gauze or small adhesive bandages. The primary long-term complications are chronic pain conditions or syndromes that can affect any of the scrotal, pelvic or lower-abdominal regions, collectively known as post-vasectomy pain syndrome. Though vasectomy results in increases in circulating immune complexes, these increases are transient. Data based on animal and human studies indicate these changes do not result in increased incidence of atherosclerosis.

Complications not withstanding, many men express concerns regarding potential adverse effects of vasectomy, including Cancer. The risk of testicular cancer is not affected by vasectomy.[20] In 2014 the AUA reaffirmed that vasectomy is not a risk factor for prostate cancer and that it is not necessary for physicians to routinely discuss prostate cancer in their preoperative counseling of vasectomy patients.[21] There remains ongoing debate regarding whether vasectomy is associated with prostate cancer. A 2017 meta-analysis found no statistically significant increase in risk.[22] A 2019 study of 2.1 million Danish males found that vasectomy increased their incidence of prostate cancer by 15%.[23] A 2020 meta-analysis found that vasectomy increased the incidence by 9%.[24] Other recent studies agree on the 15% increase in risk of developing prostate cancer, but found that people who get a vasectomy are not more likely to die from prostate cancer than those without a vasectomy.[25][26]

A vasectomy will not Impact sexual performance: A vasectomy does not affect libido or masculinity aside from its contraceptive effect. Some men have even reported increased sexual satisfaction post-vasectomy. It won't cause permanent damage to sexual organs: The risk of injury to the testicles, penis, or other reproductive organs during surgery is minimal. Although extremely rare, damage to the blood supply could potentially lead to testicular loss, but this occurrence is unlikely with a skilled surgeon.

It won't increase the risk of heart disease: There is no established connection between vasectomy and heart-related issues.

Vasectomy will not result in severe pain: While minor discomfort such as pulling or tugging sensations may occur during the procedure, severe pain is uncommon. Post-surgery, most men experience minor pain that typically resolves within a few days. In rare cases, some men report chronic post surgery pain, Post Vasectomy Pain Syndrome.

Postvasectomy pain

[edit]
Main article: Post-vasectomy pain syndrome

Post-vasectomy pain syndrome is a chronic and sometimes debilitating condition that may develop immediately or several years after vasectomy.[27] The most robust study of post-vasectomy pain, according to the American Urology Association's Vasectomy Guidelines 2012 (amended 2015)[28] surveyed people just before their vasectomy and again seven months later. Of those that responded and who said they did not have any scrotal pain prior to vasectomy, 7% had scrotal pain seven months later which they described as "Mild, a bit of a nuisance", 1.6% had pain that was "Moderate, require painkillers" and 0.9% had pain that was "quite severe and noticeably affecting their quality of life".[12] Post-vasectomy pain can be constant orchialgia or epididymal pain (epididymitis), or it can be pain that occurs only at particular times such as with sexual intercourse, ejaculation, or physical exertion.[9]

Psychological effects

[edit]

Approximately 90% are generally reported in reviews as being satisfied with having had a vasectomy,[29] while 7–10% of people regret their decision.[30] For those in relationships, regret was less common when both people in the relationship agreed on the procedure.[31]

Younger people who receive a vasectomy are significantly more likely to regret and seek a reversal of their vasectomy, with one study showing people in their twenties being 12.5 times more likely to undergo a vasectomy reversal later in life (and including some who chose sterilization at a young age). Pre-vasectomy counseling is often emphasised for younger patients.[32][33]

Dementia

[edit]

An association between vasectomy and primary progressive aphasia, a rare variety of frontotemporal dementia, was reported.[31] However, it is doubtful that there is a causal relationship.[34] The putative mechanism is a cross-reactivity between brain and sperm, including the shared presence of neural surface antigens.[35] In addition, the cytoskeletal tau protein has been found only to exist outside of the CNS in the manchette of sperm.[35]

Procedure

[edit]

The traditional incision approach of vasectomy involves numbing of the scrotum with local anesthetic (although some people's physiology may make access to the vas deferens more difficult in which case general anesthesia may be recommended) after which a scalpel is used to make two small incisions, one on each side of the scrotum at a location that allows the surgeon to bring each vas deferens to the surface for excision. The vasa deferentia are cut (sometimes a section may be removed altogether), separated, and then at least one side is sealed by ligating (suturing), cauterizing (electrocauterization), or clamping.[36] There are several variations to this method that may improve healing, effectiveness, and which help mitigate long-term pain such as post-vasectomy pain syndrome or epididymitis, however the data supporting one over another are limited.[37]

  • Fascial interposition: Recanalization of the vas deferens is a known cause of vasectomy failure(s).[38] Fascial interposition ("FI"), in which a tissue barrier is placed between the cut ends of the vas by suturing, may help to prevent this type of failure, increasing the overall success rate of vasectomy while leaving the testicular end within the confines of the fascia.[39] The fascia is a fibrous protective sheath that surrounds the vas deferens as well as all other body muscle tissue. This method, when combined with intraluminal cautery (where one or both sides of the vas deferens are electrically "burned" closed to prevent recanalization), has been shown to increase the success rate of vasectomy procedures.
  • No-needle anesthesia: Fear of needles for injection of local anesthesia is well known.[40] In 2005, a method of local anesthesia was introduced for vasectomy which allows the surgeon to apply it painlessly with a special jet-injection tool, as opposed to traditional needle application. The numbing agent is forced/pushed onto and deep enough into the scrotal tissue to allow for a virtually pain-free surgery. Lidocaine applied in this manner typically achieves anesthesia within 10 to 20 seconds.[41] Initial surveys show a very high satisfaction rate amongst vasectomy patients.[40] Once the effects of no-needle anesthesia set in, the vasectomy procedure is performed in the routine manner. However, unlike in conventional local anesthesia where needles and syringes are used on one patient only, the applicator is not single use and can only be properly disinfected by autoclaving.[42]
  • No-scalpel vasectomy (NSV): Also known as a "key-hole" vasectomy,[36] is a vasectomy in which a sharp hemostat (as opposed to a scalpel) is used to puncture the scrotum. This method has come into widespread use as the resulting smaller "incision" or puncture wound typically limits bleeding and hematomas. Also the smaller wound has less chance of infection, resulting in faster healing times compared to the larger/longer incisions made with a scalpel. The surgical wound created by the no-scalpel method usually does not require stitches. NSV is the most commonly performed type of minimally invasive vasectomy, and both describe the method of vasectomy that leads to access of the vas deferens.[43]
Open-ended vasectomy
  • Open-ended vasectomy: In this procedure the testicular end of the vas deferens is not sealed, which allows continued streaming of sperm into the scrotum. This method may avoid testicular pain resulting from increased back-pressure in the epididymis.[9] Studies suggest that this method may reduce long-term complications such as post-vasectomy pain syndrome.[44][45]
  • Vas irrigation: Injections of sterile water or euflavine (which kills sperm) are put into the distal portion of the vas at the time of surgery which then brings about a near-immediate sterile ("azoospermatic") condition. The use of euflavine does however, tend to decrease time (or, number of ejaculations) to azoospermia vs. the water irrigation by itself. This additional step in the vasectomy procedure, (and similarly, fascial interposition), has shown positive results but is not as prominently in use, and few surgeons offer it as part of their vasectomy procedure.[37]

Other techniques

[edit]

The following vasectomy methods have purportedly had a better chance of later reversal but have seen less use by virtue of known higher failure rates (i.e., recanalization). An earlier clip device, the VasClip, is no longer on the market, due to unacceptably high failure rates.[46][47][48][unreliable medical source?]

The VasClip method, though considered reversible, has had a higher cost and resulted in lower success rates. Also, because the vasa deferentia are not cut or tied with this method, it could technically be classified as other than a vasectomy. Vasectomy reversal (and the success thereof) was conjectured to be higher as it only required removing the Vas-Clip device. This method achieved limited use, and scant reversal data are available.[48]

Vas occlusion techniques

[edit]
Main article: Vas-occlusive contraception
  • Injected plugs: There are two types of injected plugs which can be used to block the vasa deferentia. Medical-grade polyurethane (MPU) or medical-grade silicone rubber (MSR) starts as a liquid polymer that is injected into the vas deferens after which the liquid is clamped in place until is solidifies (usually in a few minutes).[49]
  • Intra-vas device: The vasa deferentia can also be occluded by an intra-vas device (IVD). A small cut is made in the lower abdomen after which a soft silicone or urethane plug is inserted into each vas tube thereby blocking (occluding) sperm. This method allows for the vas to remain intact. IVD technique is done in an out-patient setting with local anesthetic, similar to a traditional vasectomy. IVD reversal can be performed under the same conditions making it much less costly than vasovasostomy which can require general anesthesia and longer surgery time.[50]

Both vas occlusion techniques require the same basic patient setup: local anesthesia, puncturing of the scrotal sac for access of the vas, and then plug or injected plug occlusion. The success of the aforementioned vas occlusion techniques is not clear and data are still limited. Studies have shown, however, that the time to achieve sterility is longer than the more prominent techniques mentioned in the beginning of this article. The satisfaction rate of patients undergoing IVD techniques has a high rate of satisfaction with regard to the surgery experience itself.[51]

Recovery

[edit]
Incision stitches and a shaved scrotum
14 days after vasectomy surgery

Sexual intercourse can usually be resumed in about a week (depending on recovery); however, pregnancy is still possible as long as the sperm count is above zero. Another method of contraception must be relied upon until a sperm count is performed either two months after the vasectomy or after 10–20 ejaculations have occurred.[52]

After a vasectomy, contraceptive precautions must be continued until azoospermia is confirmed. Usually two semen analyses at three and four months are necessary to confirm azoospermia. The British Andrological Society has recommended that a single semen analysis confirming azoospermia after sixteen weeks is sufficient.[53]

Post-vasectomy, testicles will continue to produce sperm cells. As before vasectomy, unused sperm are reabsorbed by the body.[54]

Conceiving after vasectomy

[edit]

In order to allow the possibility of reproduction via artificial insemination after vasectomy, some opt for cryopreservation of sperm before sterilization. Dr Allan Pacey, senior lecturer in andrology at Sheffield University and secretary of the British Fertility Society, notes that those he sees for a vasectomy reversal which has not worked express wishing they had known they could have stored sperm. Pacey notes, "The problem is you're asking a man to foresee a future where he might not necessarily be with his current partner—and that may be quite hard to do when she's sitting next to you."[55]

The cost of cryo-preservation (sperm banking) may also be substantially less than alternative vaso-vasectomy procedures, compared to the costs of in-vitro fertilization (IVF) which usually run from $12,000 to $25,000.[56]

Sperm can be aspirated from the testicles or the epididymides, and while there is not enough for successful artificial insemination, there is enough to fertilize an ovum by intracytoplasmic sperm injection. This avoids the problem of antisperm antibodies and may result in a faster pregnancy. IVF may be less costly per cycle than reversal in some health-care systems, but a single IVF cycle is often insufficient for conception. Disadvantages include the need for procedures on the woman, and the standard potential side-effects of IVF for both the mother and the child.[57]

Vasectomy reversal

[edit]
Main article: Vasectomy reversal

Vasectomies are not always reversible. There is a surgical procedure to reverse vasectomies using vasovasostomy (a form of microsurgery first performed by Earl Owen in 1971[58][59]). Vasovasostomy is effective at achieving pregnancy in a variable percentage of cases, and total out-of-pocket costs in the United States are often upwards of $10,000.[60] The typical success rate of pregnancy following a vasectomy reversal is around 55% if performed within 10 years, and drops to around 25% if performed after 10 years.[61] After reversal, sperm counts and motility are usually much lower than pre-vasectomy levels. There is evidence that those who had a vasectomy may produce more abnormal sperm, which may explain why even a mechanically successful reversal does not always restore fertility.[62][63] The higher rates of aneuploidy and diploidy in the sperm cells of those who have undergone vasectomy reversal may lead to a higher rate of birth defects.[62]

Approximately 2% of men who have undergone vasectomy will undergo a reversal within 10 years of the procedure.[33] A small number of vasectomy reversals are also performed in attempts to relieve post-vasectomy pain syndrome.[64]

Prevalence

[edit]

Internationally, vasectomy rates are vastly different.[65] While female sterilisation is the most widely used method worldwide, with 223 million women relying on it, only 28 million women rely on their partner's vasectomy.[66] In the world's 69 least developed countries less than 0.1% of males use vasectomies on average. Of 54 African countries, only ten report measurable vasectomy use and only Eswatini, Botswana, and South Africa exceed 0.1% prevalence.[65]

Prevalence of vasectomies[65]
Country Vasectomy usage Notes
Canada 22%
UK 17% – 21% only range given
New Zealand 17% – 21% only range given
South Korea 17% – 21% only range given
Australia ~10%
Belgium ~10%
Denmark ~10%
Spain ~10%
Switzerland ~10%
Nepal 7.8%
Brazil 5.1%
Colombia 3.4%
Eswatini 0.3%
Botswana 0.4%
South Africa 0.7%

In North America and Europe vasectomy usage is on the order of 10% with some countries reaching 20%.[65] Despite its high efficacy, in the United States, vasectomy is utilized less than half the rate of the alternative female tubal ligation.[67] According to the research, vasectomy in the US is least utilized among black and Latino populations, the groups that have the highest rates of female sterilization.[67]

New Zealand, in contrast, has higher levels of vasectomy than tubal ligation; 18% of all males, and 25% of all married males, have had a vasectomy. The age cohort with the highest level of vasectomy was 40–49, where 57% of males had taken it up.[68] Canada, the UK, Bhutan and the Netherlands all have similar levels of uptake.[69]

History

[edit]

The first human vasectomies were performed in the late 19th century. The procedure was initially used mainly as a treatment for prostate enlargement and as a eugenic method for sterilizing "degenerates".[70] Vasectomy as a method of voluntary birth control began during the Second World War.[71]

The first recorded vasectomy was performed on a dog in 1823.[71] The first human vasectomies were performed to treat benign prostatic hyperplasia, or enlargement of the prostate. Castration had sometimes been used as a treatment for this condition in the 1880s, but, given the serious side effects, doctors sought alternative treatments. The first to suggest vasectomy as an alternative to castration may have been James Ewing Mears (in 1890), or Jean Casimir Félix Guyon.[70] The first human vasectomy is thought to have been performed by Reginald Harrison.[71][additional citation(s) needed] By 1900, Harrison reported that he had performed more than 100 vasectomies with no adverse outcomes.[70]

In the late 1890s, vasectomy also came to be proposed as a eugenic measure for the sterilization of men considered unfit to reproduce. The first case report of vasectomy in the United States was in 1897, by A. J. Ochsner, a surgeon in Chicago, in a paper titled, "Surgical treatment of habitual criminals". He believed vasectomy to be a simple, effective means for stemming the tide of racial degeneration widely believed to be occurring.[72][73] In 1902, Harry C. Sharp, the surgeon at the Indiana Reformatory, reported that he had sterilized 42 inmates in an effort to both reduce criminal behavior in those individuals and prevent the birth of future criminals.[74]

Eugen Steinach (1861–1944), an Austrian physician, believed that a unilateral vasectomy (severing only one of the two vasa deferentia) in older individuals could restore general vigor and sexual potency, shrink enlarged prostates, and cure various ailments by somehow boosting the hormonal output of the vasectomized testicle.[75] This surgery, which became very popular in the 1920s, was undertaken by many wealthy individuals, including Sigmund Freud and W. B. Yeats.[76] Since these operations lacked rigorous controlled trials, any rejuvenating effect was likely due to the placebo effect, and with the later development of synthetic injectable hormones, this operation fell out of vogue.[75][77]

Vasectomy began to be regarded as a method of consensual birth control during the Second World War.[71] The first vasectomy program on a national scale was launched in 1954 in India.[78]

The procedure is seldom performed on dogs, with castration remaining the preferred reproductive control option for canines. It is regularly performed on bulls.[79]

Society and culture

[edit]

Availability and legality

[edit]

Vasectomy costs are (or may be) covered in different countries, as a method of both contraception or population control, with some offering it as a part of a national health insurance. The procedure was generally considered illegal in France until 2001, due to provisions in the Napoleonic Code forbidding "self-mutilation". No French law specifically mentioned vasectomy until a 2001 law on contraception and infanticide permitted the procedure.[80]

The U.S. Affordable Care Act (signed into law in 2010) does not cover vasectomies,[81] although eight states require state-health insurance plans to cover the cost. These include: Illinois, Maryland, New Jersey, New Mexico, New York, Oregon, Vermont and Washington.[82]

In 2014, the Iranian parliament voted for a bill that would ban the procedure.[83]

[edit]

An analysis of medical records of 217 million people in the U.S. compared tubal sterilization and vasectomy rates in the last six months of 2021 with rates in the last six months of 2022—just after the Dobbs ruling (i.e. the overturning of Roe vs Wade) in June 2022. Although the effect of Dobbs was different in various social groups, it had a strong impact on those under age 30 with their vasectomy rates increasing by 59%, and tubal sterilization rates increasing by 29%.[84]

Tourism

[edit]
Main article: Medical tourism

Medical tourism, where a patient travels to a less-developed location where a procedure is cheaper to save money and combine convalescence with a vacation, is infrequently used for vasectomy due to its low cost, but is more likely to be used for vasectomy reversal. Many hospitals list vasectomy as being available. Medical tourism has been scrutinized by some governments for quality of care and postoperative care issues.[85]

Shooting of Andrew Rynne

[edit]

In 1990, Andrew Rynne, chairperson of the Irish Family Planning Association, and the Republic of Ireland's first vasectomy specialist,[86] was shot by a former client, but he survived. The incident is the subject of a short film, The Vasectomy Doctor, by Paul Webster.[87]

See also

[edit]

References

[edit]
  1. ^ Popenoe P (1934). "The progress of eugenic sterilization". Journal of Heredity. 25 (1): 19.
  2. ^ a b c d Trussell J (2011). "Contraceptive efficacy". In Hatcher RA, Trussell J, Nelson AL, Cates W Jr, Kowal D, Policar MS (eds.). Contraceptive technology (20th revised ed.). New York: Ardent Media. pp. 779–863. ISBN 978-1-59708-004-0. ISSN 0091-9721. OCLC 781956734. Table 26–1 = Table 3–2 Percentage of women experiencing an unintended pregnancy during the first year of typical use and the first year of perfect use of contraception, and the percentage continuing use at the end of the first year. United States.
  3. ^ "Information for Patients - Vasectomy Semen Analysis" (PDF). Manchester University NHS Foundation Trust. May 2017. Retrieved 13 March 2023.
  4. ^ "What Happens When I Get a Vasectomy?". WebMD. Retrieved 7 October 2021.
  5. ^ "Vasectomy - Mayo Clinic". www.mayoclinic.org. Retrieved 19 April 2023.
  6. ^ Hattikudur S, Shanta SR, Shahani S, Shastri P, Thakker P, Bordekar A (2009). "Immunological and Clinical Consequences of Vasectomy*". Andrologia. 14 (1): 15–22. doi:10.1111/j.1439-0272.1982.tb03089.x. PMID 7039414. S2CID 10468133.
  7. ^ Deshpande RB, Deshpande J, Mali BN, Kinare SG (1985). "Vasitis nodosa (a report of 7 cases)". J Postgrad Med. 31 (2): 105–8. PMID 4057111.
  8. ^ Hirschowitz L, Rode J, Guillebaud J, Bounds W, Moss E (1988). "Vasitis nodosa and associated clinical findings". Journal of Clinical Pathology. 41 (4): 419–423. doi:10.1136/jcp.41.4.419. PMC 1141468. PMID 3366928.
  9. ^ a b c Christiansen C, Sandlow J (2003). "Testicular Pain Following Vasectomy: A Review of Post vasectomy Pain Syndrome". Journal of Andrology. 24 (3): 293–8. doi:10.1002/j.1939-4640.2003.tb02675.x. PMID 12721203.
  10. ^ a b Griffin T, Tooher R, Nowakowski K, Lloyd M, Maddern G (2005). "How Little is Enough? The Evidence for Post-Vasectomy Testing". The Journal of Urology. 174 (1): 29–36. doi:10.1097/01.ju.0000161595.82642.fc. PMID 15947571.
  11. ^ a b Nevill et al (2013) Surveillance of surgical site infection post vasectomy. Journal of Infection Prevention. January 2013. Vol 14(1) [1]
  12. ^ a b c Leslie TA, Illing RO, Cranston DW, et al. (2007). "The incidence of chronic scrotal pain after vasectomy: a prospective audit". BJU Int. 100 (6): 1330–3. doi:10.1111/j.1464-410X.2007.07128.x. PMID 17850378. S2CID 23328539.
  13. ^ "Is it possible to have my entire vas deferens removed? - Vasectomy Questions & Answers | Vasectomy.com". www.vasectomy.com.
  14. ^ Christensen RE, Maples DC (2005). "Postvasectomy Semen Analysis: Are Men Following Up?". The Journal of the American Board of Family Medicine. 18 (1): 44–47. doi:10.3122/jabfm.18.1.44. PMID 15709063.
  15. ^ Klotz KL, Coppola MA, Labrecque M, Brugh Vm VM, Ramsey K, Kim Ka, Conaway MR, Howards SS, Flickinger CJ, Herr JC (2008). "Clinical and Consumer Trial Performance of a Sensitive Immunodiagnostic Home Test That Qualitatively Detects Low Concentrations of Sperm Following Vasectomy". The Journal of Urology. 180 (6): 2569–2576. doi:10.1016/j.juro.2008.08.045. PMC 2657845. PMID 18930494.
  16. ^ Philp T, Guillebaud J, Budd D (1984). "Late failure of vasectomy after two documented analyses showing azoospermic semen". BMJ. 289 (6437): 77–79. doi:10.1136/bmj.289.6437.77. PMC 1441962. PMID 6428685.
  17. ^ a b Rolnick HC (1924). "Regeneration of the Vas Deferens". Archives of Surgery. 9: 188. doi:10.1001/archsurg.1924.01120070191008.
  18. ^ Royal College of Obstetricians and Gynaecologists. "Sterilisation for women and men: what you need to know". Archived from the original on 4 January 2011. Retrieved 31 January 2011.
  19. ^ Yang F, Li J, Dong L, Tan K, Huang X, Zhang P, Liu X, Chang D, Yu X (2021). "Review of Vasectomy Complications and Safety Concerns". The World Journal of Men's Health. 39 (3): 406–418. doi:10.5534/wjmh.200073. ISSN 2287-4208. PMC 8255399. PMID 32777870.
  20. ^ Schwingl PJ, Guess HA (2000). "Safety and effectiveness of vasectomy". Fertility and Sterility. 73 (5): 923–936. CiteSeerX 10.1.1.494.1247. doi:10.1016/S0015-0282(00)00482-9. PMID 10785217.
  21. ^ "AUA Responds to Study Linking Vasectomy with Prostate Cancer". American Urological Association. Archived from the original on 31 March 2016. Retrieved 19 March 2016.
  22. ^ Bhindi B, Wallis CJ, Nayan M, Farrell AM, Trost LW, Hamilton RJ, Kulkarni GS, Finelli A, Fleshner NE, Boorjian SA, Karnes RJ (17 July 2017). "The Association Between Vasectomy and Prostate Cancer: A Systematic Review and Meta-analysis". JAMA Internal Medicine. 177 (9): 1273–1286. doi:10.1001/jamainternmed.2017.2791. PMC 5710573. PMID 28715534.
  23. ^ Husby A, Wohlfahrt J, Melbye M (1 January 2020). "Vasectomy and Prostate Cancer Risk: A 38-Year Nationwide Cohort Study". Journal of the National Cancer Institute. 112 (1): 71–77. doi:10.1093/jnci/djz099. ISSN 1460-2105. PMID 31119294.
  24. ^ Cheng S, Yang B, Xu L, Zheng Q, Ding G, Li G (9 August 2020). "Vasectomy and prostate cancer risk: a meta-analysis of prospective studies". Carcinogenesis. 42 (1): 31–37. doi:10.1093/carcin/bgaa086. ISSN 1460-2180. PMID 32772072.
  25. ^ Seikkula H, Kaipia A, Hirvonen E, Rantanen M, Pitkäniemi J, Malila N, Boström PJ (February 2020). "Vasectomy and the risk of prostate cancer in a Finnish nationwide population-based cohort". Cancer Epidemiology. 64: 101631. doi:10.1016/j.canep.2019.101631. ISSN 1877-783X. PMID 31760357. S2CID 208276171.
  26. ^ Xu Y, Li L, Yang W, Zhang K, Ma K, Xie H, Zhou J, Cai L, Gong Y, Zhang Z, Gong K (29 April 2021). "Association between vasectomy and risk of prostate cancer: a meta-analysis". Prostate Cancer and Prostatic Diseases. 24 (4): 962–975. doi:10.1038/s41391-021-00368-7. ISSN 1476-5608. PMID 33927357. S2CID 233458537.
  27. ^ Nangia AK, Myles JL, Thomas Aj AJ (2000). "Vasectomy Reversal for the Post-Vasectomy Pain Syndrome: : A Clinical and Histological Evaluation". The Journal of Urology. 164 (6): 1939–1942. doi:10.1016/S0022-5347(05)66923-6. PMID 11061886.
  28. ^ "Vasectomy Guideline - American Urological Association". www.auanet.org.
  29. ^ THONNEAU P, D'ISLE, BÉATRICE (1990). "Does vasectomy have long-term effects on somatic and psychological health status?". International Journal of Andrology. 13 (6): 419–432. doi:10.1111/j.1365-2605.1990.tb01050.x. PMID 2096110.
  30. ^ Labrecque M, Paunescu, Cristina, Plesu, Ioana, Stacey, Dawn, Légaré, France (2010). "Evaluation of the effect of a patient decision aid about vasectomy on the decision-making process: a randomized trial". Contraception. 82 (6): 556–562. doi:10.1016/j.contraception.2010.05.003. PMID 21074020.
  31. ^ a b Köhler TS, Fazili AA, Brannigan RE (August 2009). "Putative health risks associated with vasectomy". Urol. Clin. North Am. 36 (3): 337–45. doi:10.1016/j.ucl.2009.05.004. PMID 19643236.
  32. ^ POTTS J, PASQUALOTTO, F.F., NELSON, D., THOMAS, A.J., AGARWAL, A. (June 1999). "Patient Characteristics Associated with Vasectomy Reversal" (PDF). The Journal of Urology. 161 (6): 1835–1839. doi:10.1016/S0022-5347(05)68819-2. PMID 10332448. Archived from the original (PDF) on 3 March 2021. Retrieved 28 January 2014.
  33. ^ a b Dohle GR, Diemer T, Kopa Z, Krausz C, Giwercman A, Jungwirth A, European Association of Urology Working Group on Male Infertility (January 2012). "European Association of Urology guidelines on vasectomy". European Urology. 61 (1): 159–163. doi:10.1016/j.eururo.2011.10.001. ISSN 1873-7560. PMID 22033172.
  34. ^ Köhler T, Choy J, Fazili A, Koenig J, Brannigan R (November 2012). "A critical analysis of the reported association between vasectomy and frontotemporal dementia". Asian J Androl. 14 (6): 903–4. doi:10.1038/aja.2012.94. PMC 3720109. PMID 23064682.
  35. ^ a b Rogalski E, Weintraub S, Mesulam MM (2013). "Are there susceptibility factors for primary progressive aphasia?". Brain Lang. 127 (2): 135–8. doi:10.1016/j.bandl.2013.02.004. PMC 3740011. PMID 23489582.
  36. ^ a b Cook LA, Pun A, Gallo MF, Lopez LM, Van Vliet HA (30 March 2014). "Scalpel versus no-scalpel incision for vasectomy". The Cochrane Database of Systematic Reviews. 2014 (3): CD004112. doi:10.1002/14651858.CD004112.pub4. PMC 6464377. PMID 24683021.
  37. ^ a b Cook LA, Van Vliet HA, Lopez LM, Pun A, Gallo MF (2014). Cook LA (ed.). "Vasectomy occlusion techniques for male sterilization". Cochrane Database of Systematic Reviews. 2014 (2): CD003991. doi:10.1002/14651858.CD003991.pub4. PMC 7173716. PMID 24683020.
  38. ^ webmaster@vasectomy-information.com (14 September 2007). "Recanalization of the vas deferens". Vasectomy-information.com. Archived from the original on 4 January 2012. Retrieved 28 December 2011.
  39. ^ Sokal D, Irsula B, Hays M, Chen-Mok M, Barone MA, Investigator Study G (2004). "Vasectomy by ligation and excision, with or without fascial interposition: a randomized controlled trial ISRCTN77781689". BMC Medicine. 2 (1): 6. doi:10.1186/1741-7015-2-6. PMC 406425. PMID 15056388. {{cite journal}}: |first6= has generic name (help) Open access icon
  40. ^ a b Weiss RS, Li PS (2005). "No-needle jet anesthetic technique for no-scalpel vasectomy". The Journal of Urology. 173 (5): 1677–80. doi:10.1097/01.ju.0000154698.03817.d4. PMID 15821547. S2CID 13097425.
  41. ^ Weiss RS, Li PS (May 2005). "No-needle jet anesthetic technique for no-scalpel vasectomy". The Journal of Urology. 173 (5): 1677–1680. doi:10.1097/01.ju.0000154698.03817.d4. ISSN 0022-5347. PMID 15821547.
  42. ^ Barolet D, Benohanian A (1 May 2018). "Current trends in needle-free jet injection: an update". Clinical, Cosmetic and Investigational Dermatology. 11: 231–238. doi:10.2147/CCID.S162724. PMC 5936486. PMID 29750049.
  43. ^ Sharlip ID, Belker AM, Honig S, Labrecque M, Marmar JL, Ross LS, Sandlow JI, Sokal DC (December 2012). "Vasectomy: AUA guideline". The Journal of Urology. 188 (6 Suppl): 2482–91. doi:10.1016/j.juro.2012.09.080. PMID 23098786.
  44. ^ Moss WM (December 1992). "A comparison of open-end versus closed-end vasectomies: a report on 6220 cases". Contraception. 46 (6): 521–5. doi:10.1016/0010-7824(92)90116-B. PMID 1493712.
  45. ^ Shapiro EI, Silber, SJ (November 1979). "Open-ended vasectomy, sperm granuloma, and postvasectomy orchialgia". Fertility and Sterility. 32 (5): 546–50. doi:10.1016/S0015-0282(16)44357-8. PMID 499585.
  46. ^ Levine LA, Abern MR, Lux MM (2006). "Persistent motile sperm after ligation band vasectomy". The Journal of Urology. 176 (5): 2146–8. doi:10.1016/j.juro.2006.07.028. PMID 17070280.
  47. ^ "Male Contraception Update for the public - August 2008, 3(8)". Imccoalition.org. Archived from the original on 27 March 2012. Retrieved 28 December 2011.
  48. ^ a b "VasClip". www.vasweb.com. Archived from the original on 19 October 2011.
  49. ^ "Injected plugs". MaleContraceptives.org. 27 July 2011. Retrieved 28 December 2011.
  50. ^ "Intra Vas Device (IVD)". MaleContraceptives.org. Retrieved 28 December 2011.
  51. ^ Cook LA, Van Vliet HA, Lopez LM, Pun A, Gallo MF (30 March 2014). "Vasectomy occlusion techniques for male sterilization". The Cochrane Database of Systematic Reviews. 2014 (3): CD003991. doi:10.1002/14651858.CD003991.pub4. PMC 7173716. PMID 24683020.
  52. ^ Healthwise Staff (13 May 2010). "Vasectomy Procedure, Effects, Risks, Effectiveness, and More". webmd.com. Retrieved 29 March 2012.
  53. ^ "Post Vasectomy Semen Analysis". Cambridge IVF. Archived from the original on 26 February 2021. Retrieved 23 October 2015.
  54. ^ "Vasectomy". University of Miami Health System, Miller School of Medicine. Retrieved 28 December 2019.
  55. ^ Murphy, Clare. "Divorce fuels vasectomy reversals", BBC News, 18 March 2009. Retrieved 19 September 2012.
  56. ^ Klein A (20 June 2019). "I.V.F. is Expensive. Here's How to Bring Down the Cost". The New York Times. Retrieved 8 July 2021.
  57. ^ Shridharani A, Sandlow JI (2010). "Vasectomy reversal versus IVF with sperm retrieval: which is better?". Current Opinion in Urology. 20 (6): 503–509. doi:10.1097/MOU.0b013e32833f1b35. PMID 20852426. S2CID 42105503.
  58. ^ "About Vasectomy Reversal". Professor Earl Owen's homepage. Archived from the original on 6 December 2007. Retrieved 29 November 2007.
  59. ^ Owen ER (1977). "Microsurgical vasovasostomy: a reliable vasectomy reversal". Urology. 167 (2 Pt 2): 1205. doi:10.1016/S0022-5347(02)80388-3. PMID 11905902.
  60. ^ Vasectomy Reversal http://www.epigee.org/guide/vasectomy_reversal.html
  61. ^ "Vasectomy reversal: first cut isn't final". The Independent. 29 March 2009. Retrieved 28 June 2023.
  62. ^ a b Sukcharoen N, Ngeamvijawat J, Sithipravej T, Promviengchai S (2003). "High sex chromosome aneuploidy and diploidy rate of epididymal spermatozoa in obstructive azoospermic men". Journal of Assisted Reproduction and Genetics. 20 (5): 196–203. doi:10.1023/A:1023674110940. PMC 3455301. PMID 12812463.
  63. ^ Abdelmassih V, Balmaceda JP, Tesarik J, Abdelmassih R, Nagy ZP (2002). "Relationship between time period after vasectomy and the reproductive capacity of sperm obtained by epididymal aspiration". Human Reproduction. 17 (3): 736–740. doi:10.1093/humrep/17.3.736. PMID 11870128.
  64. ^ Horovitz D (February 2012). "Vasectomy reversal provides long-term pain relief for men with the post-vasectomy pain syndrome". Journal of Urology. 187 (2): 613–7. doi:10.1016/j.juro.2011.10.023. PMID 22177173.
  65. ^ a b c d Jacobstein R (December 2015). "The kindest cut: global need to increase vasectomy availability". The Lancet. Global Health. 3 (12): e733–734. doi:10.1016/S2214-109X(15)00168-0. ISSN 2214-109X. PMID 26545447.
  66. ^ "Contraceptive Use 2011". UN Department of Economic and Social Affairs, Population Division, 2012. Archived from the original on 28 September 2014. Retrieved 8 October 2017.
  67. ^ a b Shih G, Turok DK, Parker WJ (April 2011). "Vasectomy: the other (better) form of sterilization". Contraception. 83 (4): 310–5. doi:10.1016/j.contraception.2010.08.019. PMID 21397087.[permanent dead link]
  68. ^ Sneyd MJ, Cox, Brian, Paul, Charlotte, Skegg, David C.G. (2001). "High prevalence of vasectomy in New Zealand". Contraception. 64 (3): 155–159. doi:10.1016/S0010-7824(01)00242-6. PMID 11704094.
  69. ^ Pile JM, Barone, Mark A. (2009). "Demographics of Vasectomy—USA and International". Urologic Clinics of North America. 36 (3): 295–305. doi:10.1016/j.ucl.2009.05.006. PMID 19643232.
  70. ^ a b c Drake M, Mills I, Cranston D (1999). "On the chequered history of vasectomy". BJU International. 84 (4): 475–481. doi:10.1046/j.1464-410x.1999.00206.x. PMID 10468765. S2CID 20563820.
  71. ^ a b c d Leavesley JH (1980). "Brief history of vasectomy". Family Planning Information Service. 1 (5): 2–3. PMID 12336890.
  72. ^ AJ O (1969). "Surgical Treatment of Habitual Criminals". Buck V Bell Documents.
  73. ^ Carlson EA (2011). "The Hoosier Connection: Compulsory Sterilization as Moral Hygiene". In Lombardo PA (ed.). A Century of Eugenics in America: From the Indiana Experiment to the Human Genome Era. Indiana University Press. p. 19. ISBN 978-0-253-22269-5.
  74. ^ Reilly P (1991). The Surgical Solution: A History of Involuntary Sterilization in the United States. Johns Hopkins University Press. pp. 30–33.
  75. ^ a b Schultheiss D, Engel RM (1 November 2003). "G. Frank Lydston (1858–1923) revisited: androgen therapy by testicular implantation in the early twentieth century". World Journal of Urology. 21 (5): 356–363. doi:10.1007/s00345-003-0370-z. ISSN 0724-4983. PMID 14586546. S2CID 12706657.
  76. ^ Ellmann R (9 May 1985). "Yeats's Second Puberty". The New York Review of Books. 32 (8). Retrieved 23 August 2017.
  77. ^ McLaren A (9 March 2012). Reproduction by Design: Sex, Robots, Trees, and Test-Tube Babies in Interwar Britain. University of Chicago Press. ISBN 978-0-226-56069-4.
  78. ^ Sharma S (April–June 2014). "A Study of Male Sterilization with No Scalpel Vasectomy" (PDF). JK Science. 16 (2): 67. Retrieved 23 October 2015.
  79. ^ Dean A. Hendrickson, A. N. Baird (5 June 2013). Turner and McIlwraith's Techniques in Large Animal Surgery. John Wiley & Sons. p. 541. ISBN 978-1-118-68404-7.
  80. ^ Latham M (2002). Regulating Reproduction: A Century of Conflict in Britain and France. Manchester University Press. ISBN 978-0-7190-5699-4.
  81. ^ "Where Can I Buy a Vasectomy & How Much Will It Cost?". Planned Parenthood. Retrieved 30 June 2022.
  82. ^ "My husband would like to get a vasectomy but when I checked with our insurer, they told me that the plan would cover my sterilization without cost sharing but we would have to pay part of the costs for his procedure. What is the reason for that?". Kaiser Family Foundation. 15 July 2020. Retrieved 30 June 2022.
  83. ^ Moghtader M (11 August 2014). "Iranian parliament bans vasectomies in bid to boost birth rate". Reuters. Retrieved 15 July 2018.
  84. ^ Haelle T. "Vasectomies Are Becoming Popular in a Post-Roe World". Scientific American. Retrieved 30 October 2024.
  85. ^ Lunt N, Carrera P (2010). "Medical tourism: Assessing the evidence on treatment abroad". Maturitas. 66 (1): 27–32. doi:10.1016/j.maturitas.2010.01.017. PMID 20185254.
  86. ^ "'I could look down the barrel of the gun. I could see the worm of the gun.' - RTÉ Radio 1 Highlights".
  87. ^ Jarlath Regan (26 May 2019). "Dr. Andrew Rynne". An Irishman Abroad (Podcast) (297 ed.). SoundCloud. Archived from the original on 27 May 2019. Retrieved 27 May 2019.
[edit]
Retrieved from "https://en.wikipedia.org/w/index.php?title=Vasectomy&oldid=1254422049"