Vasectomy in the United States, 2002

Barone, Mark A.; Hutchinson, Paul; Johnson, Christopher H.; Hsia, Jason; Wheeler, Jennifer

doi:10.1016/s0022-5347(06)00507-6

Cited by 99 publications

(56 citation statements)

References 13 publications

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“…Approximately 500,000 vasectomies are performed in the United States per year making it the most common urological procedure in the U.S. 1 Although more effective and less likely to have complications than tubal ligation, the number of men undergoing surgical sterilization is approximately threefold less than women. [2][3][4] Fear of complications related to surgical vasectomy ͑e.g., hematoma, infection, acute and chronic pain, sterilization failure͒ remains a prominent factor.…”

Section: Introductionmentioning

confidence: 99%

Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

et al. 2010

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Abstract. Development of a noninvasive vasectomy technique may eliminate male fear of complications and result in a more popular procedure. This study explores application of an optical clearing agent ͑OCA͒ to scrotal skin to reduce laser power necessary for successful noninvasive laser vasectomy and eliminate scrotal skin burns. A mixture of dimethyl sulfoxide and glycerol was noninvasively delivered into scrotal skin using a pneumatic jet device. Near-infrared laser radiation was delivered in conjunction with cryogen spray cooling to the skin surface in a canine model, ex vivo and in vivo. Burst pressure ͑BP͒ measurements were conducted to quantify strength of vas closure. A 30-min application of OCA improved skin transparency by 26± 3%, reducing average power necessary for successful noninvasive laser vasectomy from 9.2 W without OCA ͑BP = 291± 31 mmHg͒ to 7.0 W with OCA ͑BP= 292± 19 mmHg͒. Control studies without OCA at 7.0 W failed to coagulate the vas with burst pressures ͑82± 28 mmHg͒ significantly below typical ejaculation pressures ͑136± 29 mmHg͒. Application of an OCA reduced the laser power necessary for successful noninvasive thermal coagulation of the vas by ϳ25%. This technique may result in use of a less expensive laser and eliminate the formation of scrotal skin burns during the procedure.

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Section: Introductionmentioning

confidence: 99%

Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

et al. 2010

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“…Although NSV has been widely adopted (4,5), LE is still by far the most common vas occlusion technique performed in many parts of the world (5). Recently, the Program for Appropriate Technology in Health (PATH) recommended that FI and thermal cautery be introduced into existing and new vasectomy programs and that providers be trained in this method to maximize the cost-effectiveness of ongoing programs (6).…”

Section: Recent Developments In Vasectomy Havementioning

confidence: 99%

Vasectomy occlusion technique combining thermal cautery and fascial interposition

Labrecque

2011

Int. braz j urol.

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Introduction: Recent research on vasectomy shows that combining cautery and fascial interposition (FI) achieves the most effective occlusion of the vas and minimizes the risk of failure. We present a technique that combines cautery and FI and is suitable for low-resource settings. Surgical Technique: The surgical technique consists of 1) exposing the vas with the no-scalpel approach; 2) cauterizing the epithelium of lumen of the vas using a portable battery-powered cautery device; 3) performing FI by grasping internal spermatic fascia and applying a free tie with suture material on the fascia to cover the prostatic stump of the vas and separate the two ends of the cut vas; and 4) excising a small 0.5 to 1 cm of the testicular stump. Comments: To maximize vasectomy effectiveness, vasectomy providers should consider learning thermal cautery and FI to occlude vas deferens.

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“…Approximately 500,000 vasectomies are performed in the United States per year, making it the most common urological procedure in the U.S. 1 Although vasectomy is more effective and less likely to have complications than tubal ligation, the number of men undergoing surgical sterilization is approximately three times less than women. [2][3][4] Fear of complications related to surgical vasectomy (e.g.…”

Section: Introductionmentioning

confidence: 99%

Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy

2012

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Abstract.A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. Optical coherence tomography (OCT) and high-frequency ultrasound (HFUS) are compared for monitoring laser thermal coagulation of the vas in an acute canine model. Bilateral noninvasive laser coagulation of the vas was performed in six dogs (n ¼ 12 vasa) using a Ytterbium fiber laser wavelength of 1075 nm, incident power of 9.0 W, pulse duration of 500 ms, pulse rate of 1 Hz, and 3-mm-diameter spot. Cryogen spray cooling was used to prevent skin burns during the procedure. An OCT system with endoscopic probe and a HFUS system with 20-MHz transducer were used to image the vas immediately before and after the procedure. Vasa were then excised and processed for gross and histologic analysis for comparison with OCT and HFUS images. OCT provided high-resolution, superficial imaging of the compressed vas within the vas ring clamp, while HFUS provided deeper imaging of the vas held manually in the scrotal fold. Both OCT and high HFUS are promising imaging modalities for real-time confirmation of vas occlusion during noninvasive laser vasectomy.

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Vasectomy in the United States, 2002

Cited by 99 publications

References 13 publications

Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

Application of an optical clearing agent during noninvasive laser coagulation of the canine vas deferens

Vasectomy occlusion technique combining thermal cautery and fascial interposition

Application of optical coherence tomography and high-frequency ultrasound imaging during noninvasive laser vasectomy

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