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Vasectomy

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1. Advantages of the no-scalpel vasectomy technique

Advantages of the no-scalpel vasectomy technique Advantages of the no-scalpel vasectomy technique Toggle navigation Shared more. Cited more. Safe forever. Toggle navigation View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Search MOspace This Collection Browse Statistics Advantages of the no-scalpel vasectomy technique View/ Open Date 2012-06 Format Metadata Abstract The no-scalpel vasectomy (NSV) technique should be used instead (...) of the standard incisional method. (Strength of Recommendation: A, based on systematic reviews, mixed-quality randomized controlled trials [RCTs], cohort studies, and case-control series.) The NSV technique is associated with fewer complications, produces less perioperative and postoperative pain, results in quicker recovery, takes less time to perform, and is as effective as standard incisional vasectomy. URI Citation American Family Physician 85 (12) 2012. Collections hosted by hosted by

2019 Clinical Inquiries

2. Advantages of the no-scalpel vasectomy technique

Advantages of the no-scalpel vasectomy technique Advantages of the no-scalpel vasectomy technique Toggle navigation Shared more. Cited more. Safe forever. Toggle navigation View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Search MOspace This Collection Browse Statistics Advantages of the no-scalpel vasectomy technique View/ Open Date 2012-06 Format Metadata Abstract The no-scalpel vasectomy (NSV) technique should be used instead (...) of the standard incisional method. (Strength of Recommendation: A, based on systematic reviews, mixed-quality randomized controlled trials [RCTs], cohort studies, and case-control series.) The NSV technique is associated with fewer complications, produces less perioperative and postoperative pain, results in quicker recovery, takes less time to perform, and is as effective as standard incisional vasectomy. URI Citation American Family Physician 85 (12) 2012. Collections hosted by hosted by

2019 Clinical Inquiries

4. Interim Clinical Commissioning Policy – Vasectomy

Interim Clinical Commissioning Policy – Vasectomy NHS England » Interim Clinical Commissioning Policy – Vasectomy Search Search Menu Interim Clinical Commissioning Policy – Vasectomy Document first published: 12 August 2019 Page updated: 12 August 2019 Topic: , , Publication type: This policy aims to ensure that male Armed Forces patients are able to access NHS vasectomy services wherever they live or receive their services in England. Document PDF 178 KB 17 pages

2019 NHS England

5. The effect of vasectomy reversal on prostate cancer risk: International meta-analysis of 684,660 men with vasectomies. (PubMed)

The effect of vasectomy reversal on prostate cancer risk: International meta-analysis of 684,660 men with vasectomies. Evidence of the effect of vasectomy on prostate cancer is conflicting with the issue of detection bias a key criticism. We examined the effect of vasectomy reversal on prostate cancer risk in a cohort of vasectomized men. Evidence of a protective effect would be consistent with a harmful effect of vasectomy on prostate cancer risk while nullifying the issue of detection (...) bias.Data were sourced from a total of 5 population level linked health databases in Australia, Canada and the United Kingdom. Cox proportional hazards regression analysis was used to compare the risk of prostate cancer in 9,754 men with vasectomy reversal to the risk in 684,660 with vasectomy but no reversal. Data from each jurisdiction were combined in a meta-analysis.The combined analysis showed no protective effect of vasectomy reversal on the incidence of prostate cancer compared to that in men

2018 Journal of Urology

6. CUA guideline: Vasectomy

CUA guideline: Vasectomy CUAJ • July-August 2016 • Volume 10, Issues 7-8 © 2016 Canadian Urological Association E274 GUIDELINE CUA guideline: Vasectomy Cite as: Can Urol Assoc J 2016;10(7-8):E274-8. http://dx.doi.org/10.5489/cuaj.4017 Published online August 16, 2016 Introduction Vasectomy is a safe and effective method of birth control. Although it is a simple elective procedure, vasectomy is associated with potential minor and major complications. The early failure rate of vasectomy (presence (...) of motile sperm in the ejaculate at 3–6 months post-vasectomy) is in the range of 0.3–9% and the late failure rate is in the range of 0.04–0.08%. The no-scalpel vasectomy technique is associ- ated with a lower risk of early postoperative complications and the use of cautery or fascial interposition will reduce the risk of contraceptive failure. As such, detailed preoperative counselling and careful assessment of the post-vasectomy ejaculate (for presence of sperm) is imperative. Failure to provide

2016 Canadian Urological Association

7. Vasectomy Practice Patterns among Family Medicine Physicians and Compliance with the AUA 2012 Vasectomy Guidelines. (PubMed)

Vasectomy Practice Patterns among Family Medicine Physicians and Compliance with the AUA 2012 Vasectomy Guidelines. To survey urologists and family medicine physicians (FMPs) within a single institution to determine current vasectomy practice patterns and determine compliance with 2012 American Urological Association (AUA) vasectomy guidelines.In 2016, a single-institution survey was conducted to understand the vasectomy practice patterns among urologists and nonurologists. The survey questions (...) and 3 clinical scenarios were designed based on the 2012 AUA vasectomy guidelines. Results of the survey were compiled between urologists and nonurologists and then compared with the guideline recommendations.A total of 23 FMPs and 6 urologists responded. Fewer prevasectomy counseling topics were discussed by FMPs compared with urologists. A variety of vasectomy techniques were used among FMPs. Vas deferens segments were more likely to be sent for histology by FMPs than urologists (65% vs 17%, P

2017 Urology

8. Vasectomy reversal for post-vasectomy pain syndrome (PubMed)

Vasectomy reversal for post-vasectomy pain syndrome Post-vasectomy pain syndrome (PVPS) is a rare, but devastating outcome following vasectomy. Given the widespread utilization of vasectomy for permanent contraception, with more than 500,000 procedures performed annually in the United States, it can be a significant challenge for both patients and providers. Vasectomy reversal is a surgical option for men who fail conservative or medical management. Despite improvements in technique, vasectomy (...) carries some inherent risks making pre-procedure counseling regarding the risks of PVPS paramount. Chronic post-operative pain, or PVPS, occurs in 1-2% of men undergoing the procedure. This review will examine the utility of vasectomy reversal as a means of addressing PVPS.

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2017 Translational andrology and urology

9. Scalpel versus no-scalpel incision for vasectomy. (PubMed)

Scalpel versus no-scalpel incision for vasectomy. Currently, the two most common surgical techniques for approaching the vas during vasectomy are the incisional method and the no-scalpel technique. Whereas the conventional incisional technique involves the use of a scalpel to make one or two incisions, the no-scalpel technique uses a sharp-pointed, forceps-like instrument to puncture the skin. The no-scalpel technique aims to reduce adverse events, especially bleeding, bruising, hematoma (...) with the no-scalpel technique (OR 0.23; 95% CI 0.15 to 0.36). Operations using the no-scalpel approach were faster and had a quicker resumption of sexual activity. The smaller study did not find these differences; however, the study could have failed to detect differences due to a small sample size as well as a high loss to follow up. Neither trial found differences in vasectomy effectiveness between the two approaches to the vas.The no-scalpel approach to the vas resulted in less bleeding, hematoma, infection

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2014 Cochrane

10. Vasectomy occlusion techniques for male sterilization. (PubMed)

Vasectomy occlusion techniques for male sterilization. Vasectomy is an increasingly popular and effective family planning method. A variety of vasectomy techniques are used worldwide, including vas occlusion techniques (excision and ligation, thermal or electrocautery, and mechanical and chemical occlusion methods), as well as vasectomy with vas irrigation or with fascial interposition. Vasectomy guidelines largely rely on information from observational studies. Ideally, the choice of vasectomy (...) techniques should be based on the evidence from randomized controlled trials (RCTs).The objective of this review was to compare the effectiveness, safety, acceptability and costs of vasectomy techniques for male sterilization.In February 2014, we updated the searches of CENTRAL, MEDLINE, POPLINE and LILACS. We looked for recent clinical trials in ClinicalTrials.gov and the International Clinical Trials Registry Platform. Previous searches also included EMBASE. For the initial review, we searched

2014 Cochrane

11. Original investigations into the clearance of spermatozoa after vasectomy. (PubMed)

Original investigations into the clearance of spermatozoa after vasectomy. "The urologist and patient, with the cooperation of the laboratory performing the sperm counts, can determine within a few days after operation that aspermia has been produced and that the procedure has been successful." -Freund M, Davis JE. Disappearance rate of spermatozoa from the ejaculate following vasectomy. Fertil Steril 1969;20:163-70.Copyright © 2018 American Society for Reproductive Medicine. Published

2019 Fertility and Sterility

12. Vasectomy and Prostate Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC)

Vasectomy and Prostate Cancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Purpose Vasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostate cancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostate cancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due (...) to prostate cancer. Patients and Methods A total of 84,753 men from the European Prospective Investigation into Cancer and Nutrition (EPIC), aged 35 to 79 years, provided information on vasectomy status (15% with vasectomy) at recruitment and were followed for incidence of prostate cancer and death. We estimated the association of vasectomy with prostate cancer risk overall, by tumor subtype, and for death due to prostate cancer, using multivariable-adjusted Cox proportional hazards models. Results During

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2017 EvidenceUpdates

13. Microsurgical vasectomy reversal: contemporary techniques, intraoperative decision making, and surgical training for the next generation. (PubMed)

Microsurgical vasectomy reversal: contemporary techniques, intraoperative decision making, and surgical training for the next generation. Men seeking fertility after elective sterilization can be treated with a wide array of interventions. Reconstruction of the reproductive tract remains the gold standard and most cost-effective option for the appropriately selected candidate. In the following review, the treatment algorithm for men desiring vasectomy reversal is outlined. Specifically

2019 Fertility and Sterility

14. Use of Office Versus Ambulatory Surgery Center Setting and Associated Ancillary Services on Healthcare Cost Burden for Vasectomy Procedures. (PubMed)

Use of Office Versus Ambulatory Surgery Center Setting and Associated Ancillary Services on Healthcare Cost Burden for Vasectomy Procedures. To analyze variation in total healthcare costs for vasectomies performed in the United States, based on procedure setting and use of ancillary pathology services.We queried the MarketScan Commercial Claims database using CPT, ICD, and HCPCS codes to identify men who underwent vasectomy between 2009-2015, either in the office or ambulatory surgical center (...) (ASC) setting, with or without use of pathology services. All payments for each treatment episode were calculated based on relevant claims. Patient out-of-pocket expenses were defined as the sum of co-payments, co-insurance and deductibles for each claim. Trends in vasectomy use, and differences in procedure costs by practice setting were compared over the study period.453,492 men underwent a vasectomy between 2009-2015. The number of procedures decreased from 76,197 in 2009 to 37,575 in 2015 (p

2019 Urology

15. Routine Prescription of Opioids for Post-vasectomy Pain Control Associated with Persistent Use. (PubMed)

Routine Prescription of Opioids for Post-vasectomy Pain Control Associated with Persistent Use. The AUA Position Statement on Opioid Use recommends using opioids only when necessary. We sought to determine if routine prescribing of opioids is necessary for pain control after vasectomy and if an association exists with persistent use.We performed a retrospective chart review of patients who underwent clinic vasectomy between April 2017 and March 2018. Patients were stratified into two groups (...) , those initially prescribed opioids and those not receiving opioid prescriptions at time of vasectomy. The initial pain medication regimen was dependent on each provider's standard prescription practices. Encounters with a medical provider for scrotal pain within 30 days, subsequent opioid prescriptions, and new persistent opioid prescriptions between 90-180 days were compared between the two groups using Fisher's exact test.Between April 2017 and March 2018, 228 patients underwent clinic vasectomy

2019 Journal of Urology

16. LEGAL REVIEW OF VASECTOMY LITIGATION AND THE VARIABLES IMPACTING TRIAL OUTCOMES. (PubMed)

LEGAL REVIEW OF VASECTOMY LITIGATION AND THE VARIABLES IMPACTING TRIAL OUTCOMES. To demonstrate the substantial litigious risks associated with vasectomy, a common urologic procedure. We examined the risk factors and types of negligence involved in vasectomy cases that go to trial and their associated outcomes.Using the Westlaw legal database, we searched all jury verdicts and settlements for the term "vasectomy" from January 1, 1990 to December 31, 2017. Each case was evaluated for defendant (...) to the perioperative aspects of vasectomy involve many areas of negligence. This data may guide vasectomists in where to focus time and communication to best serve patients and minimize litigation.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 Urology

17. Vasectomy and prostate cancer risk: a 38-year nationwide cohort study. (PubMed)

Vasectomy and prostate cancer risk: a 38-year nationwide cohort study. A man's risk of prostate cancer has been linked to his prior reproductive history, with low sperm quality, low ejaculation frequency, and a low number of offspring being associated with increased prostate cancer risk. It is however highly controversial whether vasectomy, a common sterilization procedure for men, influences prostate cancer risk.We established a cohort of all Danish men (born from 1937) and linked information (...) on vasectomy, doctor visits, socioeconomic factors and cancer from nationwide registries using unique personal identification numbers. Incidence risk ratios for prostate cancer by time since vasectomy and age at vasectomy during the follow-up were estimated using log-linear Poisson regression.Overall, 26,238 cases of prostate cancer occurred among 2,150,162 Danish men during 53.4 million person-years of follow-up. Overall, vasectomized men had an increased risk of prostate cancer compared with non

2019 Journal of the National Cancer Institute

18. Vasectomy

Vasectomy Vasectomy Guideline - American Urological Association advertisement Toggle navigation About Us About the AUA Membership AUA Governance Industry Relations Education AUAUniversity Education Products & Resources Normal Histology and Important Histo-anatomic Structures Urinary Bladder Prostate Kidney Renovascular Diseases Andrenal Gland Testis Paratesticular Tumors Penis Retroperitoneum Cytology Online Learning For Medical Students Exams/LLL/Certifications Exam Prep Research Research (...) and Reporting Patient Education Vasectomy Guideline (2015) Published 2012; Amended 2015 The purpose of this clinical guideline is to provide guidance to clinicians who offer vasectomy services. This guidance covers pre-operative evaluation and consultation of prospective vasectomy patients; techniques for local anesthesia, isolation of the vas deferens and occlusion of the vas deferens during vasectomy; post-operative follow-up; post-vasectomy semen analysis (PVSA) and potential complications

2015 American Urological Association

19. Use of secondary contraception following vasectomy: insights from the Pregnancy Risk Assessment Monitoring System, 2007–2011 (PubMed)

Use of secondary contraception following vasectomy: insights from the Pregnancy Risk Assessment Monitoring System, 2007–2011 To assess postpartum use of secondary contraception with vasectomy within Pregnancy Risk Assessment Monitoring System (PRAMS).Secondary contraception and type of method used were assessed among married women reporting partner vasectomy 4 months after a recent live birth in female residents of 15 US states and New York City who participated in the 2007-2011 PRAMS.Between (...) 2007 and 2011, 1,004 married women who had a recent live birth participating in PRAMS reported they and their partners relied on vasectomy for postpartum contraception. Among these couples, 57.8% reported not using additional forms of contraception postpartum. Of those reporting additional contraception, condoms were most commonly used (50.0%), followed by oral contraceptive pills (26.5%), and withdrawal (9.5%). Multivariable modeling showed that use of secondary contraception was twice as high

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2018 Translational andrology and urology

20. Microdenervation of the Spermatic Cord for Post Vasectomy Pain Syndrome. (PubMed)

Microdenervation of the Spermatic Cord for Post Vasectomy Pain Syndrome. To evaluate the outcomes of patients who underwent microdenervation of the spermatic cord (MDSC) for post-vasectomy pain syndrome (PVPS) at our institution.A retrospective study of all patients who underwent MDSC for PVPS by a single surgeon between March 2002 and October 2016 was performed. Pain was documented using the numerical rating scale (NRS). Spermatic cord block (SCB) was performed on all patients, and success

2018 BJU international

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