The effects of vasectomy on the reproductive organs in various species are controversial. This study investigated the morphological change and apoptosis of the testis, epididymis, and vas deferens in beagle dogs 12 mo...The effects of vasectomy on the reproductive organs in various species are controversial. This study investigated the morphological change and apoptosis of the testis, epididymis, and vas deferens in beagle dogs 12 months after vasectomy. The male beagles were divided into two groups: vasectomized and sham-operated groups (n=5 in each). Histopathological, ultrastructural, and TUNEL evaluation of the changes in the testis, epididymis, and ductus deferens of each animal were conducted 12 months after surgery. The mean lumen diameter, cellular thickness, mean interstitial distance, and lumen area fraction of each seminiferous tubule and ductus epididymis were measured by stereological analysis. The results showed that, compared with the sham-operated group, the seminiferous tubular epithelial cells of the testes in the vasectomized group were disorderly arranged and scattered. Significant atrophy and apoptosis were found in the endothelial cells, and a range of ultrastructural variations were observed in the cells of testes, epididymis, and vas deferens in vasectomized group. It was concluded that complete obstruction of the vas deferens as a traditional contraception method is not absolutely safe in terms of the reversal of fertility in the long run. Techniques of relieving the inner pressure in the vas deferens while maintaining the efficacy of male contraception need to be explored.展开更多
Objective:Evaluate the influence of fellowship training,resident participation,reconstruction type,and patient factors on outcomes after vasectomy reversals in a high volume,open access system.Methods:Retrospective re...Objective:Evaluate the influence of fellowship training,resident participation,reconstruction type,and patient factors on outcomes after vasectomy reversals in a high volume,open access system.Methods:Retrospective review of all vasectomy reversals performed at a single institution from January 1,2002 to December 31,2016 was conducted.Patient and spouse demographics,patient tobacco use and comorbidities,surgeon training and case volume,resident participation,reconstruction type,and postoperative patency were collected and analyzed.Results:Five hundred and twenty-six vasectomy reversals were performed during the study period.Follow-up was available in 80.6%of the cohort and overall patency,regardless of reconstruction type was 88.7%.The mean time to reversal was 7.87 years(range of 0-34 years).The majority of cases included resident participation.Case volume was high with faculty and residents logging a mean of 37.0 and 38.7(median 18 and 37)cases respectively.Bilateral vasovasostomy was the most common reconstruction type(83%)and demonstrated a significantly better patency rate(89%)than all other reconstructions(p=0.0008).Overall patency and patency by reconstruction type were not statistically different among faculty surgeons and were not impacted by fertility fellowship training,resident participation or postgraduate year.Multivariate analysis demonstrated that increased time to reversal and repeat reconstructions had a negative impact on patency(p=0.0023 and p=0.043,respectively).Conclusions:Surgeons with a high volume of vasectomy reversals have outcomes consistent with contemporary series regardless of fellowship training in fertility.Patency was better for bilateral vasovasostomies.Patency was not negatively impacted by tobacco use,comorbidities,resident participation,or post-graduate year.展开更多
Objective - The effects of vasectomy on testes and related structures are disputable. The aim of this study was to determine whether the reproductive organs of rabbits were influenced after 12 months vasectomy. Study ...Objective - The effects of vasectomy on testes and related structures are disputable. The aim of this study was to determine whether the reproductive organs of rabbits were influenced after 12 months vasectomy. Study design – Bilateral vasectomy was performed on 10 male adult New Zealand Big Eared White Rabbits (another 10 rabbits set as sham operated group) and tissue samples were examined by light microscopy after 12 months treatment. The histologic alterations were observed and analyzed by stereology method. Cell apoptosis by Terminal Deoxynucleotidyl Transferase Mediated dUTP Nick End Labeling (TUNEL) assay were employed. Result - Bilateral vasectomy for 12 months affected the morphology of testis, epididymis and vas deferens tissues. Significant changes were noted in the histological stereology analysis. The apoptosis of the cells on the testis, epididymis and vas deferens increased compared with the sham operated group. Conclusion - Our findings suggest that the reproductive tissues of rabbits were influenced in a relatively longer term vasectomy.展开更多
This review highlights the evaluation and treatment of men who have undergone vasectomy and desire vasectomy reversal to father children. For surgeons offering this treatment, the appropriate evaluation and treatment ...This review highlights the evaluation and treatment of men who have undergone vasectomy and desire vasectomy reversal to father children. For surgeons offering this treatment, the appropriate evaluation and treatment are crucial for acceptable outcomes. Although variations on surgical approaches have evolved over the years, one constant is the need for a high level o training and skill in microsurgical techniques.展开更多
Background and aims:Indonesian government is regulating a family planning program to restricted fertility among reproductive aged.However,participated of married male for using contraceptive is very lowest in Indonesi...Background and aims:Indonesian government is regulating a family planning program to restricted fertility among reproductive aged.However,participated of married male for using contraceptive is very lowest in Indonesia.Methods:A cross-sectional study was conducted among 168 of married male(84 of condom method and 84 of vasectomy method)from April to August 2019 in Jember regency of East Java,Indonesia using purposive sampling method.A self-administered questionnaire was used to measure sociodemographic and contraceptive method of participants.Chi square test was performed to analyze the differences of characteristic of contraceptive method of condom and vasectomy among married male(P<0.05).Results:There were a significant differenced ethnic(χ^2=7.664,P-value=0.006)and access of information(χ^2=8.111,P-value=0.044)between condom and vasectomy method among married male.Conclusion:Characteristics of ethnic and access information are related with contraceptive method choosing for using condom and vasectomy among married male in Indonesia.Therefore,accessibility of contraceptive method through health education should be implemented for married male in Indonesia setting regarding their social and cultural context.展开更多
Vasectomy is a practical and straightforward approach to birth control.This paper presented a 31-year-old patient who desired to restore his fertility five years after being vasectomized.He met several obstacles.He de...Vasectomy is a practical and straightforward approach to birth control.This paper presented a 31-year-old patient who desired to restore his fertility five years after being vasectomized.He met several obstacles.He developed severe psychological distress with symptoms of stress,anxiety,and aggression.He underwent microsurgical vasovasostomy,and vassal patency was confirmed by return of spermatozoa in semen samples 6 and 10 weeks after surgery,and symptoms of psychological distress disappeared.Preoperative vasectomy counseling should include information about vasectomy reversal.At the most,vasectomy reversal can be considered in selected men with psychological problems due to vasectomy.Microsurgical training should be offered to more urological surgeons,especially those who are interested in andrology.展开更多
To date,there is little information about the demography of vasectomy reversal(VR)patients or the factors currently influencing VR effectiveness in China,especially after the universal two-child policy was released in...To date,there is little information about the demography of vasectomy reversal(VR)patients or the factors currently influencing VR effectiveness in China,especially after the universal two-child policy was released in 2015.In this research,demographic data and perioperative medical records of VR patients were extracted from seven major hospitals in different provinces or municipalities of China.Meanwhile,a telephone survey of the patients was conducted to collect follow-up information.Eventually,448 VR cases from the past 13 years were included.The results were analyzed by stratified comparison to investigate factors that can influence postoperative vas deferens patency and pregnancy rate.Appropriately statistical methods were used,and all of the protocols were approved by the Ethics Committees of the institutes in this research.The results showed that the annual operation volume of VR quadrupled after the two-child policy was implemented.Nonmicrosurgery and a long duration of vasectomy were significantly associated with a lower patency rate.A follow-up survey showed that the general postoperative pregnancy rate was 27.2%.For female partners over the age of 35 years,the postoperative pregnancy rate showed a more severe decline,but only 35.5%of them had been given a fertility examination before their husbands’VR surgery.Our work revealed that more patients in China have been demanding VR in recent years.High-quality microsurgery and a short duration of vasectomy are crucial for restoring patency by VR.Clinical andrologists should perform a preoperative fertility evaluation of the patients’female partners.展开更多
Urologists perform the majority of vasectomies in the United States;however,family medicine physicians(FMPs)perform up to 35%.We hypothesized that d iff ere nces exist in practice patterns and outcomes between urologi...Urologists perform the majority of vasectomies in the United States;however,family medicine physicians(FMPs)perform up to 35%.We hypothesized that d iff ere nces exist in practice patterns and outcomes between urologists and FMPs.Patie nts who underwent a vasectomy from 2010 to 2016 were identified.Postvasectomy semen analysis(PVSA)practices were compared between urologists and FMPs,before and after release of the 2012 AUA vasectomy guidelines.From 2010 to 2016,FMPs performed 1435(35.1%)of all vasectomies.PVSA follow-up rates were similar between the two groups(63.4%vs 64.8%,P=0.18).Of the patients with follow-up,the median number of PVSAs obtained was 1(range 1-6)in both groups(P=0.22).Following the release of guidelines,fewer urologists obtained multiple PVSAs(69.8%vs 28.9%pre-and post-2012,P<0.01).FMPs had a significant but lesser change in the use of multiple PVSAs(47.5%vs 38.4%,P<0.01).Both groups made appropriate changes in the timing of the first PVSA,but FMPs continued to obtain PVSAs before 8 weeks(15.0%vs 6.5%,P<0.01).FMPs had a higher rate of positive results in PVSAs obtained after 8 weeks,the earliest recommended by the AUA guidelines(4.1%vs 1.3%,P<0.01).Significant differences in PVSA utilization between FMPs and urologists were identified and were impacted by the release of AUA guidelines in 2012.In summary,FMPs obtained multiple PVSAs more frequently and continued to obtain PVSAs prior to the 8-week recommendation,suggesting less penetration of AUA guidelines to nonurology specialties.Furthermore,FMPs had more positive results on PVSAs obtained within the recommended window.展开更多
基金supported by a grant from the 11th Five-year National Technology Research and Development Program of China(No. 2006BAI03B03)
文摘The effects of vasectomy on the reproductive organs in various species are controversial. This study investigated the morphological change and apoptosis of the testis, epididymis, and vas deferens in beagle dogs 12 months after vasectomy. The male beagles were divided into two groups: vasectomized and sham-operated groups (n=5 in each). Histopathological, ultrastructural, and TUNEL evaluation of the changes in the testis, epididymis, and ductus deferens of each animal were conducted 12 months after surgery. The mean lumen diameter, cellular thickness, mean interstitial distance, and lumen area fraction of each seminiferous tubule and ductus epididymis were measured by stereological analysis. The results showed that, compared with the sham-operated group, the seminiferous tubular epithelial cells of the testes in the vasectomized group were disorderly arranged and scattered. Significant atrophy and apoptosis were found in the endothelial cells, and a range of ultrastructural variations were observed in the cells of testes, epididymis, and vas deferens in vasectomized group. It was concluded that complete obstruction of the vas deferens as a traditional contraception method is not absolutely safe in terms of the reversal of fertility in the long run. Techniques of relieving the inner pressure in the vas deferens while maintaining the efficacy of male contraception need to be explored.
文摘Objective:Evaluate the influence of fellowship training,resident participation,reconstruction type,and patient factors on outcomes after vasectomy reversals in a high volume,open access system.Methods:Retrospective review of all vasectomy reversals performed at a single institution from January 1,2002 to December 31,2016 was conducted.Patient and spouse demographics,patient tobacco use and comorbidities,surgeon training and case volume,resident participation,reconstruction type,and postoperative patency were collected and analyzed.Results:Five hundred and twenty-six vasectomy reversals were performed during the study period.Follow-up was available in 80.6%of the cohort and overall patency,regardless of reconstruction type was 88.7%.The mean time to reversal was 7.87 years(range of 0-34 years).The majority of cases included resident participation.Case volume was high with faculty and residents logging a mean of 37.0 and 38.7(median 18 and 37)cases respectively.Bilateral vasovasostomy was the most common reconstruction type(83%)and demonstrated a significantly better patency rate(89%)than all other reconstructions(p=0.0008).Overall patency and patency by reconstruction type were not statistically different among faculty surgeons and were not impacted by fertility fellowship training,resident participation or postgraduate year.Multivariate analysis demonstrated that increased time to reversal and repeat reconstructions had a negative impact on patency(p=0.0023 and p=0.043,respectively).Conclusions:Surgeons with a high volume of vasectomy reversals have outcomes consistent with contemporary series regardless of fellowship training in fertility.Patency was better for bilateral vasovasostomies.Patency was not negatively impacted by tobacco use,comorbidities,resident participation,or post-graduate year.
文摘Objective - The effects of vasectomy on testes and related structures are disputable. The aim of this study was to determine whether the reproductive organs of rabbits were influenced after 12 months vasectomy. Study design – Bilateral vasectomy was performed on 10 male adult New Zealand Big Eared White Rabbits (another 10 rabbits set as sham operated group) and tissue samples were examined by light microscopy after 12 months treatment. The histologic alterations were observed and analyzed by stereology method. Cell apoptosis by Terminal Deoxynucleotidyl Transferase Mediated dUTP Nick End Labeling (TUNEL) assay were employed. Result - Bilateral vasectomy for 12 months affected the morphology of testis, epididymis and vas deferens tissues. Significant changes were noted in the histological stereology analysis. The apoptosis of the cells on the testis, epididymis and vas deferens increased compared with the sham operated group. Conclusion - Our findings suggest that the reproductive tissues of rabbits were influenced in a relatively longer term vasectomy.
文摘This review highlights the evaluation and treatment of men who have undergone vasectomy and desire vasectomy reversal to father children. For surgeons offering this treatment, the appropriate evaluation and treatment are crucial for acceptable outcomes. Although variations on surgical approaches have evolved over the years, one constant is the need for a high level o training and skill in microsurgical techniques.
文摘Background and aims:Indonesian government is regulating a family planning program to restricted fertility among reproductive aged.However,participated of married male for using contraceptive is very lowest in Indonesia.Methods:A cross-sectional study was conducted among 168 of married male(84 of condom method and 84 of vasectomy method)from April to August 2019 in Jember regency of East Java,Indonesia using purposive sampling method.A self-administered questionnaire was used to measure sociodemographic and contraceptive method of participants.Chi square test was performed to analyze the differences of characteristic of contraceptive method of condom and vasectomy among married male(P<0.05).Results:There were a significant differenced ethnic(χ^2=7.664,P-value=0.006)and access of information(χ^2=8.111,P-value=0.044)between condom and vasectomy method among married male.Conclusion:Characteristics of ethnic and access information are related with contraceptive method choosing for using condom and vasectomy among married male in Indonesia.Therefore,accessibility of contraceptive method through health education should be implemented for married male in Indonesia setting regarding their social and cultural context.
文摘Vasectomy is a practical and straightforward approach to birth control.This paper presented a 31-year-old patient who desired to restore his fertility five years after being vasectomized.He met several obstacles.He developed severe psychological distress with symptoms of stress,anxiety,and aggression.He underwent microsurgical vasovasostomy,and vassal patency was confirmed by return of spermatozoa in semen samples 6 and 10 weeks after surgery,and symptoms of psychological distress disappeared.Preoperative vasectomy counseling should include information about vasectomy reversal.At the most,vasectomy reversal can be considered in selected men with psychological problems due to vasectomy.Microsurgical training should be offered to more urological surgeons,especially those who are interested in andrology.
基金This work was supported by the Youth Foundation of First Hospital of Shanxi Medical University(grant No.YQ1304).
文摘To date,there is little information about the demography of vasectomy reversal(VR)patients or the factors currently influencing VR effectiveness in China,especially after the universal two-child policy was released in 2015.In this research,demographic data and perioperative medical records of VR patients were extracted from seven major hospitals in different provinces or municipalities of China.Meanwhile,a telephone survey of the patients was conducted to collect follow-up information.Eventually,448 VR cases from the past 13 years were included.The results were analyzed by stratified comparison to investigate factors that can influence postoperative vas deferens patency and pregnancy rate.Appropriately statistical methods were used,and all of the protocols were approved by the Ethics Committees of the institutes in this research.The results showed that the annual operation volume of VR quadrupled after the two-child policy was implemented.Nonmicrosurgery and a long duration of vasectomy were significantly associated with a lower patency rate.A follow-up survey showed that the general postoperative pregnancy rate was 27.2%.For female partners over the age of 35 years,the postoperative pregnancy rate showed a more severe decline,but only 35.5%of them had been given a fertility examination before their husbands’VR surgery.Our work revealed that more patients in China have been demanding VR in recent years.High-quality microsurgery and a short duration of vasectomy are crucial for restoring patency by VR.Clinical andrologists should perform a preoperative fertility evaluation of the patients’female partners.
文摘Urologists perform the majority of vasectomies in the United States;however,family medicine physicians(FMPs)perform up to 35%.We hypothesized that d iff ere nces exist in practice patterns and outcomes between urologists and FMPs.Patie nts who underwent a vasectomy from 2010 to 2016 were identified.Postvasectomy semen analysis(PVSA)practices were compared between urologists and FMPs,before and after release of the 2012 AUA vasectomy guidelines.From 2010 to 2016,FMPs performed 1435(35.1%)of all vasectomies.PVSA follow-up rates were similar between the two groups(63.4%vs 64.8%,P=0.18).Of the patients with follow-up,the median number of PVSAs obtained was 1(range 1-6)in both groups(P=0.22).Following the release of guidelines,fewer urologists obtained multiple PVSAs(69.8%vs 28.9%pre-and post-2012,P<0.01).FMPs had a significant but lesser change in the use of multiple PVSAs(47.5%vs 38.4%,P<0.01).Both groups made appropriate changes in the timing of the first PVSA,but FMPs continued to obtain PVSAs before 8 weeks(15.0%vs 6.5%,P<0.01).FMPs had a higher rate of positive results in PVSAs obtained after 8 weeks,the earliest recommended by the AUA guidelines(4.1%vs 1.3%,P<0.01).Significant differences in PVSA utilization between FMPs and urologists were identified and were impacted by the release of AUA guidelines in 2012.In summary,FMPs obtained multiple PVSAs more frequently and continued to obtain PVSAs prior to the 8-week recommendation,suggesting less penetration of AUA guidelines to nonurology specialties.Furthermore,FMPs had more positive results on PVSAs obtained within the recommended window.
