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Vasectomy Postoperative Counseling

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1. Vasectomy Postoperative Counseling

Vasectomy Postoperative Counseling Vasectomy Postoperative Counseling Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Vasectomy (...) Postoperative Counseling Vasectomy Postoperative Counseling Aka: Vasectomy Postoperative Counseling II. Management: Clinic Follow-up Postoperative Care Handout describing below Call patient to check on status on day 1 or 2 post-op III. Management: Analgesics Wear athletic supporter (jock strap) for first 3-4 days Medications (e.g. ) for daytime use Consider (e.g. ) for night pain IV. Management: Postoperative Activity Off Work for 1-3 days Day 1: Supine with ice on for 20 minutes/hour Day 2: Minimal

2018 FP Notebook

2. Vasectomy Counseling

Vasectomy Counseling Vasectomy Counseling Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Vasectomy Counseling Vasectomy Counseling (...) Aka: Vasectomy Counseling II. Indications All patients 2-4 weeks before procedure III. Risk factors: Regretting Vasectomy Age under 30 years (12.5 times more likely to request reversal) Few children (but men with no children are less likely to request reversal) Relationship not stable Religious affiliation prohibiting Pressure from partner to have procedure performed during time of personal crisis Lack of discussion with partner regarding Hope will solve sexual and marital problems High interest

2018 FP Notebook

3. CUA guideline: Vasectomy

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 (...) of spermatozoa in nearly 10% of ejaculates from men undergoing semen assessment prior to vasectomy reversal. 27 It is unlikely that the reappearance (or persistence) of immotile sperm years after vasectomy is of clinical sig- nificance, as this has not been associated with documented pregnancies. 28,29 4. Postoperative counselling After the vasectomy has been performed, men should be told to remain in the clinic for 15?20 minutes to be assessed for possible scrotal bleeding or vaso-vagal reaction. It may

2016 Canadian Urological Association

4. Vasectomy

and the criteria used to diagnose these conditions. Chronic scrotal pain associated with negative impact on quality of life occurs after vasectomy in about 1-2% of men. Few of these men require additional surgery. Other permanent and non-permanent alternatives to vasectomy are available. 3. Clinicians do not need to routinely discuss prostate cancer, coronary heart disease, stroke, hypertension, dementia or testicular cancer in pre-vasectomy counseling of patients because vasectomy is not a risk factor (...) 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) to verify sterility and potential complications and consequences of vasectomy. Currently, the practice of vasectomy is characterized by wide variation in pre-operative counseling, surgical technique and post-operative follow-up. The intent of this Guideline is to provide a set of approaches and procedures

2015 American Urological Association

5. Vasectomy Postoperative Counseling

Vasectomy Postoperative Counseling Vasectomy Postoperative Counseling Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Vasectomy (...) Postoperative Counseling Vasectomy Postoperative Counseling Aka: Vasectomy Postoperative Counseling II. Management: Clinic Follow-up Postoperative Care Handout describing below Call patient to check on status on day 1 or 2 post-op III. Management: Analgesics Wear athletic supporter (jock strap) for first 3-4 days Medications (e.g. ) for daytime use Consider (e.g. ) for night pain IV. Management: Postoperative Activity Off Work for 1-3 days Day 1: Supine with ice on for 20 minutes/hour Day 2: Minimal

2015 FP Notebook

6. Vasectomy Counseling

Vasectomy Counseling Vasectomy Counseling Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Vasectomy Counseling Vasectomy Counseling (...) Aka: Vasectomy Counseling II. Indications All patients 2-4 weeks before procedure III. Risk factors: Regretting Vasectomy Age under 30 years (12.5 times more likely to request reversal) Few children (but men with no children are less likely to request reversal) Relationship not stable Religious affiliation prohibiting Pressure from partner to have procedure performed during time of personal crisis Lack of discussion with partner regarding Hope will solve sexual and marital problems High interest

2015 FP Notebook

7. Vasectomy: Performing the Operation And Counselling Your Anxious Patient (PubMed)

Vasectomy: Performing the Operation And Counselling Your Anxious Patient In counselling the increasing number of men applying for vasectomy the practitioner should be aware that anxiety demonstrated in office interviews has no correlation with postoperative satisfaction. Young, childless men need special consideration, and a waiting period of at least one month is recommended for all. The operative procedure should be kept as simple as possible without reducing effectiveness. The use (...) of the Weck clips is a step in this direction. Special attention to hemostasis is necessary to avoid postoperative swelling. Operative techniques, management of complications and the status of reversal operations are discussed. Small amounts of sperm in the semen after three months are not uncommon, but the testing routine recommended allows surety of permanent sterility.

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1971 Canadian Family Physician

8. Increased Follicle-Stimulating Hormone is Associated With Higher Assisted Reproduction Use After Vasectomy Reversal. (PubMed)

with greater assisted reproduction use.We evaluated preoperative follicle-stimulating hormone as a predictor of reproductive outcome in men with suspected subfertility who underwent vasectomy reversal. Increased follicle-stimulating hormone was associated with a higher rate of assisted reproduction even after controlling for confounding covariates. Thus, men with increased follicle-stimulating hormone should be counseled on the increased likelihood of needing assisted reproduction to achieve pregnancy (...) Increased Follicle-Stimulating Hormone is Associated With Higher Assisted Reproduction Use After Vasectomy Reversal. Of men with vasectomy 6% elect to have more children. When considering vasectomy reversal vs in vitro fertilization/intracytoplasmic sperm injection, an elucidation of preoperative factors that predict surgical success would help determine appropriate management. We tested the hypothesis that preoperative follicle-stimulating hormone 10 U/l or greater predict a lower paternity

2011 Journal of Urology

9. Nomograms to Predict Patency After Microsurgical Vasectomy Reversal. (PubMed)

Nomograms to Predict Patency After Microsurgical Vasectomy Reversal. After undergoing vasectomy up to 6% of men will elect to undergo vasectomy reversal. For these men paternity can be achieved with vasectomy reversal or surgical sperm retrieval coupled with assisted reproduction. Nevertheless, it remains difficult for surgeons to accurately counsel men on the chance of patency after vasectomy reversal.A retrospective review was conducted of 548 patients who underwent microsurgical vasectomy (...) ± 0.10 years. Mean patient age was 43.4 ± 0.3 years and mean duration of obstruction was 10.4 ± 0.2 years. Two nomograms to predict patency were generated, one for preoperative counseling and a second for postoperative counseling. The factors with the largest effect on patency were average testicular volume and obstruction duration. The factor with the least effect was the presence of sperm granuloma. The concordance index for the preoperative and the postoperative nomograms was 0.64 and 0.66

2011 Journal of Urology

10. Vasectomy

usually takes less than thirty 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, men are usually counseled/advised to consider how the long-term (...) permanent form of contraception available to men. In nearly every way that vasectomy can be compared to 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 too soon after the procedure while some sperm continue to pass through the vasa

2012 Wikipedia

11. Effect of Obesity on Sex Hormone Levels, Antisperm Antibodies, and Fertility After Vasectomy Reversal. (PubMed)

Effect of Obesity on Sex Hormone Levels, Antisperm Antibodies, and Fertility After Vasectomy Reversal. Little is known about the effect of obesity as quantified by the body mass index on the serum levels of sex hormones, antisperm antibodies, and postoperative fertility of men undergoing vasectomy reversal. The aim of the present study was to investigate the effect of obesity on sex hormone levels, the presence of antisperm antibodies, and fertility after vasectomy reversal.We identified 500 (...) patients with complete clinical and laboratory data who had undergone vasectomy reversal by a single surgeon. Data on postoperative vas patency and pregnancy were available for 315 and 334 patients, respectively.Postoperative vas patency was observed in 93.2%, 91.9%, and 93.3% of normal weight, overweight, and obese patients, respectively (P = .931). Pregnancy was achieved by the partners of 63.9%, 60.2%, and 55.6% of the normal weight, overweight, and obese patients, respectively (P = .672

2010 Urology

12. What are the causes and treatment of post-vasectomy pain? What are the other common complications after vasectomy (apart from bleeding)?

and congestive (non-infective) epididymitis ? the most common side effects are wound haematoma and staphylococcal wound infection ? most men will develop wound haematoma to a degree, but large problematical haematoma formation is rare. Development of postoperative haematoma may be limited by adequate scrotal support and by the avoidance of physical exercise for up to 3–4 days following the procedure • late complications following vasectomy o chronic testicular pain has been found to be the most common late (...) , respectively. Postoperatively 9 of the 13 men (69%) became completely pain-free. Mean followup was 1.5 years. We observed no differences in vasectomy site histological features in patients with the post-vasectomy pain syndrome and matched controls, and no difference in histological findings in patients with the post-vasectomy pain syndrome who did and did not become pain-free postoperatively. No histological features aid in identifying a cause of pain or provide prognostic value for subsequent pain relief

2008 TRIP Answers

13. Overweight, Obesity and Contraception

bariatric surgery but appear to be safe and effective. D For women with BMI =35 kg/m 2 , risks associated with CHC use generally outweigh the benefits. Clinical recommendations ü Women receiving counselling regarding bariatric surgery should have a discussion about contraception and have a plan for contraception in place prior to surgery. D Women should be advised that the effectiveness of oral contraception (OC), including oral EC, could be reduced by bariatric surgery and OC should be avoided (...) counselling a woman with raised BMI who has irregular menstruation and is considering FAM, HCPs should discuss how irregular bleeding patterns affect fertility awareness. 5.8 Emergency contraception (EC) Key information ü The available evidence suggests that effectiveness of the Cu-IUD is not affected by body weight or BMI. C 1.5 mg levonorgestrel emergency contraception (LNG-EC) appears to be less effective in women with BMI >26 kg/m 2 or weight >70 kg. C Ulipristal acetate emergency contraception (UPA

2019 Faculty of Sexual & Reproductive Healthcare

14. Chronic Pelvic Pain

. Elcombe, S., et al. The psychological effects of laparoscopy on women with chronic pelvic pain. Psychol Med, 1997. 27: 1041. 309. Onwude, J.L., et al. A randomised trial of photographic reinforcement during postoperative counselling after diagnostic laparoscopy for pelvic pain. Eur J Obstet Gynecol Reprod Biol, 2004. 112: 89. 310. Peters, A.A., et al. A randomized clinical trial to compare two different approaches in women with chronic pelvic pain. Obstet Gynecol, 1991. 77: 740. 311. Cole, E.E., et al (...) . Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg, 2010. 97: 600. 184. Nariculam, J., et al. A review of the efficacy of surgical treatment for and pathological changes in patients with chronic scrotal pain. BJU Int, 2007. 99: 1091. 185. Manikandan, R., et al. Early and late morbidity after vasectomy: a comparison of chronic scrotal pain at 1 and 10 years. BJU Int, 2004. 93: 571. 186. Leslie, T.A., et al. The incidence of chronic

2019 European Association of Urology

15. Prostate Cancer

of tobacco use and prostate cancer mortality and incidence in prospective cohort studies. Eur Urol, 2014. 66: 1054. 63. Ju-Kun, S., et al. Association Between Cd Exposure and Risk of Prostate Cancer: A PRISMA-Compliant Systematic Review and Meta-Analysis. Medicine (Baltimore), 2016. 95: e2708. 64. Russo, G.I., et al. Human papillomavirus and risk of prostate cancer: a systematic review and meta-analysis. Aging Male, 2018: 1. 65. Bhindi, B., et al. The Association Between Vasectomy and Prostate Cancer

2019 European Association of Urology

17. The management of obstructive azoospermia: a committee opinion

and Cryopreservation Patients should be counseled about the option of intraopera- tive sperm retrieval forcryopreservation via testicular biopsy or aspiration at the site of a vaso-vasal or vaso-epididymal anastomosis if microsurgical reconstruction is unsuccessful. Thisoptionmaybemorerelevantforpatientswithahighpre- operative likelihood of requiring a bilateral vasoepididymos- tomy. Costs of cryopreservation should also be discussed preoperatively. POSTOPERATIVE CARE Mostsurgeonswilladvisepatients (...) to a complete absence of sperm in the ejaculate, and accounts for approximately 40% of all cases of azoospermia (1). Obstruction may be congenitaloracquiredandmayinclude oneormoresegmentsofthemalerepro- ductive tract: epididymis, vas deferens, and ejaculatory ducts. Congenital causes of obstructive azoospermia include congenital bilateral absence of thevasdeferens(CBAVD)andidiopathic epididymal obstruction. Acquired causes of obstructive azoospermia include vasectomy, infection, trauma, or iatrogenic injury

2019 Society for Assisted Reproductive Technology

18. Prostate Cancer

of tobacco use and prostate cancer mortality and incidence in prospective cohort studies. Eur Urol, 2014. 66: 1054. 63. Ju-Kun, S., et al. Association Between Cd Exposure and Risk of Prostate Cancer: A PRISMA-Compliant Systematic Review and Meta-Analysis. Medicine (Baltimore), 2016. 95: e2708. 64. Russo, G.I., et al. Human papillomavirus and risk of prostate cancer: a systematic review and meta-analysis. Aging Male, 2018: 1. 65. Bhindi, B., et al. The Association Between Vasectomy and Prostate Cancer

2018 European Association of Urology

19. Chronic Pelvic Pain

. Elcombe, S., et al. The psychological effects of laparoscopy on women with chronic pelvic pain. Psychol Med, 1997. 27: 1041. 309. Onwude, J.L., et al. A randomised trial of photographic reinforcement during postoperative counselling after diagnostic laparoscopy for pelvic pain. Eur J Obstet Gynecol Reprod Biol, 2004. 112: 89. 310. Peters, A.A., et al. A randomized clinical trial to compare two different approaches in women with chronic pelvic pain. Obstet Gynecol, 1991. 77: 740. 311. Cole, E.E., et al (...) . Chronic pain 5 years after randomized comparison of laparoscopic and Lichtenstein inguinal hernia repair. Br J Surg, 2010. 97: 600. 184. Nariculam, J., et al. A review of the efficacy of surgical treatment for and pathological changes in patients with chronic scrotal pain. BJU Int, 2007. 99: 1091. 185. Manikandan, R., et al. Early and late morbidity after vasectomy: a comparison of chronic scrotal pain at 1 and 10 years. BJU Int, 2004. 93: 571. 186. Leslie, T.A., et al. The incidence of chronic

2018 European Association of Urology

20. Selected practice recommendations for contraceptive use

Selected practice recommendations for contraceptive use Third edition 2016 World Health Organization Department of Reproductive Health and Research Selected practice recommendations for contraceptive useWHO Library Cataloguing-in-Publication Data Selected practice recommendations for contraceptive use – 3rd ed. 1.Contraception – methods. 2.Contraceptive Agents, Female. 3.Contraceptives, Oral, Combined. 4.Intrauterine Devices. 5.Natural Family Planning Methods. 6.Vasectomy. 7.Practice Guideline (...) Emergency contraception 56 7.5.1 Copper-bearing IUDs (Cu-IUD) for EC, and emergency contraceptive pills (ECPs) 57 7.5.2 Resumption or initiation of regular contraception after using EC 59 7.6 Standard Days Method® 62 7.7 Male sterilization 63 7.7.1 Vasectomy 63 Web annex: Development of updated guidance for the third edition (www.who.int/reproductivehealth/ publications/family_planning/SPR-3/en/) Selected practice recommendations for contraceptive use • Third edition 2016 2Acknowledgements The World

2017 World Health Organisation Guidelines

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