Reflexiones sobre la vasectomía sin bisturí
01 Apr 2014-Atención Familiar (Universidad Nacional Autonoma de Mexico)-Vol. 21, Iss: 2, pp 33-34
About: This article is published in Atención Familiar.The article was published on 2014-04-01 and is currently open access. It has received None citation(s) till now.
TL;DR: This guideline was peer reviewed by 55 independent experts during the guideline development process and recommended that vasectomy be considered for permanent contraception much more frequently than is the current practice in the U.S. and many other nations.
Abstract: Purpose: The purpose of this guideline is to provide guidance to clinicians who offer vasectomy services.Materials and Methods: A systematic review of the literature using the search dates January 1949-August 2011 was conducted to identify peer-reviewed publications relevant to vasectomy. The search identified almost 2,000 titles and abstracts. Application of inclusion/exclusion criteria yielded an evidence base of 275 articles. Evidence-based practices for vasectomy were defined when evidence was available. When evidence was insufficient or absent, expert opinion-based practices were defined by Panel consensus. The Panel sought to define the minimum and necessary concepts for pre-vasectomy counseling; optimum methods for anesthesia, vas isolation, vas occlusion and post-vasectomy follow up; and rates of complications of vasectomy. This guideline was peer reviewed by 55 independent experts during the guideline development process.Results: Vas isolation should be performed using a minimally-invasive vasect...
TL;DR: No-scalpel vasectomy is a method of fertility planning very effective with low morbidity, and in a great proportion healthy, in the fourth decade of life, with high school or greater, satisfied fertility and high socioeconomic status.
Abstract: Background: Men have few effective methods for birth control The surgical method vasectomy is highly safe and effective although in Mexico represents only 24% of all contraceptive methods used Objective: To determine the characteristics complications and results of the men who requested and underwent no-scalpel vasectomy in the Instituto Nacional de Perinatologia Isidro Espinosa de los Reyes in Mexico Material and method: Retrospective cohort study with data of clinical records of men who underwent no-scalpel vasectomy from 2003 to 2007 Sociodemographic and clinical variables and complications reported as well as espermatobioscopy data were included Descriptive analysis was performed of different variables and chi squared test between proportions Results: A total of 596 no-scalpel vasectomies were performed The average age was 365 years and 134 of schooling 869% were married with 96 years of union Socioeconomic status was as follows: medium (25%) middle high (201%) and high (247%) The 943% of men requested the no-scalpel vasectomy because of satisfied fertility and 57% by morbidity in his couple The complications were as follows: epididymitis (22%) mild haematoma (15%) and contact dermatitis (02%) The surgical complications were significantly more frequent for the group with varicocele compared with the normal men group (p < 005) Azoospermia was achieved in 991% of men at 18 weeks after the no-scalpel vasectomy Early recanalization occurred in 05% of men There were no pregnancies Conclusions: The profile of men who requested no-scalpel vasectomy was in a great proportion healthy in the fourth decade of life with high school or greater satisfied fertility and high socioeconomic status No-scalpel vasectomy is a method of fertility planning very effective with low morbidity
TL;DR: This new method of vas occlusion seems to be rapid and compatible with the NSV instruments and has been performed in 158 consecutive cases.
Abstract: Objective-The current vasectomy methods including the no scalpel vasectomy (NSV) have received considerable attention in recent years because they are minimally invasive and utilize special instruments to expose the vas. However at least 28 different methods for vas occlusion have been utilized with these procedures and some postoperative complications have been attributed to the method of vas occlusion. Therefore in this report we will critique the existing methods for vas occlusion and introduce a new and rapid method. Patients and Methods-The NSV instruments were used to expose the vas but in addition a fine skin hook a short-bladed tenotomy scissors and a hand-held hotwire cautery were used for the new no suture inline method of vas occlusion. No ligatures were placed around the vas no portion of the vas was removed and the mesentery behind the vas was not disturbed. The vas sheath was disrupted there was luminal cautery on both the abdominal and testicular sides a section of vas was detubularized and trimmed and its epithelium was destroyed by cautery. This technique has been performed in 158 consecutive cases. Results-All patients have demonstrated complete azoospermia on two follow-up semen analyses with no pregnancies reported. Conclusion-This new method of vas occlusion seems to be rapid and compatible with the NSV instruments. (authors)
TL;DR: This surgical technique, using Moon's clamp, may be effective in reducing the operative time, the postoperative complications and the recovery time after different types of vas surgeries, such as vasectomy or vasectomy reversal.
Abstract: Introduction We have recently designed a novel surgical instrument, a double-ringed clamp (Moon's clamp), with which the vas deferens can be located and isolated both simply and safely while minimizing unnecessary injury to the surrounding tissue.