Monthly Archives: May 2018

No Scapel Vasectomy Versus Other Birth Control Options | Minnesota

spermAll birth control methods work the best if used correctly and every time you have sex. Your choice of birth-control method is a personal one and depends on a number of variables, including short or long-term family planning, personal health, associated risks, failure rate and cost.

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 less than 1 per 20000 in no scalpel vasectomy with the fascia clipping technique.

Dr. Shu uses 3 steps to insure complete occlusion: he cuts the vas deferens and destroys the lining of the tube on upper end with cautery (scarring it) and places small titanium clips (or sutures) in the vas fascia to separate the opened ends of vas deferens. The lower end keeps open without cauterization (open-ended technique). The vas deferens are then placed back into the scrotum in its normal anatomic position.

Birth Control Methods Comparison

Contraception Cost Failure Rate Duration Availability Advantages Disadvantages
Condom <10 18% one time OTC prevent STIs; no hormonal side effects local reaction & breakage
Vasectomy $700 – $2000 0.2% Permanent Office procedure No effect on hormones and sex drive No protection in the first 3 months, Surgical side effects
Female Condom $2-$4 21% one time OTC prevent STIs; use during menstruation local reaction & breakage
Spermicide $5-$10 28% one time OTC Lubricate, use with other BCP forms local reaction
Sponge $3-$5 24% Up to 24h OTC Lasts 24 hours Local effects and infections
Diaphragm $50-$300 5-20% Reusable Prescription Lasts 24 hours, reusable Insert challenging,local reaction
Cervical cap $50-$75 14-30% 48-72 hours, reusable Prescription Protect 48-72 hours Abnormal Pap smear, local reaction & infection
Birth Control Pill $15-$50/month 9% A month Prescription Regulate menstruation; reduce cramps and ovarian cysts Take daily, weight changes, and medical /risks/side effects*
Vaginal ring $15-80/month 9% Wear monthly Prescription Regulate menstruation; reduce cramps and ovarian cysts Weight changes and medical risks/side effects*
Contraceptive Patch $15-80/month 9% A month, replace weekly Prescription Regulate menstruation; reduce cramps and ovarian cysts Weight changes and medical risks/side effects*
Birth Control shot $35-75/injection 6% 3 months doctor’s visit 4 shots/year; reduces menstrual cramps and the risk of ovarian cysts/cancer and PID Take up to 8 months to return; medical risks/side effects*
Intrauterine device (IUD) $500-$1000 1% 5-12 years Doctor’s visit immediately effective Migrates, ovarian cysts, PID, and ectopic pregnancy
Hormone Implants $400-$800 1% 3 yearse Doctor’s visit reduce menstrual flow, cramping, and PID office procedure, local reaction, Medical side effects**
Tubal Ligation $1500-$6000 1% Permanent Outpatient surgery Permanent and immediate; does not impact sex drive More invasive, complicated than vasectomy, surgical side effect
Essure $1500-6000 1% Permanent Outpatient surgery Less invasive than tubal ligation 3 months to take effect; side effects:cramping,irregular menstrual cycle, GI reaction, and infection

* Medical risks and side effects: may increase risk of blood clots, stroke, breast cancer, heart attack, high blood pressure, depression and anxiety; may decrease sex drive; other side effects include weight gain, breast lumps, and hair loss or excessive growth.

**Medical risks and side effects: can cause loss of bone density and sex drive, and mood swings, weight gain, breast and abdominal pain, and allergic reaction.

References: Birth Control Guide. Food and Drug Administration Office of Women’s Health.

Is the Chance of Birth Defects Higher After a Vasectomy Reversal? | Minnesota

Some patients are concerned over the possibility of birth defects being higher after a vasectomy reversal. The decision to continue having kids after a vasectomy can be a big one and it’s natural to want all your bases covered. So, what does the science say about it?

A landmark study known as the Vasovasostomy Study Group (VVSG) trial sought to answer to that question. Published in 1991 by Dr. Arnold Belker, he and four other surgeons conducted the trial accross five different centers. Described by Herrel as a landmark surgical study in “Meta-analysis of the Microsurgical Vasovasostomy literature”, this study holds quite a bit of weight.

The study followed 291 children born after a vasectomy reversal, tracking their development and medical histories to see what effects, if any, vasectomy reversal had. The study found that, out of the 291, 3 had birth defects- or about 1%.

So how does that compare to the prevalence of birth defects across the nation? Well, according to the Annual Summary of Vital Statistics, published in Pediatrics by Hoyert in 2006, the annual birth defect rate is said to be 3%. Other studies fluctuate between 3% and 5%. The defect rate was actually lower for children born post-vasovasostomy.

Now, does vasectomy reversal reduces or increases the risk of birth defects?
Probably not. Based on what we know, vasectomy and vasovasostomy does not affect the genetic quality of the sperm. In actuality, there is almost certainly no difference in the rate of birth defects regardless if you had a vasectomy reversal or not.

Back in 2006, a study conducted at Chulalongkorn University in Bangkok showed that chromosomal abnormalities of sperms were more common in vasectomized men than men with healthy fertility. However, the authors of the study acknowledged that they were unsure whether these findings would support the theory that the risk of birth defects was higher after vasectomy reversal. So far, there have been no follow-up studies to confirm that such a link exists.

Although vasectomy reversal birth defects are among the possible risks discussed during the consultation, most men are pleased to hear that there is no definitive evidence to suggest that the rate of birth defects after vasectomy reversal is significantly higher than that among the general population. In fact, the rate of birth defects may actually be higher among those who achieve pregnancy through in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), which has been indicated in many researches.

Based on the available scientific literature and our own experiences, if you are looking for a vasectomy reversal, you have nothing to worry about as far as having healthy children go.

How Long After a Vasectomy Will the Patients Become Completely Sterile? | Minneapolis & St Paul

The patients in Minnesota offer ask how long after a vasectomy they become completely sterile and how they can get cleared faster for unprotected sex after a vasectomy. This blog will address these two questions.

Every man produces the sperms that are reabsorbed back into the body. In fact, it is estimated that up to 50% of sperms a man produces is reabsorbed. Sperm travels to the epididymis for storage and maturing. While maturing in the epididymis, some sperms die and break down and reabsorbed through the membranes of tubules by macrophages.

Sperm continues to be produced in the testicles after the procedure. The sperm continue to be stored in the epididymis and are eventually dissolved and absorbed by the body. With the increase of stagnant sperms, 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.

The life cycle of sperm is 63 days. 80% of men will be sterile after 15 ejaculations or 6 weeks after a vasectomy. By 10 weeks, 85% of men will have no sperm in the ejaculate. Therefore, a safe time period to say would be approximately 3 months (12 weeks) after vasectomy with about 20 ejaculations.

It is important to have a semen analysis after vasectomy to confirm absence of live sperm before stopping contraception. Keep in mind, there is a small chance of re-canalization even after no sperm is seen after 12 weeks.

Should the patients be ejaculating a lot in order to clean the pipes out? That’s what some doctors recommended.

The policy in our clinic is that all patients need to do semen analysis in 3 months after vasectomy with about 20 ejaculations.

How to Prepare Before the Easy VasectomyⓇ ?

The introduction of Easy VasectomyⓇ with no scalpel, no needle has successfully allayed many men’s fears with regard to the scalpel and needle. It is safer, less invasive, and has fewer complications and quick recovery. Under local anesthesia, only a tiny puncture is made at the midline of the scrotum skin. It can be done in less than 10 minutes. You don’t need to do any special preparations except simple consideration and common sense as listed below.

Instructions

Before the Easy VasectomyⓇ :

  • Review the information on vasectomy in our website. Read and Understand the “Post Vasectomy Instructions”in the website, so that you know what to expect.
  • To prevent the possibility of increased bleeding, do not take aspirin or other blood thinners for 7 days before the procedure.
  • Please shave the front wall of scrotum and underside of the penis, then take a good shower before you leave home for vasectomy. You will be asked to refrain from doing so again until 2 days after your procedure.
  • Shower and Use no powder or deodorant in the genital area on the day of your procedure.
  • Don’t bring an athletic supporter, we provide you a free athletic supporter on the day of the procedure.
  • Be prepared to sign the operative consent sheet upon your arrival in the office. Think of any questions you may want to ask your doctor.
  • You are able to drive home by yourself after the surgery although a flat tire or fender bender could lead to complications.
  • Eat before your procedure, a normal breakfast or lunch. Nervous men who do not eat beforehand are more likely to become lightheaded during or after their vasectomies.
  • If you are extremely nervous about it, please call us or come half hour early. You may need a sedative to relax, then you should arrange a driver.
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