Monthly Archives: June 2013

Psychological Effects of Vasectomy | Minnesota

Men have been surveyed about their vasectomy satisfaction since the mid 1970’s. The goal was to find out whether they were happy over all with their decision to have a vasectomy based on their sexual satisfaction and happiness.  90% agreed that their sexual desires and satisfaction levels were the same or better than before they had their vasectomy. 7-10% of men surveyed regretted their decision. The first surveys being done were just asking whether men were satisfied or dis-satisfied with their procedure. It did not ask about how they were feeling about it.

When the men were interviewed about their feelings and the psychological aspect was looked at, it was found there were valid reasons for men regretting their decision. Some were feeling bullied by their wife into having the procedure done. Others felt good about their decision but major changes in their life made them feel regretful.  Life changes such as divorce and re-marrying or re-partnering with someone have a big impact on men especially if their new spouse or partner wants to have children. Up to 5% of men have a vasectomy reversal. A higher percentage would probably have a reversal done if it wasn’t for the cost and low success rates. Men who are typically younger when they have a vasectomy tend to have more regrets down the road.

Dr. Steven Shu of One Stop Medical Center located in Edina, MN always requires a consultation and likes to make sure that both partners are in agreement before doing a vasectomy. It is important to have both couples on the same page in order to maintain high satisfaction levels in the emotional and sexual relationship.

Doctor in UK Performs a DYI Vasectomy

So far in Minnesota, we haven’t had any doctors reporting a DYI surgery but in the UK they have a brave doctor who gave it a try. Dr. Jonathan Heatley of Horsham, West Sussex in the UK, performed 3 vasectomies and decided that he should be number 4 that day. He and his wife already have 3 boys who are ages, 12, 14, and 16 and he knew at some point he wanted to get a vasectomy.   He called in his nurse and his wife who works with him as the practice manager.  The doctor, who admittedly was a little nervous, gave himself a local anesthetic. His main concern was making sure that the area was numb before he started his procedure.   His nurse and wife were standing by to help and everything went smoothly.  He had his wife stepping on the foot pedal of the apparatus as needed for the DYI surgery. The procedure he performed on himself only took 20 minutes. Then he went home, relaxed and read a book. The next day he was back to work and just a couple days later was out riding his bike around town. Here is proof that a vasectomy is relatively pain free and nothing to be afraid of.

Chronic Pain After a Vasectomy in Minnesota

Vasectomy is a minimally invasive procedure that can be done safely in the office. The complications of vasectomy in Minnesota are very rare. The bleeding and hematoma formation is the most common immediate complication after vasectomy. The most significant long term side effect in the Minneapolis and St Paul areas is chronic pain after a vasectomy. About 1 in 1,000 men experience pain afterward, and we haven’t had any reports on the chronic pain from our vasectomy patients yet. After a vasectomy, men continue to produce sperm at about the same rate as before, and those sperm have to go somewhere. They typically build up in the epididymis, which is a 16-foot-long tightly coiled tube behind each testicle. Some men become sensitive to the buildup of pressure in the duct and begin to experience pain.

What can be done to relieve the pain? In many cases, taking an anti-inflammatory medication such as ibuprofen, wearing a supporter and sitting in a warm tub to increase blood flow is enough to treat the problem. Eventually the pain goes away.

If it doesn’t, there are several options. We can redo the vasectomy, leaving the testicle end open, allowing the sperm to leak out, which relieves pressure in the epididymis. The downside is that this increases the chance that sperm will find a new channel into the ejaculate, so we have to monitor men by doing periodic sperm counts. Another option is to remove the epididymis, which is a much more complicated procedure than the original vasectomy. Or some patients may consider reverse the vasectomy, which always relieves the pain. The drawback, of course, is that the man is fertile again.

Indications of Vasectomy in Minnensota

Vasectomy is a permanent sterilization surgical procedure. No scalpel vasectomy in Minnesota is a minimally invasive office procedure that makes a man sterile (unable to get a woman pregnant). Vasectomy may be recommended for men who are 100% sure they do not want to get a woman pregnant in the future.

A vasectomy is not recommended as a short-term form of birth control.  A vasectomy reverse procedure is a much more complicated operation and very costly. So if the men in Minnesota are not sure about vasectomy, they should not do it.

Vasectomy is indicated for men in Minnesota who:

  • Are in a stable relationship, and both partners agree that they do not want any more children. They do not want to use, or cannot use, other forms of birth control.
  • Are in a stable relationship, and their partner has health problems that would make pregnancy unsafe for her.
  • Are in a stable relationship, and one or both partners have genetic disorders that they do not want to risk passing on to their children.

Vasectomy may not be a good choice for the men in Minneapolis and St Paul areas who:

  • Are in a relationship with someone who does not know whether or not they want children in the future.
  •  Are in a unstable or stressful relationship.
  • Are thinking about having the operation just to please their partner.
  • Want to have children later by storing their sperm or by reversing their vasectomy.
  • Are young and still have many life changes ahead.
  • Are single when they want to have a vasectomy. This includes men who are divorced, widowed, or separated.
  • Do not want, or his partner does not want, to be bothered by having to use other forms of birth control during sexual activity.

Vasectomy Cost in Minnesota

Vasectomy costsare usually affordable and often covered under health insurance plans in Minnesota. Typically, vasectomy costs will be in the range of $700 to $1,000 in Minneapolis and St Paul areas, the suggested price range of a vasectomy includes your initial consultation, vasectomy procedure, and post semen analyses. The price can fluctuate based on where you live in Minnesota, the method of procedure, and other variables. Some clinics will include all of these in one price, while many may charge for each individually, so make sure to inquire about the price of consultation and post-op analysis when looking for potential doctors. In most cases, the cost is the same for the no-scalpel vasectomy or a conventional vasectomy.

Vasectomy costs may differ depending on where the procedure takes place. Getting one at a doctor’s office under local anesthesia is usually the cheapest, as hospitals or surgical centers, while still a valid option, may cost more due to anesthesia or facility fees. Vasectomy in men is significantly less expensive than tubal ligation in women, which may be as much as five times more costly. Generally, this is because tubal ligation is a more complex surgery, performed in a hospital or surgery center and requiring a general anesthesia. A vasectomy is simpler, safer office procedure.

Most health insurance companies in Minnesota will cover vasectomy costs, but you should check it to make sure that your insurance company includes vasectomy benefits. If you do not have a health insurance plan, you may ask if the clinic may offer you a discount on your vasectomy cost. Our clinic usually offers a 20% discount for patients who pay in cash.

Vasectomy Consultation in Minnesota

A preoperative interactive consultation on vasectomy is an important step in planning on vasectomy in Minnesota. We recommend that a preoperative consultation should be conducted in person, so the vasectomy consultation will be more effective.

The minimum and necessary concepts that should be discussed in a preoperative vasectomy consultation include the following: (based on American Urological Association Guideline)

  • Vasectomy is intended to be a permanent form of contraception.
  • Vasectomy does not produce immediate sterility.
  • Following vasectomy, another form of contraception is required until vas occlusion is confirmed by post-vasectomy semen analysis.
  • Even after vas occlusion is confirmed, vasectomy is not 100% reliable in preventing pregnancy.The risk of pregnancy after vasectomy is approximately 1 in 2,000.
  • Repeat vasectomy is necessary in ≤1% of vasectomies, provided that a technique for vas occlusion known to have a low occlusive failure rate has been used.
  • Patients should refrain from ejaculation for approximately one week after vasectomy.
  • Options for fertility after vasectomy include vasectomy reversal and sperm retrieval with in vitro fertilization. These options are not always successful, and they may be expensive.
  • The rates of surgical complications such as symptomatic hematoma and infection are 1-2%. These rates vary with the surgeon’s experience 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.

Birth Control Methods And Failure Rates Minnesota

All birth control methods work the best if used correctly and every time you have sex. The vasectomy is one of the lowest failure rates among the birth control methods. The study showed the traditional vasectomy failure rate is 1-3 per 1000 cases; the failure rate would be even lower in no scalpel vasectomy with the fascia clipping technique.

Here is a list of some birth control methods with their failure rates.

Birth control methods and failure rates
(the number of pregnancies expected per 100 women)

Sterilization surgery for women: Less than 1 pregnancy
Sterilization implant for women: Less than 1 pregnancy
Sterilization surgery for men (vasectomy): Less than 1 pregnancy
Implantable rod: Less than 1 pregnancy
Intrauterine device: Less than 1 pregnancy
Shot/injection (Depo-Provera): Less than 1 pregnancy
Oral contraceptives: 5 pregnancies
Skin patch: 5 pregnancies
Vaginal ring: 5 pregnancies
Male condom 11-16 pregnancies
Diaphragm with spermicide 15 pregnancies
Sponge with spermicide 16-32 pregnancies
Cervical cap with spermicide 17-23 pregnancies
Female condom: 20 pregnancies
Natural family planning (rhythm method): 25 pregnancies
Spermicide alone: 30 pregnancies
Emergency contraception: 1 pregnancy

 

No Scalpel Vasectomy | Minnesota

More than half million vasectomy procedures are performed in the United States every year. Vasectomy is a minimally invasive sterilization procedure for male patients in Minnesota, in which the vas deferens tube leading from each testicle is cut and sealed, preventing sperm from becoming part of the seminal fluid that leaves the body at sexual climax. Without sperm in the semen after the vasectomy is done, a man can not impregnate his female partner.

No scalpel vasectomy procedure is usually done in an office setting under the local anesthesia, and the procedure takes about 20 minutes. The semen analysis will confirm the effectiveness of a vasectomy in 3 months.

The immediate risksof vasectomy are bleeding and infection, but these risks are generally very low for vasectomies. The risks are even lower in our no scalpel vasectomy.  We have performed almost 200 no scalpel vasectomies in Minneapolis/St Paul area in the past years, and there have been no cases of infection or large hematoma (bleeding).

It is important to follow the post vasectomy instructions.

  • Discomfort should be mild, may take Tylenol or Ibuprofen as needed, normally strong pain relievers are not necessary. Get plenty of rest and stay off your feet. Don’t need to use ice packs.
  • You should wear a new scrotal support immediately after the vasectomy and for a few days afterward.
  • Contact your doctor immediately if you experience severe swelling or a growing mass related to bleeding, any sudden fever, chills, increasing pain, swelling or drainage, and lasting pain.
  • You should be able to take showers after a day or two. Do not take baths or submerge your body in water for a few days after surgery.
  • You should be able to return to work after three days. No strenuous activities or heavy lifting for 1-2 weeks.

It is recommended that you abstain from sex 1-2 weeks after the surgery. Keep in mind that until your doctor confirms that you are sterile, use an alternate form of birth control.

Important Question to Ask Before Vasectomy | Minnesota

The practice of vasectomy was pioneered in 1950, but for many years the vasectomy procedure was used sparingly; many men were uncomfortable with the idea of elective surgery on their sexual organs. But today, vasectomy is becoming more frequent among men in Minnesota, and men are more comfortable with the procedure as education about vasectomy becomes more widely available online. Men realize that the idea that vasectomy will lower sex drive or libido is a myth; The two vas deferens are cut in the vasectomy, preventing any sperm from exiting the body through the penis. All other functions of the testes are still intact. Even sperm is still produced, but it is absorbed by the body.

The most popular vasectomy technique – no stitch, no scalpel vasectomy – requires work off for less than 3 days compared that of 1-2 weeks with traditional vasectomy, and it is also much less invasive than tubal litigation on women.

No scalpel vasectomy is a affordable, reliable form of birth control that is more practical than other permanent alternatives in Minnesota. But men must know that sterilization is not immediate after vasectomy. Even after the vas deferensare cut, there is still sperm lingering in your system that can be present in semen. It will take several months before sterility is complete. You should use birth control until your physician determines you are completely sterile.

Still, vasectomies are permanent, so it is important to be informed before you decide to get one. There is the most important question one must consider:

    • Do I want any more children in the future?

Vasectomies are more or less permanent. Once the procedure is done, it’s done. It is possible to have vasectomies reversed, but to do so is prohibitively expensive, unreliable, not to mention that sperm production will never be the same as it was before. Do not getting vasectomies if you are not absolutely sure that you want it, and do not assume you can reverse it.

Biological Implications After Vasectomy | Minneapolis

The patients who had the no scalpel vasectomy in Minnesota often ask where the sperms go after no scalpel vasectomy. Here is the explanation for biological implication.

After a vasectomy, the tube running from testes to the penis is no longer connected. The testes are still very much alive and functioning; Leydig cells continue to produce testosterone and hormones, which continue to be absorbed into blood. The only difference is that the path that sperm travels is interrupted. Sperm that is produced is broken down by the body. The epididymis’s membranes absorb the liquid created, while solids substances are broken down by macrophages and absorbed into the bloodstream. With the increase of stagnant sperm, the membranes of the epididymis increase in size to absorb more liquid. The immune system increases the amount of macrophages to handle an increase of solid waste.

No scalpel vasectomies are, for all intents and purposes, permanent. Reversals are costly, have a considerably lower success rate, and often does not restore the sperm count and/or motility to pre-vasectomy levels.

Confirmed, properly performed no scalpel vasectomies ensure life-long sterility with almost no chance of making a woman pregnant . It does not, however, prevent the transmission of STDs.

No Scalpel Vasectomy | Minneapolis

With so many options available in terms of birth control for women,  many men inquire regarding the availability of other options for male birth control excluding the usual abstinence, condoms, withdrawal before ejaculation, and vasectomy.  I would predict that with the fast development of modern medical science in 21th century,  just as women do, men will soon be able to simply take a pill to control the release of their sperm.

There are actually much medical research being done in this field; such a market has a high demand. A number of research groups across the globe have tried different alternatives to male birth control. These include injected plugs, heat methods, pharmaceuticals, hormonal therapy, and obstruction of the vas deferens. Despite promising developments, these treatments are experimental , and not approved by FDA , and not worth any potential risks.

Many people are still misinformed about vasectomy; it is not as painful and inconveniencing as one may believe. Modern developments in vasectomy have reached a point where a no scalpel vasectomy can be done in a doctor’s office in less than 20 minutes, using only local anesthesia. The procedure is incredibly simple and pain free- it involves making a small incision in the scrotum, where the vas deferens are severed and prevented from joining back together. Discomfort afterwards is minimal and patients can quickly return to their everyday lives. The patient  who gets a “no-scalpel” no scalpel vasectomy typically feel no change in libido, as vasectomies cause no physical change in sensation, testosterone levels, blood flow to the penis, amount of semen, or satisfaction of an orgasm. The only difference is that the semen has no sperm in it.

Simply put, office no scalpel vasectomy is a safe, simple, and convenient method of birth control with few drawbacks.

March Madness brings Vasectomy Madness | Minneapolis & St Paul

NCAA Basketball tournament time seems to be a very popular time for vasectomies. Some clinics in the nation report a 50% increase in vasectomies at that time. Men can do two things at once; recover from their vasectomy and catch some great basketball action. The recovery time is usually a day or two of rest and using ice packs. What a great way to watch some guilt free basketball knowing that the “to do” list will need to wait.  If March is the month you are looking at getting your procedure done, you may want to set up your appointment early.

It just may become a trend.  Pick your favorite sport and time your procedure with the games you want to watch. It may be the World Series, The Super Bowl or the Stanley Cup playoffs that you want to watch with your wife’s approval during your recovery time.  Dr. Steven Shu, of One Stop Medical Center in Edina, MN said that so far he has not noticed a trend with vasectomies in Minnesota the NCAA Basketball tournament.  Maybe that is something that he will use for advertising down the road for his vasectomy procedures .

Anti-Vasectomy Bill Is Introduced | Minneapolis & St Paul

Georgia Democrats propose limitations on vasectomies for men.

In a ploy to get people to take a serious look at the right for a woman to make decisions about her own body, an anti-vasectomy bill was introduced by state representative Yasmin Neal this year. She is quoted as saying, “If we legislate women’s bodies, it’s only fair that we legislate men’s,” said Neal, who said she wanted to Write a bill that would generate emotion and conversation the way anti-abortion bills do. “There are too many problems in the state. Why are you under the skirts of women? I’m sure there are other places to be."

The bill, HB 1116 reads: "It is patently unfair that men avoid the rewards of unwanted fatherhood by presuming that their judgment over such matters is more valid than the judgment of the General Assembly. … It is the purpose of the General Assembly to assert an invasive state interest in the reproductive habits of men in this state and substitute the will of the government over the will of adult men."

This bill was written in response to a new anti-abortion bill that was introduced in Georgia that contained a prison sentence of 1-10 years for abortions done after 20 weeks of pregnancy. It is currently illegal for abortions to be performed after 20 weeks unless the life or health of the mother will be in jeopardy.

Many people feel that this bill is making light of a very serious topic and are disappointed in the approach of using an anti-vasectomy bill to make a political statement. Even Representative Neal admits that she has no problems with men getting vasectomies. She made her point and it is definitely getting the attention that she wanted. Other states are also following suit with the same tactic. It is not likely however that this bill will get any serious debate.

Vasectomy and Sexual Health | Minneapolis

Many men worry about how a vasectomy will affect their sex drive. Will I be able to have an erection, or ejaculate? How will it affect being able to have an orgasm? Will I still have a sex drive? The good news is that there is no relationship between a vasectomy and sex drive because there are no physiological changes that take place during a vasectomy, and the testicles and adrenal glands continue to manufacture testosterone hormone.  Testosterone also controls masculinity that is why the sex drive and masculinity are not affected by the surgery, either. It will not interfere with the blood vessels or the nerves that are responsible for having an erection and ejaculation.  Men will still have the same ability to maintain an erection and reach the orgasm.  The color and consistency of the semen after vasectomy are not changed since the semen mainly comes from the prostrate and seminal vesicles which are not affected by the vasectomy.

It takes a few months of testing to determine that there are no more sperm present in the semen. Once that is established couples do not have to worry about using another method of birth control. It has been reported by both men and women that their sex life improved after a vasectomy. There is no more anxiety over an unplanned pregnancy and the sex drive has not decreased.

Besides the initial mild swelling and aching right after no scalpel vasectomy, most men recover very quickly and return to work in a few days. Very few men may experience occasional mild aching in their testicles during sexual intercourse within a few months of vasectomy.

What a vasectomy does is prevent the sperm from being able to fertilize an egg. A man will no longer be able to father a child. Since a vasectomy is more of a permanent form of sterilization, it should be seriously and thoroughly discussed between husband and wife and medical professionals in the initial counseling, and all concerns such as; lowered sex drive, any pain related to the surgery, and reversibility, should be addressed.

Vasectomy Techniques | Minneapolis & St Paul

There are quite a few vasectomy techniques to choose from –  traditional vasectomy, no-scalpel vasectomy, laser vasectomy and clip vasectomy. Below is a rundown of how each method is performed.

Traditional Vasectomy
The traditional vasectomy is a small surgical procedure performed in a surgical center or doctor’s office that typically takes about 30 minutes to complete. Using a scalpel, your doctor makes 1-2 small incisions in the skin of the scrotum to access each testicle’s vas deferens tubes. The tubes are then lifted, cut, and tied or cauterized. The cut tubes are placed back into the scrotal sac before each incision is stitched up, and the sutures are removed in a week. Patients who undergo a traditional vasectomy typically experience more pain and swelling and longer recovery time due to more trauma, bleeding and sutures. Fewer surgeons learn the traditional vasectomy technique nowadays.

Laser Vasectomy
Most of the steps involved for a laser vasectomy are the same as those of a traditional vasectomy. Incisions must first be made in the scrotal skin so that your doctor can access the vas deferens tubes. After the tubes are lifted, a laser is usually used to cut the tubes or stop any bleeding, or a smaller laser wire is used to coagulate the lining of the vas tubes. However, because a laser is not actually needed, there is no significant advantage to using one for a vasectomy. The name “laser vasectomy” is used more for marketing purposes than for actual procedure benefits. Most vasectomies are usually performed with a battery-operated disposable eye cautery.

Clip Vasectomy
The vas clip idea is not new. The use of clips, or permanent staple-like devices, was expected to shorten a vasectomy’s overall procedure time without actually cutting the tubes. These clips cost the patients extra money, typically a few hundred dollars for titanium clips. Studies have also reported that the Vasclip is less effective than the no-scalpel vasectomy for reducing sperm count. To date, there is insufficient evidence showing that the Vasclip is better than a standard vasectomy or offers any known advantages compared to no-scalpel vasectomy techniques. Some insurance companies consider this procedure to be investigational and will not pay for it.

No-Scalpel Vasectomy
Developed in China in the 1970s, the no-scalpel technique is a minimally invasive procedure that does not require a large skin cut or sutures. In the past few decades, it has become increasingly popular around the world, as it is considered a more gentle vasectomy technique that minimizes bruising and discomfort. Other advantages include less noticeable scars and quicker recovery time.

While a scalpel is not used for this method, an opening must still be made in order to access the vas deferens tubes. Under local anesthesia, your doctor uses a specially designed sharp hemostat to penetrate the skin. After he locates and holds the tubes using a small ring clamp, he uses same hemostat to separate the tissue layers and pull the tubes out; the tubes are cut and cauterized a battery-operated disposable eye cautery, and a tiny metal clip is applied to each vas fascia to separate the ends and improve the effectiveness. After placing the tubes back into the scrotal sac, your doctor usually allows the openings to close on their own since the incisions are significantly smaller than those of a traditional vasectomy procedure.

History of Vasectomy – Part IV | Minneapolis & St Paul

This is the final part of the long and interesting history of the vasectomy. The first non-scalpel vasectomy was not performed until 1985 in the United States by Dr. Mark Goldstein at the New York Presbyterian Hospital Cornell Medical Center. He was a member of the international team, sponsored by the Association of Voluntary Surgical Contraception that went to China to learn the procedure. The procedure was then introduced to other countries by the other team members.

In 1999 the no-needle vasectomy is introduced after 6 years of preparation. A spray jet injector was used for the local anesthesia. This technique was developed by Dr. Charles L. Wilson of Seattle, WA in consultation with the late Dr. Ralph Adam who was the inventor of the MadaJet device used in this technique. The local anesthesia given with 30 gauge needle is almost painless in the good hands, mild pain while given anesthesia is actually caused by the acidic lidocaine, but the application of Madajet does reduce the anxiety in the needle phobia patients.

A Study is published in China in 2003 about the long term effects of vasectomy on benign enlargement of the prostrate. (BPH) The study concludes that vasectomy reduces the incidence rate of BPH significantly.

Robotic vasectomy reversal is first performed on rats in 2004. A study was done using a new microsurgical robot that had FDA approval in 2000. It was used to perform two types of reversal procedures on rats. The robot does not have the shaking hands that humans do. The initial results were that the robotic group had less obstruction or blockage than the group where humans performed the procedure. The incidence of granulomas was also much lower in the robotic groups.

A 2005 publication of research into the “no needle” technique of using a high pressure injector to administer anesthetic shows results of less discomfort to patients and is much faster acting than needle administered anesthetic.

The Vasclip which was FDA approved in 2003, has its first independent study into the effectiveness and short term complications of the device published in2006. In 2007 the Vasclip website went dead. It was found that it was not easier to reverse this procedure than a regular vasectomy. Many men got the Vasclip thinking that it would be easier to reverse when they wanted to have children again. In many cases it did more damage to the vas deferens.

Dr. Shu has performed no scalpel vasectomy for 15 years. He invented two-finger technique in facilitating the local anesthesia and holding the vas during the surgery. In 2008, Dr. Steven Shu opened his own clinic, One Stop Medical Center in Edina and Shoreview, MN which is focused on in-office procedures including no-scalpel vasectomy. In 2009 Dr. Steven Shu also adds the “no needle” vasectomy. The clinic has been doing many more vasectomies every year after the procedure-oriented clinic gained more reputation and became the number one vasectomy clinic in Minnesota. Dr. Shu was an assistant professor in the University of Minnesota medical school from 2007-2012, teaching no scalpel vasectomy and other office procedures in the Smiley’s Clinic. You can read more about it at vasectomy.

History of Vasectomy – Part III | Minneapolis & St Paul

In 1918 the first vasectomy on humans is performed for rejuvenation. This was done based on experiments of old senile rats that were transformed after obstructing the outflow from the testes. Two notable people, Sigmund Freud and WB Yeats had vasectomy performed for rejuvenation.

Twyman and Nelson reported a successful case of a vasectomy anastomosis known as a reversal in1938. The patient had a reversal 4 years after having an elective vasectomy. The procedure was recommended due to depression caused by the desire to father children. After the procedure the patient’s emotional condition improved and he was able to father children.

By 1948 the list of indications for vasectomy were: prevention of the insane, criminal or perverse producing offspring, the wife having precarious health and is unable or refuses to undergo tubal ligation, an agreement between the husband and wife to prevent pregnancy, to prevent epididymitis following prostrate surgery, male rejuvenation, and mass sterilization for the purpose of racial limitation/extermination.

In the 1950’s a case is reported of a vassoraphy or repair performed 10 years after the original vasectomy with complete function. The patient’s wife was able to become pregnant 6 months after the procedure. Vasectomy is becoming favorable for use for sterilization. By 1953, vasectomy procedures had been watched for a period of 30 years and were found to have no adverse side effects. Any complications were reported were a result of technical surgical errors. In 1955 Jhaver introduces the single incision, single stitch approach. The advantage being that a bilateral vasectomy was possible using one incision with less surgical trauma and post-operative care. He publishes his technique in 1958.

New techniques continue to appear for vasectomy. In 1967 a new technique is introduced in India by Kothari and Pardanani. They demonstrated that it’s possible to produce a sub fertile sperm count by using a synthetic thread to temporarily obstruct the vas deferens. Removing it would restore fertility. Based on two cases the thread was left in for 20 weeks and 6 weeks later fertility had returned to previous levels. No-scalpel vasectomy was developed in China in 1974 by Dr. Li Shungiang of Chongqing Family Planning Research Institute, Sichuan province. Tubal ligation was the most commonly used method of voluntary sterilization. Vasectomy was not popular with Chinese men. The new technique was minimally invasive with a much lower complication than the conventional method.

History of Vasectomy – Part II | Minneapolis & St Paul

In 1890 vasectomy is suggested as an alternative to castration by Ewing Mears for the treatment of severe symptoms of enlarged prostate glands. Then in 1899 Ochsner (future professor of Surgery at the University of Illinois) publishes his paper “Surgical treatment of habitual criminals”, which kick-starts the Eugenics movement. The Eugenics movement uses science to reform and control nature and human society. It stems from the idea of survival of the fittest.

In 1900, Harrison publishes a paper based on over 100 cases where vasectomy was the primary procedure for the removal of bladder stones. Claims of rapid and substantial improvement with minimal morbidity led to the treatment being fashionable for a short time for management of enlarged prostate. Wood publishes a case study of 193 patients undergoing vasectomy as treatment for enlarged prostate. 15% had improved urination, but 67% manifested some “General improvement”.

In 1902, Bilateral vasectomy was first established to be effective in reducing the incidence of epididymitis after prostatectomy. The medical profession had sought hard to find an alternative to the existing practice of castration for enlarged prostate, and it was established by White that vasectomy was an effective treatment. One of the reasons an alternative was sought is because of the reputed case whereby a disgruntled patient murdered a surgeon! vasectomy remained in common use as a cure for post-prostate surgery until antibiotics were common place.

In 1907, Parlovechoi first attempted to reverse an accidental vasectomy that occurred in a hernia operation. Later authors describe the technique under the names of Vasorraphy or vasovasal anastomis.

During 1907-1910 vasectomy is recommended to be used to sterilize “the undesirables” of the world. Belfield publishes his paper “Race suicide for social parasites”. He was one of the proponents of enforced vasectomy for criminals. This is where the Eugenics movement comes into play. In 1910 Russia sent a delegate to the United States to observe a male prisoner being sterilized.

History of Vasectomy – Part I | Minneapolis & St Paul

It is difficult to find another surgical procedure as simple as vasectomy that has sparked so much medical and social controversies for more than a century. The history of this procedure is a combination of finding the the most ideal technique and the best results but also filled with misconceptions, false beliefs and incorrect indications. Vasectomy has a long and interesting history. The term vasectomy means an excision of the vas deferens. In Latin, vas means vessel and deferre means to carry down. As a medical term, vasectomy is somewhat misapplied because only part of the vas deferens is excised during the procedure. Vas deferens as an anatomic structure was not a subject of significant clinical and research interest until the nineteenth century.

Most people believe that the practice of vasectomy started in 1950 but the concept of male birth control dates as far back as the 1640’s when the first known condoms were used. The first condoms were made from fish and animal intestines. It was believed they were used to stop sexually transmitted disease.

In 1830, Sir Ashley Cooper’s “Observations on the Structure and Diseases of the Testis” was published in London. Cooper found that when the blood vessels of a dog’s testicle were tied, no issues followed coitus. This experiment on the dog, is what seeded the development of a surgical procedure for birth control in men called vasectomy. The dog, however, retained the ability to produce sperm even after 6 years of the surgery. In 1847, Gosselin found while dissecting human corpses with the vas deferens entirely blocked. He started studying the effects of removing part of the vas deferens and tying it together using dogs for his experiments.

In 1844, the first rubber condoms were being used for male birth control. Goodyear and Hancock began to mass produce condoms made out of vulcanized rubber. Vulcanization is a process which turns crude rubber into a strong elastic material. In 1861, the first advertisement for condoms was published in the New York Times. The printed ad was for Dr. Power’s French Preventatives. Unfortunately the Comstock Law, named after Anthony Comstock, was passed in 1873 making it illegal to advertise any sort of birth control. The law also allowed the postal service to confiscate condoms sold through the mail. We have come a long way since then.

More on this interesting piece of history coming up in part 2.

No-Scalpel Vasectomy | Minneapolis & St Paul

What is a Vasectomy?

A vasectomy is a surgical procedure that closes off the vas deferens in the scrotum, effectively sealing off the tubes that carry sperm from the testicles out. Known casually as ‘tube tying,’ a vasectomy is intended to render a man sterile.

What’s a Non-Scalpel Vasectomy?

A no scalpel vasectomy, is a type of vasectomy procedure where there is virtually no intensive surgery involved. Under local anesthesia, a small punch was made scrotal skin, the vas deferens are pulled through that hole and all surgical interaction takes place outside of the scrotum. No scalpel is necessary. The process is reversible, but with no guarantee. While the vasectomy itself is typically nearly 100% effective, the reversal process is only 60%.

Benefits of a No-Scalpel Vasectomy

no scalpel vasectomies are simple procedures. Because it requires no scalpel and only a small puncture, the wound will heal quickly and naturally. No incision is made, and there is no unsightly scarring. There is a much lower chance of infection. Additionally, the procedure heals easily, meaning a patient can get back to work within a few days and can resume sexual activity after one to two weeks. The entire process will usually take half an hour, including paperwork. The vasectomy will not affect a patient’s sexual enjoyment negatively. There is virtually no risk of complications or cancer as a result of the procedure.

Potential Risks

While complications are rare, some may occur. Possible complications include bleeding that appears like bruising, infection, chronic ache or temporary acute pain, psychological sexual difficulties, or sperm granulomas. All of these can be treated in some form or another should they occur.

Psychological issues can be addressed before and after the procedure. Men have an understandable fear of genital surgery. Doctors are capable of answering any question the patient may have. The procedure is nearly 100% effective with virtually no risk of complications, and within a month the man will be back to peak performance in every way. After three months testing is required to ensure sterility.

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