European Association of Urology Guidelines on Vasectomy

doi:10.1016/J.EURURO.2011.10.001

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European Association of Urology Guidelines on Vasectomy

Journal Article•DOI•

European Association of Urology Guidelines on Vasectomy

Gert R. Dohle¹, Thorsten Diemer², Zsolt Kopa³, Csilla Krausz⁴, Aleksander Giwercman, A. Jungwirth - Show less +2 more•Institutions (4)

Erasmus University Rotterdam¹, University of Giessen², Semmelweis University³, University of Florence⁴

01 Jan 2012-European Urology (Elsevier)-Vol. 61, Iss: 1, pp 159-163

TL;DR: These guidelines aim to provide information and recommendations for physicians who perform vasectomies and to promote the provision of adequate information to the patient before the operation to prevent unrealistic expectations and legal procedures.

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About: This article is published in European Urology.The article was published on 2012-01-01. It has received 120 citations till now. The article focuses on the topics: Vasectomy reversal & Vasectomy.

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Citations

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Journal Article•DOI•

European Association of Urology Guidelines on Male Infertility: The 2012 Update

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A. Jungwirth, Aleksander Giwercman¹, Herman Tournaye², Thorsten Diemer³, Zsolt Kopa⁴, Gert R. Dohle⁵, Csilla Krausz⁶ - Show less +3 more•Institutions (6)

Lund University¹, Free University of Brussels², University of Giessen³, Semmelweis University⁴, Erasmus University Rotterdam⁵, University of Florence⁶

01 Aug 2012-European Urology

TL;DR: These EAU guidelines are a short comprehensive overview of the updated guidelines of male infertility as recently published by the EAU and are also available in the National Guideline Clearinghouse ( www.guideline.gov/).

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802 citations

Guidelines on Male Infertility

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A. Jungwirth, Thorsten Diemer, Aleksander Giwercman, Zsolt Kopa, Csilla Krausz, Herman Tournaye - Show less +2 more

01 Jan 2012

TL;DR: 52. Weidner W, Schiefer HG, Garbe C. Acute nongonococcal epididymitis.

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Abstract: 52. Berger RE. Epididymitis. In: Holmes KK, Mardh PA, Sparling PF et al. (eds). Sexually Transmitted Diseases. New York: McGraw-Hill, 1984, pp. 650-662. 53. Weidner W, Schiefer HG, Garbe C. Acute nongonococcal epididymitis. Aetiological and therapeutic aspects. Drugs 1987;34 (Suppl 1):111-117. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3481311&do

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232 citations

Journal Article•DOI•

Positive surgical margins after nephron-sparing surgery.

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Martin Marszalek¹, Marco Carini², Piotr Chlosta, Klaus Jeschke, Ziya Kirkali³, Ruth Knüchel⁴, Stephan Madersbacher, Jean Jacques Patard⁵, Hendrik Van Poppel⁶ - Show less +5 more•Institutions (6)

University of Graz¹, University of Florence², Dokuz Eylül University³, RWTH Aachen University⁴, University of Paris-Sud⁵, Katholieke Universiteit Leuven⁶

01 Apr 2012-European Urology

TL;DR: As indicated by intermediate follow-up data, the majority of patients with PSMs after PN remain without disease recurrence, and a surveillance strategy seems preferable to surgical reintervention.

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190 citations

Journal Article•DOI•

Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination.

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Sandro C. Esteves

01 Jul 2014-International Braz J Urol

TL;DR: A template for semen analysis reports that incorporates the distribution of the semen characteristics of recent fathers in centiles rather than solely the minimum thresholds could aid clinicians to better understand how a given patient results compare with the reference population.

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Abstract: Semen analysis is the corner stone of infertility evaluation as it provides information on the functional status of the seminiferous tubules, epididymis and accessory sex glands. The methods on how the human semen should be evaluated are provided by the World Health Organization, which periodically releases manuals that include specific protocols and reference standards. In 2010, the WHO published new criteria for human semen characteristics that were markedly lower than those previously reported. In this review initially it is discussed the limitations of semen analysis as a surrogate measure of a man's ability to father a pregnancy. Secondly, it is analyzed methodology issues that could explain why the newly released reference values were different from those earlier reported. Thirdly, it is speculated on the likely effects of the 2010 WHO criteria in the management of male infertility. Due to the several inherent limitations of semen analysis as a surrogate marker of male infertility, physicians should exercise caution when interpreting results. A template for semen analysis reports that incorporates the distribution of the semen characteristics of recent fathers in centiles rather than solely the minimum thresholds could aid clinicians to better understand how a given patient results compare with the reference population. Importantly, a male infertility evaluation must go far beyond a simple semen analysis, as it has to be complemented with a proper physical examination, a comprehensive history taking, and relevant endocrine, genetic, and other investigations.

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121 citations

Journal Article•DOI•

Treatment and overall survival in renal cell carcinoma : a Swedish population-based study (2000-2008)

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Thomas Wahlgren¹, Ulrika Harmenberg², Per Sandström², Sven Lundstam³, Jan Kowalski, Maria Jakobsson¹, Rickard Sandin¹, Börje Ljungberg⁴ - Show less +4 more•Institutions (4)

Pfizer¹, Karolinska University Hospital², Sahlgrenska University Hospital³, Umeå University⁴

16 Apr 2013-British Journal of Cancer

TL;DR: OS was improved in Swedish patients diagnosed with RCC and mRCC in the period 2006–2008 compared with 2000–2005 and 2002–2005, and results suggest that increased nephrectomy rates and the use of TKIs contributed to the improvement seen in mR CC patients.

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Abstract: Background: This retrospective register study assessed overall survival (OS) and influential factors on OS in Swedish renal cell carcinoma (RCC) patients.Methods: Using three merged national health ...

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86 citations

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References

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Journal Article•DOI•

World Health Organization Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction, 4th ed.

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Dolores J. Lamb¹•Institutions (1)

Baylor College of Medicine¹

02 Jan 2000-Journal of Andrology

2,119 citations

Journal Article•DOI•

Safety and effectiveness of vasectomy

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Pamela J. Schwingl¹, Harry A. Guess², Harry A. Guess¹•Institutions (2)

Research Triangle Park¹, University of North Carolina at Chapel Hill²

01 May 2000-Fertility and Sterility

TL;DR: Suggestions are made that future studies should include evaluations of the long-term effectiveness of vasectomy, evaluating criteria for postvasectomy discontinuation of alternative contraception for use in settings where semen analysis is not practical, and characterizing complications including chronic epididymal pain syndrome.

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191 citations

"European Association of Urology Gui..." refers background in this paper

...Vasectomy is the most reliable form of male contraception, and it is estimated that 40--60 million men worldwide rely on it.(1) Although highly effective, problems can arise related to insufficient patient information before the procedure, to the actual surgical procedure, and to the process of postoperative follow-up until definitive sterility is achieved....
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Journal Article•DOI•

Complications of Vasectomy: Review of 16,000 Patients

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T. Philp¹, John Guillebaud¹, D. Budd¹•Institutions (1)

Churchill Hospital¹

01 Dec 1984-BJUI

TL;DR: There were six cases of late recanalisation in men previously thought sterile by two consecutive azoospermic analyses 4 months after vasectomy, not influenced by the operative technique used, but varied markedly between individual surgeons.

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Abstract: Sixteen thousand, seven hundred and ninety-six men underwent vasectomy between 1970 and December 1983 and have been reviewed. Post-operative side effects were few and significant complications were reported in 0.9%. Failure to achieve sterility occurred in 72 men, 69 of whom have been analysed. The early recanalisation rate was 0.36%. This rate was not influenced by the operative technique used, but varied markedly between individual surgeons. Experience and care with technique should result in a failure rate of 0.2% or better. There were six cases of late recanalisation in men previously thought sterile by two consecutive azoospermic analyses 4 months after vasectomy.

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108 citations

"European Association of Urology Gui..." refers background in this paper

...• The procedure has a low but existing failure rate.(3,7,10) • Couples need to continue their contraceptive measures until sterility is achieved....
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...Although highly effective, problems can arise related to insufficient patient information before the procedure, to the actual surgical procedure, and to the process of postoperative follow-up until definitive sterility is achieved.(2,3) Common long-term complications from vasectomy are scrotal pain, with about 1% reporting pain that noticeably affects quality of life,(4) and spontaneous recanalisation of the vas deferens that occurs in 0....
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...• The procedure has a low complication rate.(2,3) • The procedure has a low but existing failure rate....
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Journal Article•DOI•

Vasectomy surgical techniques: a systematic review

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Michel Labrecque, Caroline Dufresne, Mark A. Barone¹, Karine St-Hilaire•Institutions (1)

EngenderHealth¹

24 May 2004-BMC Medicine

TL;DR: Current evidence supports no-scalpel vasectomy as the safest surgical approach to isolate the vas when performing vasectomy andOcclusive effectiveness appears to be further improved by combining FI with cautery, and fascial interposition increases effectiveness beyond ligation and excision alone.

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Abstract: Background A wide variety of surgical techniques are used to perform vasectomy. The purpose of this systematic review was to assess if any surgical techniques to isolate or occlude the vas are associated with better outcomes in terms of occlusive and contraceptive effectiveness, and complications.

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88 citations

"European Association of Urology Gui..." refers background or methods in this paper

...semen analysis is the highest with simple excision and ligation with sutures and clips and the lowest with occlusion techniques combining cautery and fascial interposition.(12)...
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...• The no-scalpel vasectomy technique of isolation of the vas deferens is associated with fewer early complications, such as infections, haematomas, and less postoperative pain.(12,13)...
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Journal Article•DOI•

Late failure of vasectomy after two documented analyses showing azoospermic semen.

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T. Philp, John Guillebaud, D. Budd

14 Jul 1984-BMJ

TL;DR: From April 1970 to December 1980, 14 047 men underwent vasectomy for sterilisation under local anaesthetic at this clinic, and the wives of six of these men subsequently became pregnant between 16 months and three years after vasectomy.

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Abstract: From April 1970 to December 1980, 14 047 men underwent vasectomy for sterilisation under local anaesthetic at this clinic. In each man sterility was confirmed by two analyses of semen showing azoospermia. Allowing for a minimum follow up of three years, the wives of six of these men subsequently became pregnant between 16 months and three years after vasectomy. Analyses of semen confirmed recanalisation of the vasa deferentia in all six men. Only five similar cases initially fulfilling the same criteria for sterility have previously been reported. Full account of the rare possibility of recanalisation should be taken both when couples are counselled preoperatively and when pregnancy occurs after the male partner has been confirmed to be sterile.

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74 citations

"European Association of Urology Gui..." refers background in this paper

...• The procedure has a low but existing failure rate.(3,7,10) • Couples need to continue their contraceptive measures until sterility is achieved....
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...In case of rare nonmotile spermatozoa after vasectomy, a special clearance is advised.(7) Special clearance suggests that contraceptive measures are no longer needed but also that no 100% guarantee can be given for permanent sterility....
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