Monthly Archives: July 2016

Three Major Reasons a Vasectomy Beats a Tubal Ligation | Minnesota

Every couple in Minnesota whose family is complete may consider permanent birth control. The sterilization procedures include vasectomy, tubal ligation, or tubal blocking. Both men and women should know and compare the differences, benefits and risks of these procedures. For most couples, vasectomy is often the safer, simpler and more affordable. There are ample medical and personal reasons why a couple might prefer vasectomy to tubal ligation or blocking. This blog may help you make a more informed decision.

1.Hospital based Versus Office based
Tubal ligation in Minnesota is usually laparoscopic procedure that involves hospitalization, general anesthesia and lengthier, more complicated surgery than a vasectomy. In comparison, vasectomy may be completed in 10 minutes with minimal trauma. Tubal ligation requires much longer recovery time than vasectomy. Moreover, Women are more likely to have the immediate and long term complications related to a tubal ligation than men who have a vasectomy.

Vasectomies are usually outpatient procedures performed in the doctors’ office and usually take 10 minutes to complete. No scalpel vasectomy has a very quick recovery and very low risk of complications.

2.Pain
Women who have had tubal ligation may experience abdominal pain/cramping, dizziness, fatigue, gas, bleeding from the incision, and discharge. Of course, not every woman will experience these symptoms, and severity of symptoms can vary from woman to woman.

Believe or not, the Easy™ no scalpel vasectomy procedure is incredibly simple and almost pain free. How do we achieve it?

    No scalpel: The new surgical techniques of the no scalpel vasectomy greatly minimize trauma and pain by only making a small, single punch in the skin of scrotum with special instruments, as opposed to a conventional, more invasive open procedure.
    No Needle: Madajet is a spray applicator that delivers a fine stream of anesthetic at a pressure great enough to penetrate the skin and envelop the vas deferens tube beneath the skin with an almost 100% efficacy rate, eliminating the need for additional anesthetic.
    No suture: the wound is so tiny ( a few millimeter) that it doesn’t require a suture to close it.

3.Cost
When it comes to cost, a simple office vasectomy is more than four to five times less expensive than a routine tubal ligation.

An advantage of tubal ligation is that it works immediately, but a vasectomy doesn’t give you instant result, it requires 15-20 ejaculations in the period of 2-3 months. So you have to use a backup method of contraception until you’re in the clear in semen analysis.

The Essure and Adiana devices, which are inserted into the Fallopian tubes, are new alternatives to traditional tubal ligation in Minnesota; it requires a confirmation in 3 months with an x-ray test called a hysterosalpingogram to ensure that they’re installed properly. Another form of birth control must be used in the first 3 months. These tubal blocking procedures are less invasive than tubal ligation, but failure rates are higher in tubal blocking procedures than tubal ligation and no scalpel vasectomy.

People in the Minneapolis and St Paul areas should review all information on sterilization procedures from the reliable websites and your physicians, however, when it comes to risks, benefits, cost, and effectiveness, no scalpel vasectomy is more often the best option of sterilization.

An Affordable and One Trip Vasectomy Care System in Minnesota

In the previous blog, we talked about the fear of pain, one of three most common road blockers for Minnesotan men hesitating to have a vasectomy. This blog talks about affordability and convenience in vasectomy care in Minnesota.

Not too long ago, there was no Internet, or very limited information on Internet. All medical information came from the words of doctors only. Therefore, the patients had to come to the doctor’s office for detailed counseling on sterilization. In the 21st century, medical information on the Internet has been exploding, including vasectomy information. The patients are able to study everything about vasectomy procedures as much as they want and take their time to make a wise decision on their family planning. As we all know, men are a different creature, and they hate coming to the doctor’s office three times for finishing the whole process of vasectomy care.

We understand men’s psychology. That is why One Stop Medical Center developed a powerful website, EZvasectomy.com, with rich information on vasectomy and vasectomy reversal. All patients are required to review the important vasectomy information and watch a consultation video. A separate initial consultation is no longer required, although it is an option in certain special situations or per patient’s request. Dr. Shu will finalize the consultation on the same day of the surgery, so the patients don’t need another trip for the initial consultation. Moreover, the patients are able to register their vasectomy procedures by filling out the online registration form in the website.

Traditionally, the vasectomized patients need to bring specimen for semen analysis three months following the surgery. One Stop Medical Center developed a mailer system to eliminate another trip for patients. Patients who live far away may simply mail the specimen to the clinic instead of bringing it personally. Therefore, most patients are able to have a vasectomy done in just one trip to our clinic instead of three.

Our clinic used to charge much more for vasectomy procedure. In order to reduce the financial burden for our vasectomy patients, we cut the price of no scalpel vasectomy almost in half. This way, more men can afford to have their vasectomy done.

One Stop Medical Center has simplified the vasectomy care system to create a more affordable, friendly and convenient vasectomy care system.

Factors Affecting the Pregnancy in Vasectomy Reversal Procedures | Minnesota

Sperm recovery is the first goal in the success of a vasectomy reversal procedure. We all know the ultimate measure of success in vasectomy reversal procedure is a pregnancy. There are several factors affecting pregnancy in vasectomy reversal procedures, and these factors are outlined here.

1. A pregnancy involves male and female partners. If both of the count and quality of sperm after vasectomy reversal surgery are good, female fertility factors may play an indirect role in pregnancy failure.

A woman’s age affects her fertility. The decline in fertility begins to accelerate after 35. Advanced maternal age is a common reason for vasectomy reversal failure. Therefore, female partners age >35 years old should consider an evaluation to determine if they have adequate fertility before a vasectomy reversal is undertaken.

Age_pregnancy

This evaluation panel of fertility usually includes

  • Follicle-Stimulating Hormone (FSH) and estradiol levels at a menstrual cycle day 3.
  • Anti-Mullerian Hormone (AMH) levels.
  • Assessment of menstrual regularity.
  • Hysterosalpingogram

2. Up to 60% of men with vasectomies develop antisperm antibodies in their body, which may impair fertility. Antisperm antibodies are usually assessed >6-12 months after the vasectomy reversal if no pregnancy has ensued.

3. A man may have abnormal sperm quality even before the vasectomy, especially in men without prior paternity. This could be a reason for pregnancy failure.

4. A number of men fail who have been placed on testosterone replacement before vasectomy reversal procedure, and they continue to use it afterwards. Testosterone is a very effective form of male birth control, effectively stopping sperm production.

5. If an epididymal blowout has occurred in both sides of vas deferens before the vasovasostomy procedure, the vasectomy reversal will likely fail. In this case, an epididymovasostomy would need to be performed.

6. Not only is epididymis a “storage site” or, but also is where sperm mature. In certain patients, their epididymis is adversely affected after the vas deferens has been blocked for a long time. In these patients, sperm counts may be normal, but sperm functions (movement and penetration ability) may be poor after vasectomy reversal. Most patients will gradually recover from epididymal dysfunction.

7. Sometimes, scar tissue develops at the site of anastomosis, causing a blockage and late failure. It may be treated with anti-inflammatory medication or could consider repeating vasectomy reversal procedure.

Common Questions Men Ask About A Vasectomy: Pain | Minnesota

The idea of Easy™ no scalpel vasectomy can seem daunting – on the one hand, it is a minimal invasive procedure done in a doctor’s office in 10 minutes, using only local anesthesia, and it is one of the most reliable, cost-effective forms of long term birth control available. On the other hand, a vasectomy can feel like kind of a drastic step to take because vasectomy is a surgical procedure. Although the techniques used in Easy™ no scalpel vasectomy is so advanced and so minimal invasive, still, many men in Minnesota hesitate to have their vasectomy done due to three factors: fear of pain, cost, and time. We are talking about each of them in this series of blogs. The first blog is to talk about pain related to vasectomy.

Is there pain during the Easy™ vasectomy procedure?
The number one objection voiced by the male in Minnesota to having a vasectomy done is the fear of pain. Believe or not, the Easy™ no scalpel vasectomy procedure is incredibly simple, safe and almost pain free. How do we achieve it?

1. No scalpel: The new surgical techniques of the no scalpel vasectomy greatly minimize trauma and pain by only making a small, single punch in the skin of scrotum with special instruments, as opposed to a conventional, more invasive open procedure.

2. No Needle: Madajet is a spray applicator that delivers a fine stream of anesthetic at a pressure great enough to penetrate the skin and envelop the vas deferens tube beneath the skin with an almost 100% efficacy rate, eliminating the need for additional anesthetic.

95% of Minnesotan patients said there was mild, minimal, or no pain with their brief vasectomy procedure. Each patient is unique, and some are more sensitive to pain and discomfort than others. For some men, thinking about it may be more discomforting anxiety than the actual procedure. By offering no needle and no scalpel techniques for a vasectomy, One Stop Medical Center in the Twin Cities has mitigated the pain of the procedure and the fear that comes with it.

How long will I experience discomfort after Easy™ vasectomy?
The single wound in the middle of scrotum after Easy™ vasectomy is so tiny that it doesn’t even require a suture to close it, which further facilitates the recovery and healing. Discomfort afterwards is minimal. A shorter recovery time with mild swelling and bruise means that patients will be back to their normal routine just in two days after the procedure.

Small percentage men state they still felt a certain degree of ache or discomfort for a few weeks after the procedure, but if you’re still sore or tender after more than a couple weeks you may want to give your physician a call.

Factors Affecting the Sperm Recovery Rate of Vasovasostomy

The microsurgical vasovasostomy is a treatment of choice in restoring sperm to the ejaculate and in establishing pregnancy for men wishing to resume paternity after vasectomy. The success of the reversal is dependent upon the length of time since the vasectomy, vasectomy techniques, the experience of the surgeon, and many other factors.

Success rate for vasectomy reversal is generally reported in two ways: sperm recovery rate (patency success rate) and pregnancy rate. This blog will talk about sperm recovery rate after vasovasectomy. The relationship of pregnancy rates and reversal procedures will be discussed in a separate blog.

The sperm recovery rate of vasovasostomy is influenced by several factors.

1. The single most important factor in whether a vasectomy reversal procedure will be successful is the interval in time (years) between the vasectomy and the vasectomy reversal. Our clinic data is consistent with reported studies demonstrating that sperm recovery rate after vasovasostomy is inversely related to the duration of vasal obstruction after vasectomy. Vasectomy has time dependent adverse effects on the testis, epididymis, and vas deferens (this will be discussed separately).

2. The surgical technique of vasectomy also affects the success rate of vasovasostomy. If the surgeon or family physician uses a technique that is difficult to reverse, such as cutting or burning away too long of segments of vas, or cutting too high or too low, then it will be much more difficult to do anastomosis without tension due to the shortage of vas and too much scar in the tissue. The shorter the proximal end, the greater the “back-pressure”, which will cause “blowout” and scarring of the epididymal tubule.

3. The presence of sperm granuloma in the proximal end was associated with better sperm quality at the anastomosis site and had an improved outcome.

4. The quality of vasal fluid was correlated to a successful outcome after vasovasostomy. If the vasal fluid is clear and lightly milky in color, it is more likely that sperm will be found in the ejaculate following vasovasostomy.

5. The presence of sperm in the fluid retrieved from the proximal vas deferens before anastomosis was highly correlated with successful patency.

6. Finally, the surgeon’s experience and microsurgical skills is important for successful vasectomy reversal procedures.

  • If the ends of vas are not precisely aligned, it may result in leakage of sperm fluid, inflammation, and scarring. While technical failures can occur even with a very experienced microsurgeon, they are far more likely in less experienced surgeons.
  • Many vasectomy physicians use cautery during vasectomy procedures. Careless and extensive cauterization damages the blood supply to a long length of the vas. Vasectomy reversal procedures could further cause inadequate blood supply to the vas. Scar tissue develops at the site of anastomosis, causing a blockage and late failure. This type of failure usually results in some sperm being present early after surgery, with failure 3-12 months later.
  • Therefore, it is important to ask how many reversal procedures the surgeon does every year, as there are will be a big difference between a surgeon who does less than ten reversal procedures and a surgeon who does 200 reversal procedures every year.