21. Vasectomy Techniques - July 1999 - American Academy Of Family Physicians shown to be effective and to cause few postoperative complications in a The vas after vasectomy comparison of cauterization techniques. urology 1992;4046870 http://www.aafp.org/afp/990700ap/137.html

Advanced Search Vasectomy Techniques TIMOTHY L. CLENNEY, LCDR, MC, USN, and JAMES C. HIGGINS, CDR, MC, USN Naval Hospital Jacksonville, Florida A patient information handout on vasectomy, written by the authors of this article, is provided on page 151. Vasectomy can be performed by means of various techniques, although each vasectomy technique requires isolation and division of the vas and operative management of the vasal ends. Removal of at least 15 mm of vas is recommended, although division of the vas without removal of a segment is effective when this technique is combined with other techniques for handling the vasal ends, such as thermal luminal fulguration and proximal fascial interposition. Ligation of the ends without the aid of surgical clips may result in necrosis and sloughing of the ends, which may cause early failure. Leaving the testicular end of the vas open has been shown to be effective and to result in a lower incidence of epididymal congestion and sperm granuloma. The no-scalpel technique offers shorter operating time, less pain and swelling, and faster recovery. (Am Fam Physician 1999;60:137-52.) V asectomy is among the most reliable and cost-effective methods of contraception. Family physicians perform approximately 15 percent of the estimated 500,000 vasectomies performed each year in the United States.

22. Letters To The Editor - January 15, 2000 - American Academy Of Family Physicians urology 1992;4046870. 2 No-scalpel vasectomy has several advantages over traditional vasectomy techniques that include fewer complications, an improved http://www.aafp.org/afp/20000115/letters.html

Advanced Search Letters to the Editor Comments on Vasectomy Closure Techniques TO THE EDITOR: We found the article "Vasectomy Techniques" to be an excellent review by Drs. Clenney and Higgins. In their description of scrotal incision closure, the authors state that "the incision is closed with absorbable suture." No reference or alternate techniques are offered. Leaving the scrotal incision open or briefly clamping the scrotal incision may be a superior technique. A Medline search (1966 to 1999) provided no comparisons of scrotal closure techniques. However, Campbell's Urology states, "Suture closure of the scrotal wounds is optional. Leaving the small incision open helps prevent hematoma formation. The wound seals itself in 24 hours." Additionally, an unpublished review of scrotal closure practices in one community hospital showed no statistical difference and a very low complication rate with all three techniques. This review included approximately 150 patients in whom the scrotal incision was left open, 500 in whom scrotal incisions were clamped and 900 in whom scrotal incisions were closed with suture. Leaving the incision open requires no special treatment other than the normal postoperative scrotal support. The "clamp technique" involves approximating the scrotal incision with the "first click" of a hemostat to lightly approximate the skin for five minutes. These two techniques would save suture cost and time, especially if suture is not required in another part of the procedure.

23. Virtual Hospital: Department Of Urology: Fact Sheet: Vasectomy Reversal check to be sure there are no complications, and then We perform vasectomy reversals on a regular basis at the See related Patient Textbooks about urology. http://www.vh.org/adult/patient/urology/vasectomyreversal/

For Patients Vasectomy Reversal Jay Sandlow, M.D. Department of Urology University of Iowa Hospitals and Clinics Creation Date: August 2001 Last Revision Date: August 2001 Peer Review Status: Internally Peer Reviewed *Currently Associate Professor and Vice Chair, Medical College of Wisconsin, Department of Urology Vasovasostomy Vasoepididymostomy Introduction Vasectomy is currently one of the most common methods of birth control in the United States. However, circumstances occasionally arise in which a couple wishes to have a child of their own after the male has had a vasectomy. Because of the greater availability of assisted reproductive techniques, as well as improvements in microsurgical techniques, a greater number of couples can now conceive a child of their own following vasectomy. The following is a brief overview of the evaluation, success rates, and costs of a vasectomy reversal. There are two types of reversal, depending upon the level of obstruction in the male reproductive tract. Vasovasostomy involves re-connecting the two ends of the vas deferens back together, whereas vasoepididymostomy connects the epididymis to the vas deferens. The decision of which to perform is made at the time of surgery, depending upon the surgical findings. It is partially related to the length of time since the vasectomy, since a longer period of time can cause a secondary obstruction in the epididymis. Evaluation The initial evaluation consists of a thorough history and physical, in order to identify any concurrent conditions that may also lead to fertility problems. This would include the male's partner as well, since a woman with significant fertility problems would need to be evaluated prior to performing a vasectomy reversal. Important information for the history would include the date of the vasectomy, a copy of the operative report if available, any medical conditions, medications, or previous surgeries. It is also beneficial to identify any problems that may have occurred following the vasectomy procedure. The physical exam consists of a general exam, as well as a detailed genital exam to assess the condition of the vas deferens. We do not routinely check any blood tests or a semen analysis unless there are specific reasons for which to do so.

24. Urology At UT Southwestern hematoma) and infections are the most common complications. there are alternatives to vasectomy reversal, but about the Department of urology, contact Phone http://www2.utsouthwestern.edu/urology/pt_vasec.htm

25. Vasectomy The complications of vasectomy are (1) bleeding, (2) infection Physicians in the Department of urology at UCLA that perform the vasectomy procedure are http://www.urology.medsch.ucla.edu/vasectomy.htm

ABOUT THE VASECTOMY PROCEDURE A vasectomy is a surgical procedure whereby each tube ( vas deferens ) that transports the sperm from the testicle to the urethra (the channel in the penis where the sperm and urine come out) is cut and tied off. This prevents the sperm from being transported to the outside during sexual intercourse. Although it is possible to reconnect the two ends of the severed vas at a later date, we advise all patients that a vasectomy should be contemplated only by those patients (and couples) who desire a permanent and irreversible form of male contraception. The vasectomy procedure is performed in the office. In the office, the patient is placed on an examination table lying face up, and the scrotum is cleansed with an antiseptic solution. Novacaine (a local anesthetic) is injected into the scrotal skin and the vas is grasped, exposed, cut and then tied off. A specimen of each vas is sent to the laboratory for pathology confirmation. The tied ends of the vas are allowed to fall back into the sac and the skin is closed with sutures that fade away and do not require removal at a later date. The procedure is performed on each of the two tubes. After the procedure, a dressing is applied and the patient removes this dressing the following day. The patient is able to get off the examination table himself and is able to walk to his car. A family member should accompany the patient in order to drive him home. At home, the patient help relieve any discomfort as long as he feels it is necessary. The patient may go back to work the next day but should not do any heavy lifting or straining for at least fo

26. The Patient's Guide To Vasectomy Reversal Postoperative complications that require prompt attention are wound Linnet L. Clinical immunology of vasectomy and vasovasostomy. urology 1983;2210114. http://cpmcnet.columbia.edu/dept/urology/vasrev.html

The Patient's Guide to Vasectomy Reversal The Patient's Guide to Vasectomy Reversal has been written to assist men who want to restore their fertility through vasectomy reversal surgery. In practice, I have treated many individuals who have successfully undergone vasectomy reversal surgery and while each case is unique, I have found similar questions and concerns. The purpose of the Patient's Guide to Vasectomy Reversal is to familiarize men with the procedures that are involved, from the initial examination through surgery and the post-operative period, to help lessen the apprehension that can accompany the decision process. This guide is designed in a simple question and answer format to address particular concerns, as well as to expand on other issues that also need to bb understood before proceeding with a vasectomy reversal. Harry Fisch, MD Table of Contents The Basics 1. What is a vasectomy? 2. What is a vasectomy reversal? 3. What are the success rates associated with vasectomy reversal? 4. Is vasectomy reversal a common procedure? ... 7. Does health insurance cover vasectomy reversal? The Specifics of Microsurgery 8.How have microsurgical techniques improved results of vasectomy reversal?

27. EngenderHealth Update has several advantages over traditional vasectomy it is painful, heals more quickly, and has fewer complications. October 1998 issue of urology provides the http://www.engenderhealth.org/pubs/avscnews/wn98/935-nsv.html

Advanced Search Tips Home Our Publications ... EngenderHealth Update Article from the AVSC News archive Study Shows Many U.S. Doctors Now Use NSV Jeanne M. Haws In 1985, AVSC International staff traveled to China to learn about a new vasectomy technique, developed by Dr. Li Shunqiang. This "no-scalpel vasectomy" (NSV) technique has several advantages over traditional vasectomy: it is less invasive, less painful, heals more quickly, and has fewer complications. In 1988, AVSC pioneered the introduction of NSV in the United States. Now an article in the October 1998 issue of Urology provides the first-ever estimate of the extent to which physicians adopted this surgical technique: within 10 years of its introduction in the U.S., NSV accounted for approximately 29% of the vasectomies performed annually nationwide. The article reports on a 1995 study of 1,800 family physicians, general surgeons, and urologists about their practice of vasectomy. The study was conducted jointly by AVSC, the Tulane University School of Public Health and Tropical Medicine, and the U.S. Centers for Disease Control and Prevention. According to the study, approximately 494,000 vasectomies were performed by 15,800 physicians in the U.S. in 1995. About 76% of all vasectomies were performed by urologists, 15% by family physicians, and 9% by general surgeons.

28. Postgraduate Medicine: Vasectomy urology 1998;52(4)68591; Raspa RF. complications of vasectomy. Am Fam Physician 1993;48(7)1264-8; Stockton MD, Davis LE, Bolton KM. http://www.postgradmed.com/issues/2000/08_00/greek.htm

Procedures in Primary Care Vasectomy A safe, effective, economical means of sterilization Greg Greek, MD VOL 108 / NO 2 / AUGUST 2000 / POSTGRADUATE MEDICINE CME learning objectives To appreciate the value of careful patient counseling before vasectomy To review a simple technique To be aware of the potential complications The author discloses no financial interests in this article. Ninth in a series of articles on office procedures coordinated by David A. Driggers, MD, faculty member of the Alaska Family Practice Residency Program, Anchorage, and Roger A. Schauer, MD, director of predoctoral medical education in family medicine and associate professor of family medicine, University of North Dakota School of Medicine, Grand Forks. Preview : Vasectomy is a cost-effective, safe method of contraception with a low failure rate and few complications. Men who request permanent sterilization should be offered vasectomy, but not before thorough counseling about the procedure and its benefits and potential complications. Dr Greek describes the simple vasectomy technique he uses and discusses preoperative and postoperative concerns. Greek G. Vasectomy: a safe, effective, and economical means of sterilization. Postgrad Med 2000;108(2):173-9

29. Vasectomy are possible. • Though rare, bleeding (hematoma) and infections are the most common complications of vasectomy. Noscalpel vasectomy http://www.clevelandclinic.org/urology/patients/infertility/vasectomy.htm

Infertility Sperm Bank Reproductive Research Center Information provided by: Jeannette M. Potts, M.D. Cleveland Clinic Foundation Glickman Urological Institute Safe, Effective Birth Control Vasectomy is one of the safest and most effective methods of permanent birth control. It is much safer and less expensive than the other most common contraceptive surgery, tubal ligation. For these reasons, some 500,000 men in North America choose vasectomy each year. No-Scalpel Vasectomy Benefits of NSV No-scalpel vasectomy uses an advanced technique to anesthetize the scrotum more effectively. It requires no scalpel. Instead, the physician avoids complex surgery by carefully isolating the vas deferens using the fingers of one hand. The vas deferens are then fixed just below the scrotal skin with an instrument designed to hold firmly without pinching. A single small opening in the skin is made with a pointed forceps. The vasa are then delivered through the skin, cut, and sealed in a conventional way. When the operation is complete, no sutures are needed to close the tiny opening.

30. Shands HealthCare Vasectomy Information Postoperative effect The patient heals quickly and complications or failures are rare. vasectomy causes no change in sexual performance, but the semen no http://www.shands.org/find/service/urology/vasectomy.htm

urology circumcision erection problems hematuria ... urologic evaluations Vasectomy Postoperative effect The patient heals quickly and complications or failures are rare. Vasectomy causes no change in sexual performance, but the semen no longer carries sperm, which are reabsorbed in each testis. No-scalpel vasectomy Reversal surgery Although vasectomy is intended as a permanent form of male sterilization, it is sometimes possible to reverse the process surgically several years after the original operation. Information For more information or to schedule an appointment, please call the UF Division of Urologic Surgery at (352) 392-2501 or the Shands HealthCare Consultation Center at (800) 749-7424 or (352) 265-8000. home doctors' offices hospitals jobs at shands ... FAQ search medical services find a healthcare professional clinical trials

31. Vasectomy - Vasectomy Reversals - Vascenter frequently asked questions (FAQ’s) to expected costs and complications. will be tailored to help women evaluate vasectomy and other urology procedures. http://www.vascenter.com/

Vasectomy Vasectomy questions? VasCenter.com can provide you with all the information you need to make an educated decision about vasectomy. It is important that your vasectomy is performed by an experienced urologist. In some areas vasectomies are performed by family practitioners and general surgeons who don't have as much training in this surgical procedure and may not know how to take care of complications, should they arise. Our Find A Doctor service will help you locate a urologist in your area. The failure rate of birth control pill is up to 30 per 1000. The failure rate of tubal ligation is up to 4 per 1000. The failure rate of vasectomy is only 1 to 3 per 1000. The cost of birth control pill averages $30 per month. If you are paying for this out of pocket, that is significant, especially considering that vasectomy is usually covered by insurance. If it is not covered, paying out of pocket for vasectomy pays for itself in eighteen to twenty-one months. Vasectomy is a procedure that can be done in the office under local anesthesia, but tubal ligation requires the woman to be hospitalized and is done under general or spinal anesthesia, therefore it is much easier for the man to undergo vasectomy than it is for the woman to undergo tubal ligation.

32. Worldbook Medical Encyclopedia > Vaccination - Vulvovaginitis > Vasectomy pathology procedure complications reco http//www.yoursurgery.com/data/Procedures/vasectomy/p_vasectomy.htm. 10. Southwest urology vasectomy, Prostate http://www.s-books.com/wbmedical/33575/33600/1.htm

Worldbook Medical Encyclopedia Vaccination - Vulvovaginitis Vasectomy Vasectomy Search the Web with All Surfable Books World Book Encyclopedia 2000 World Book Medical Encyclopedia Geography History Humanities Industry and Technology Life Science Physical Science and Math Recreation Social Science Documents 1 - 10 of 13 on the subject : Vasectomy Public Educational Sources News and Magazines Encyclopedias Vasectomy WHO/FHE/FPP/94.3 Rev.1 Vasectomy: What health workers need to know Department of Reproductive Health and Research World Health Organization 1994 © World Health Organization, 1999. This document is issued by the World Health Organization (WHO) for ge http://www.who.int/rht/documents/FPP94-3/fpp943.htm Sci.Electronics.Repair FAQ: Notes on the Troubleshooting and Repair of Audio Equipment and Other Miscellaneous Stuf Bulletin Boards http://www.student.io.tudelft.nl/io113177/F_audiofaq.html Sci.Electronics.Repair FAQ: Notes on the Troubleshooting and Repair of Audio Equipment and Other Miscellaneous Stuff Listings http://www.repairfaq.org/REPAIR/whole/F_audiofaq.html

33. Published Physician Abstracts On Vasectomy British Journal of urology, Volume 79, 269270. Questionnaire-based outcomes study of nononcological post-vasectomy complications. J Urol. 1551284-6. http://physicians.vasclip.com/Webpage.asp?MID=681286

34. Prostatitis Website -- Vasectomy Page vasectomy has several known potential complications, including hematomas in 1985, noted Dr. Allen Seftel, an associate professor of urology at Case http://www.prostatitis.org/vasectomy.html

Home Causes of prostatitis Drainage in Prostatitis Methods of treatment ... Archive Vasectomy Many patients report that their chronic prostatitis problems began after they had a vasectomy. Doctors and scientists have not provided any evidence which firmly disproves or proves that vasectomy can lead to chronic prostatitis. As is usual with issues unresolved by science, we're not going to tell you what to think, but just present the several arguments and let you make up your own mind. This file contains a number of newsgroup comments and private e-mails on the topic. Most of the names and e-mail addresses have been removed. Webmaster I've been suffering with pain and a "non bacterial" prostatitis diagnosis for 5 years now, following a painful vasectomy. I too have had a vasectomy, but I had my first run-ins with prostatitis before the vasectomy. I date my chronic prostatitis (continuous symptoms for 9 years now) to the time I was catheterized for unrelated back surgery. I think the catheter introduced drug-resistant, hospital-bred bacteria into my prostate. But who can prove such a thing? My feeling is, with millions of men have vasectomies, and millions of men having prostatitis, there will be many cases of both whether prostatitis is causative or not.

35. Marin Urology Unanswered Questions penis head; chlamydia testing at urology clinic and oxalaterich foods; 3 weeks after vasectomy; urethral stricture; post prostatectomy complications; Blood in urine http://www.greenspun.com/bboard/q-and-a-unanswered.tcl?topic=Marin Urology

36. Marin Urology Top Level Problems Pissing; post colon surgery urology complications; injured nerve; Small Stable chlamydia testing at urology clinic? vasectomy; Trying to get the connection http://www.greenspun.com/bboard/q-and-a.tcl?topic=Marin Urology

37. Vasectomies Not Necessarily As Permanent As You Might Think Although complications such as swelling, bruising, inflammation, and infection you may have about vasectomy or vasectomy reversal procedures Journal of urology. http://www.meridianhealth.com/index.cfm/MediaRelations/News/MensHealth/vasectomy

Public Events Health News Breaking News Breast Health ... Press Releases Men's Health Vasectomies - Not Necessarily As Permanent As You Might Think An Oregon urologist contends in a new study that men can successfully reverse vasectomies more than 15 years after the original operation. Some physicians have thought the success rate of reversals declined significantly over time, and some patients wanting to have children were forced to turn to in-vitro fertilization. However, Dr. Eugene Fuchs, a urologist at Oregon Health Sciences University, found half of his patients with old vasectomies were able to impregnate their wives the old-fashioned way. "They do have a realistic chance of fathering a biological child," says Dr. Larry Lipshultz, professor of urology at Baylor College of Medicine. In a vasectomy, a physician snips the vas deferens, the tube that carries sperm to the urethra, and then seals off the two ends. Various methods are used for the sealing process; physicians use stainless steel clips or sutures. No one knows how many vasectomies are performed in the United States each year, Lipshultz says. Some estimate the number near 500,000.

38. Vasectomy And Prostate Cancer and vasectomy reversal procedure including its risks and complications. Robotic Prostate Surgery, Robot Prostate Cancer Treatment, urology and vasectomy http://www.gday-mate.com/prostate_cancer/vasectomy_and_prostate_cancer.htm

Home prostate cancer symptom scale vasectomy and prostate cancer The best information on vasectomy and prostate cancer can be found at these sites http://www.ottawa-vas.com/prostate.htm 8 No Link Between Vasectomy And Prostate Cancer ... No Link Between Vasectomy And Prostate Cancer SEATTLE, WA December ... who did not have prostate cancer. The prevalence of vasectomy was almost the same ... between undergoing a vasectomy and developing prostate cancer. Brawer noted that ... SEATTLE, WA December 30, 1999 A study by Northwest Hospital urologist Michael K. Brawer M.D. finds that undergoing a vasectomy does not increase a man's risk of developing prostate cancer. The study was published in volume eight of the journal Cancer... http://www.pslgroup.com/dg/1541a6.htm HealthScout-Vasectomy's Link to Prostate Cancer Debunked ... Vasectomy's Link to Prostate ... Cancer Debunked ... vasectomy find themselves ... prostate cancer ... and prostate cancer. In the newest ... s highest vasectomy ... TUESDAY, June 18 (HealthScoutNews) A new study should put to rest any worries that men who get a vasectomy find themselves at a greater risk for... http://www.vasectomy-information.com/pages/prostatedebunk.htm

39. Links Page Lots of information on fertility, infertility, vasectomy and reversal, and much more. CORNELL urology NSV, LONG TERM complications, POSTvasectomy-PAIN.COM, http://www.vasectomy-information.com/links/

Useful links Please help us by submitting any links you find whilst surfing the net that you feel are useful. We do check each link that is submitted, also we attempt to regularly check that the links featured here are still available. What we are looking for are quality information sites. Sites do not have to be specifically vasectomy sites - we also feature general men's health sites of interest. We will feature sites that mutually "Trade links" with us also. What we do not want to feature are advertising sites, or pornographic sites. To email your links to our webmaster CLICK HERE VISITORS SUBMITTED LINKS ORGANISATIONS PROMOTING BIRTH CONTROL ONLINE MEDICAL JOURNALS ... MEN'S HEALTH SITES A flag beside a link indicates that the link's content is particularly applicable to that country Organisations promoting birth control MARIE STOPES UK based international charity promoting all methods of birth control PLANNED PARENTHOOD US organisation advising on birth control VASECTOMY SUPPORT FOUNDATION, Inc. "Eliminating Financial Barriers to Vasectomy". Florida based organisation who will find low or no cost providors in your area. Back to top Online Medical Journals Search the National Library of Medicine database for published journal extracts and study abstracts from the worlds most respected medical journals. Has related links to clinical trials, and the NLM gateway.

40. Open-ended Vasectomy: Improved Reversibility With Less Chance Of Chronic Pain at least 20,000 men in the US suffer painful complications from vasectomy 9. Linnet L, Clinical immunology of vasectomy and vasovasectomy urology 1983;22 http://www.vasectomy-information.com/pages/oevas.htm

Open-ended Vasectomy: Improved Reversibility with Less Chance of Chronic Pain A Literature Study by Kenneth D. Reda Introduction Problems with the Traditional Vasectomy Open-Ended Vasectomy Research Results Open-Ended Vasectomy Technique ... References Introduction: When I was considering vasectomy, I discovered that there is an option to either close both ends of the cut vas (traditional method), or leave the testicular end open (the open-ended method). If you read the relevant literature, you will find the latter procedure leaves the testicles relatively unaffected with improved reversibility and less chance of long term chronic pain. This option is seldom discussed despite a large body of strong evidence that indicates it should be the preferred technique. (Please see the American Family Physician's July '99 Article on Vasectomy Technique .) If you are planning to get a vasectomy, ask your doctor to do it "open-ended". Top Problems with the Traditional Vasectomy: Blocking the normal exit of sperm in a vasectomy can cause pain for a number of reasons: 1) elevated pressure within your testes, 2) swelling (i.e.dilation of seminiferous tubules) 3) thickening sperm debris and 4) interstitial fibrosis. Reversal becomes less successful with time as conditions foster potentially painful complications. In the words of the inventor of the method, "The success rate of reversal after standard vasectomy decreases with time because the rise in pressure produces leaks of sperm in the epididymus resulting in granulomas that obstruct it so that no sperm reaches the vas."(Dr. Edward Shapiro, personal communication, 1999) Please also see Professor Earl Owens'

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