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Encyclopedia > Vasectomy
Vasectomy
Background
B.C. type Sterilization
First use 1897 (experiments from 1785)[1]
Failure rates (first year)
Perfect use <0.1%
Typical use 0.15%
Usage
Duration effect Permanent
Reversibility Often, but not always
User reminders Additional methods required until 2 negative semen samples. Almost all failures are due to disregarding this instruction.
Clinic review None
Advantages and Disadvantages
STD protection No
Benefits Local anesthetic to the scrotum and vasa deferentia by needle or jet injection, as opposed to general anesthesia usually needed for female sterilization.
Risks Risk of chronic pain, incidence and severity is widely debated.

Vasectomy is a surgical procedure in which the vasa deferentia of a male mammal are cut for the purpose of sterilization. There are some variations on the procedure such as no-scalpel (keyhole) vasectomies, [2] in which a surgical hook, rather than a scalpel, is used to enter the scrotum. Sterilization is a surgical technique leaving a male or female unable to procreate. ... The vas deferens (plural: vasa deferentia), also called ductus deferens, (Latin: carrying-away vessel) is part of the male anatomy of some species, including humans. ... Sterilization is a surgical technique leaving a male or female unable to procreate. ...


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. Some studies find that sexual desire (libido) is unaffected in over 90% of vasectomized men [3] whereas other studies find higher rates of diminished sexual desire. [4] The sperm-filled fluid from the testes contributes about 10% to the volume of an ejaculation (in men who are not vasectomized) and does not significantly affect the appearance, texture, or taste of the ejaculate[citation needed]. Leydig cells, also known as interstitial cells of Leydig, are found adjacent to the seminiferous tubules in the testes. ... Testosterone is a steroid hormone from the androgen group. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... For other uses, see Libido (disambiguation). ...


When the vasectomy is complete, sperm can no longer exit the body through the penis. They are 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 macrophages and re-absorbed via the blood stream. Sperm is matured in the epididymis for about a month once it leaves the testicles. Approximately 50% of the sperm produced never make it to ejaculation in a non-vasectomized man. After vasectomy, the membranes increase in size to absorb more fluid, and more macrophages are recruited to break down and re-absorb more of the solid content. The fraction of sperms that exceed the digestive capabilities of macrophages exit into the scrotum as sperm granulomas. The penis (plural penises, penes) is an external male sexual organ. ... Male Anatomy The epididymis is part of the human male reproductive system and is present in all male mammals. ... Macrophages (Greek: big eaters) are cells found in tissues that are responsible for phagocytosis of pathogens, dead cells and cellular debris. ... Macrophages (Greek: big eaters) are cells found in tissues that are responsible for phagocytosis of pathogens, dead cells and cellular debris. ... A sperm granuloma is a lump of extravasated sperm that appears along the vasa deferentia or epididymides in vasectomized men. ...

Contents

Effectiveness

Early failure rates, i.e. pregnancy within a few months after vasectomy, are below 1%, but the effectiveness of the operation and rates of complications vary with the level of experience of the surgeon performing the operation and the surgical technique used.


Although late failure, i.e. pregnancy after recanalization of the vasa deferentia, is very rare, it has been documented.[5]


Popularity

How popular vasectomy is as a birth control method varies by age and nationality[citation needed]. Men in their mid 30s to mid 40s are most likely to have a vasectomy[citation needed].


Compared to tubal ligations

The rate of vasectomies to tubal ligations worldwide is extremely variable, and the statistics are mostly based on questionnaire studies rather than actual counts of procedures performed. In the U.S. in 2005, the CDC published state by state details of birth control usage by method and age group.[6] Overall, tubal ligation is ahead of vasectomy but not by a large factor. In Britain vasectomy is more popular than tubal ligation, though this statistic may be as a result of the data-gathering methodology. Couples who opt for tubal ligation do so for a number of reasons, including: The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ...

  • Convenience of coupling the procedure with delivery at a hospital
  • Fear of side effects in the man
  • Fear of surgery in the man

Couples who choose vasectomy are motivated by, among other factors:[7]

  • The lower cost of vasectomy
  • The simplicity of the surgical procedure
  • The lower mortality of vasectomy
  • Fear of surgery in the woman

Complications

Short-term complications include temporary bruising and bleeding, known as hematoma. The primary long-term complication is a permanent feeling of pain - chronic post-vasectomy Pain. A bruise or contusion or ecchymoses is a kind of injury, usually caused by blunt impact, in which the capillaries are damaged, allowing blood to seep into the surrounding tissue. ... For other uses, see Bleeding (disambiguation). ... Hematoma on thigh, 6 days after a fall down stairs, 150ml of blood drained a few days later A hematoma, or haematoma, is a collection of blood, generally the result of hemorrhage, or, more specifically, internal bleeding. ... Post-Vasectomy Pain Syndrome (PVPS, PVP, CPTP, CPVSP) is a chronic pain condition, marked by severe and unremitting pain, that affects between 5% to 33% of vasectomized men. ...


Animal and human data indicate that vasectomy does not increase atherosclerosis and that increases in circulating immune complexes after vasectomy are transient. Furthermore, the weight of the evidence regarding prostate and testicular cancer suggests that men with vasectomy are not at increased risk of these cancers.[8]


Post-Vasectomy Pain Syndrome

Post-Vasectomy Pain Syndrome (PVPS), genital pain of varying intensity that may last for a lifetime, is estimated to appear in between 5% and 33% of vasectomized men, depending on the severity of pain that qualifies for the particular study[9] [10] [11] [12] In one study, vasectomy reversal was found to be 69% effective for reducing the symptoms of chronic post-vasectomy pain. Treatment options for 31% of patients whose pain did not respond to vasectomy reversal were limited. The study was very small, only evaluating 13 patients, making it difficult to draw solid conclusions. [13] In severe cases orchiectomy has been resorted to. [14] Post-Vasectomy Pain Syndrome (PVPS, PVP, CPTP, CPVSP) is a chronic pain condition, marked by severe and unremitting pain, that affects between 5% to 33% of vasectomized men. ... Orchiectomy is the surgical removal of one or both testicles. ...


Possible Vasectomy-Dementia Link

Researchers reported in February 2007 that a survey of a small number of men with a rare form of dementia found that more than twice as many as would be expected had undergone vasectomies. The study has not yet been verified by other researchers, and the authors say larger studies are needed to better understand the issue.[15]


Reversal

Although men considering vasectomies should not think of them as reversible, and most men and their spouses are satisfied with the operation, [16][17][18] there is a procedure to reverse vasectomies using vasovasostomy (a form of microsurgery first performed by Earl Owen in 1971[19][20]). Vasovasostomy is effective at achieving pregnancy in only 50%-70% of cases, and it is very costly, with total out-of-pocket costs in the United States ranging from $7,000 [21] to more than $35,000[citation needed]. The rate of pregnancy depends on such factors as the method used for the vasectomy and the length of time that has passed since the vasectomy was performed. The reversal procedures are frequently impermanent, with occlusion of the vas recurring two or more years after the operation. Sperm counts are rarely at pre-vasectomy levels. There is evidence that men who have had a vasectomy may produce more abnormal sperm, which would explain why even a mechanically successful reversal does not always restore fertility.[22][23] A reversible process (or reversible cycle if the process is cyclic) , in thermodynamics, is a process that can be reversed by means of infinitesimal changes in some property of the system (Sears and Salinger, 1986). ... Vasovasostomy (literally connection of the vas to the vas) is the surgery by which vasectomies are reversed in males. ... Microsurgery is a type of surgery where an operation microscope is required in order to perform opératoire precision acts. ... This article is about human pregnancy in biological females. ... A term indicating that the state of something, which is normally open, is now totally closed. ...


In order to allow a possibility of reproduction (via artificial insemination) after vasectomy, some men opt for cryostorage of sperm before sterilization, and some experts advise that this be done before vasectomy.[24] AIH redirects here. ... Cryopreservation, also cryogenically freeze, is a process where cells or whole tissues are preserved by cooling to low sub-zero temperatures, such as (typically) -80°C or -196°C (the boiling point of liquid nitrogen). ...


Various reversible male contraceptives are in research and development, but none are available. Many of these involve the implantation of micro-valves[citation needed]. Male Contraceptive Male contraception refers to the process of inhibiting fertilization of the egg with the sperm using methods that deal solely (or primarily) with procedures applied to the male partner. ... The phrase research and development (also R and D or, more often, R&D), according to the Organization of Economic Cooperation and Development, refers to creative work undertaken on a systematic basis in order to increase the stock of knowledge, including knowledge of man, culture and society, and the use...


Availability

  • In the UK vasectomy is often available free of charge through the National Health Service upon referral by one's GP. However, some PCTs do not fund the procedure. There are private clinics (such as Marie Stopes International) who perform the operation with short waiting times.

NHS redirects here. ... A general practitioner (GP), family physician or family practitioner (FP) is a medical doctor who provides primary care. ... National Health Service Trusts (NHS Trusts) provide many services of the United Kingdom National Health Service in England and Wales. ... Marie Stopes (October 15, 1880 - October 2, 1958) was a Scottish author, campaigner for womens rights and pioneer in the field of family planning. ...

See also

Sterilization is a surgical technique leaving a male or female unable to procreate. ... Tubal ligation (informally known as getting ones tubes tied) is a permanent form of female sterilization, in which the fallopian tubes are severed and sealed or pinched shut, in order to prevent fertilization. ...

References

  1. ^ Paul Popenoe (1934). "The Progress of Eugenic Sterilization". Journal of Heredity 25:1: 19. 
  2. ^ "No-scalpel vasectomies by skilled surgeons may speed recovery", EurekaAert, April 18 2007. Retrieved on 2007-04-18. 
  3. ^ Nielsen CM, Genster HG (1980). "Male sterilization with vasectomy. The effect of the operation on sex life.". Ugeskr Laeger 142 (10): 641-643. PMID 7368333. 
  4. ^ Dias PL (1983). "The long-term effects of vasectomy on sexual behavior.". Acta Psychiatr Scand. 67 (5): 333-338. PMID 6869041. 
  5. ^ Philp, T; Guillebaud et al (1984). "Late failure of vasectomy after two documented analyses showing azoospermic semen". British Medical Journal (Clinical Research Ed.) 289 (6437): 77–79. PMID 6428685. 
  6. ^ Bensyl, D.M. and Iuliano, D. and Carter, M. and Santelli, J. and Gilbert, B.C. (November 2005). "Contraceptive Use — United States and Territories, Behavioral Risk Factor Surveillance System, 2002". Morbidity and Mortality Weekly Report 54 (SS06): 1-72. Retrieved on 2006-05-05. 
  7. ^ William R. Finger (Spring 1998). "Attracting Men to Vasectomy". Network 18 (3). Retrieved on 2006-05-05. 
  8. ^ Pamela J. Schwingl, Ph.D., and Harry A. Guess, M.D. (2000). "Safety and effectiveness of vasectomy". Fertility and Sterility 73 (5): 923–936. 
  9. ^ Ahmed I, Rasheed S, White C, Shaikh N. "The incidence of post-vasectomy chronic testicular pain and the role of nerve stripping (denervation) of the spermatic cord in its management." British Journal of Urology. 1997; 79:269-270. PMID 9052481
  10. ^ Choe J, Kirkemo A. "Questionnaire-based outcomes study of nononcological post-vasectomy complications." The Journal of Urology. 1996; 155:1284-1286. PMID 8632554
  11. ^ McMahon A, Buckley J, Taylor A, Lloyd S, Deane R, Kirk D. "Chronic testicular pain following vasectomy." British Journal of Urology. 1992;69:188-191. PMID 1537032
  12. ^ Leslie TA, Illing RO, Cranston DW, Guillebaud J. "The incidence of chronic scrotal pain after vasectomy: a prospective audit." BJU International. 2007. PMID 17850378
  13. ^ JK Nangia, JL Myles and AJ JR Thomas (December 2000). "Vasectomy reversal for the post-vasectomy pain syndrome: a clinical and histological evaluation.". Journal of Urology 164 (6): 1939-1942. doi:10.1016/S0022-5347(05)66923-6. PMID 11061886. Retrieved on 2007-05-16. 
  14. ^ Granitsiotis P, Kirk D. "Chronic testicular pain: an overview." European Urology. 2005;47(5)720. PMID 15041105
  15. ^ Salynn Boyles (February 2007). "Study Suggests Vasectomy-Dementia Link". WebMD Medical News. 
  16. ^ Turek P, "Minimally Invasive Reproductive Urology: The No-Scalpel Vasectomy." University of California-San Francisco. http://urology.ucsf.edu/patientGuides/pdf/maleInf/Vasectomy.pdf
  17. ^ Evelyn Landry and Victoria Ward (1997). "Perspectives from Couples on the Vasectomy Decision: A Six-Country Study". Reproductive Health Matters (special issue): 58–67. 
  18. ^ Denise J. Jamieson et al (2002). "A Comparison of Women’s Regret After Vasectomy Versus Tubal Sterilization". Obstetrics & Gynecology 99 (6): 1073–1079. PMID 12052602. 
  19. ^ About Vasectomy Reversal. Professor Earl Owen's homepage. Retrieved on 2007-11-29.
  20. ^ Owen ER (1977). "Microsurgical vasovasostomy: a reliable vasectomy reversal". Urology. PMID 11905902. }
  21. ^ Vasectomy Reversal Cost and Payment Plans http://www.vasectomyinfo.com/vasectomy_reversal_costs.html
  22. ^ Nares Sukcharoen, Jiraporn Ngeamvijawat, Tippawan Sithipravej and Sakchai Promviengchai (May 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. Retrieved on 2006-07-18. 
  23. ^ Vicente Abdelmassih, Jose P. Balmaceda, Jan Tesarik, Roger Abdelmassih and Zsolt P. Nagy (March 2002). "Relationship between time period after vasectomy and the reproductive capacity of sperm obtained by epididymal aspiration". Human Reproduction 17 (3): 736-740. PMID 11870128. Retrieved on 2006-07-18. 
  24. ^ "Men advised to freeze sperm before vasectomy", Reuters.com, Reuters news agency, June 21, 2006. Retrieved on 2006-07-18. 

Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 108th day of the year (109th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 125th day of the year (126th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 125th day of the year (126th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 136th day of the year (137th in leap years) in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ... is the 333rd day of the year (334th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 199th day of the year (200th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 199th day of the year (200th in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 199th day of the year (200th in leap years) in the Gregorian calendar. ...

External links


  Results from FactBites:
 
Vasectomy and Cancer Risk - National Cancer Institute (649 words)
Some studies have raised questions about a possible relationship between vasectomy (an operation to cut or tie off the two tubes that carry sperm out of the testicles) and the risk of developing cancer, particularly prostate and testicular cancer.
A few studies have suggested a link between vasectomy and an increased risk of testicular cancer, but the evidence is inconsistent and the association in some studies may be due to factors other than vasectomy.
Vasectomy and the risk of prostate cancer: A meta-analysis examining vasectomy status, age at vasectomy, and time since vasectomy.
NICHD - Publications On-line (2148 words)
All vasectomy techniques involve cutting or otherwise blocking both the left and right vas deferens, so the man's ejaculate will no longer contain sperm, and he will not be able to make a woman pregnant.
In a no-scalpel vasectomy, the doctor feels for the vas under the skin of the scrotum and holds it in place with a small clamp.
Vasectomy reversal is not warranted to prevent prostate cancer, and screening for prostate cancer should not be any different for men who have had a vasectomy than for those who have not undergone the procedure.
  More results at FactBites »

 
 

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