Is Ouabain the Key to Male Birth Control? | Minneapolis & St. Paul

A safe, oral contraceptive pill for men has yet to be made available, but recent research on ouabain, an ancient African arrow poison, may be the key to developing the ever elusive male birth control.

Led by a small team of scientists from the Institute for Therapeutics Discovery and Development at the University of Minnesota, the search for a non-hormonal male birth control pill ultimately zeroed in on the toxic substance known as ouabain. Found in two types of African plants, ouabain was traditionally used as poison on hunting arrows and is sometimes medically used to treat heart arrhythmias.

In addition to disrupting ion-transporting proteins in cardiac tissue, ouabain is known to affect a transporter subunit found only in sperm cells, an integrin called α4. Because α4 plays a major role in male fertility, research has focused on developing an ouabain-based contraceptive that would specifically bind to the α4 protein and disrupt sperm motility.

This newly created derivative compound, designed to target α4 proteins in sperm cells, has successfully interfered with the cells’ ability to swim and fertilize eggs—without any signs of toxicity when tested on rats. Moreover, the contraceptive effect should, hypothetically, also be reversible since the α4 protein is only found in mature sperm cells.

While there’s still plenty of testing left to do before this pill hits the market, current studies have been extremely promising. The University of Minnesota researchers plan to test the effectiveness of their ouabain-based compound in animal mating trials before moving on to toxicology and safety pharmacology studies. If all goes well, human clinical trials may launch within five years.

A safe, reversible male birth control pill is clearly within reach!

 

Vasectomy Procedures Predicted to Increase By 30 Percent in 2019 | Minneapolis & St. Paul

As the sixth annual World Vasectomy Day quickly approaches, it’s no surprise that more men around the world are becoming increasingly informed about vasectomy options and family planning. With vasectomy global awareness rapidly rising, it’s only a matter of time before we see a spike in procedures performed.
 
VasectomyStore.com, a New York “web-based surgical instrument and information store” that has promoted vasectomies for over two decades, recently predicted that US doctors will see a whopping 30 percent increase in vasectomy procedures in 2019. As public perceptions and knowledge of male contraception slowly change, more men and couples are expected to consider the underutilized vasectomy procedure.

“Vasectomy has experienced a popularity surge in recent years,” the company said in a statement. “It’s partly the economy but also events like World Vasectomy Day that really spotlight the value of men taking responsibility in family planning.”

World Vasectomy Day celebrates responsible men who rise up out of love for their partner, their family and our future. Please join One Stop Medical Center in supporting this movement—our clinic will offer a gift card for one free large pizza to all patients who undergo a vasectomy on November 14, 2018.

For more information on our clinic’s vasectomy services, please click here or call us at (952) 922-2151.

 

Celebrate World Vasectomy Day on Nov. 14 With One Stop Medical Center | Minneapolis & St. Paul



From Bali to Kenya to Mexico, the World Vasectomy Day (WVD) movement has rapidly spread across the globe with the crucial mission of engaging men in family planning conversations. This year’s WVD celebration, held in Kigali, Rwanda, on November 14, is set to feature the movement’s most comprehensive and innovative event lineup to date.

By teaming up with local NGOs and the Rwanda Ministry of Health, WVD aims to not only provide high-quality vasectomies to men whose families are complete, but to also promote family planning through a broad media campaign. This dynamic, exciting two-week lineup showcases everything from doctor training programs and vasectomy-focused lectures to a reproductive health fair and an all-day vasectomy-athon.

Dr. Shu and One Stop Medical Center are proud to support WVD for a sixth straight year. Our clinic will offer a gift card for one free large pizza to all patients who undergo a vasectomy on November 14, 2018. Through our collaboration efforts, we hope to make vasectomies more accessible worldwide while helping more men explore family planning options.

World Vasectomy Day celebrates responsible men who rise up out of love for their partner, their family and our future. Please join us in supporting this movement.

 

The Curious Case of Vasectomy Late Failure | Minneapolis & St. Paul

After undergoing a vasectomy procedure, patients typically aren’t declared sterile until a post-surgery semen examination comes back negative. While early failure of a vasectomy—where semen is detected in the ejaculate soon after the procedure—has been recorded and recognized as a possibility for nearly 50 years, late failure of a vasectomy wasn’t considered until years later.

Late failure of a vasectomy occurs when semen reappears in the ejaculate even after two previous negative specimens. In an eight-year span between 1984 and 1992, six spontaneous late failure cases were recorded. All six cases resulted in DNA-proven fatherhood despite previously consistent negative semen analyses that confirmed patients could forego secondary contraception.

In one case, a patient who underwent a vasectomy in March ’84 recorded one positive semen analysis before recording two consecutive negative analyses later that year. Despite his negative semen results, he conceived a child in November ’85 while still showing a negative sperm count post-conception.

How does late failure of a vasectomy even happen? Based on study results from Churchill Hospital in the UK, it’s assumed that patients must have intermittently produced small amounts of viable semen either in between semen analyses or after the final analysis. Furthermore, results showed that even when post-conception semen analyses came back negative, paternity was still possible and, in these cases, actually confirmed via DNA.

All in all, a vasectomy is still the most reliable method of permanent male contraception. However, it’s important for all patients to note that late failure and/or pregnancy after a vasectomy, while rare, is still a possibility.

 

Study Finds Limited Use of Post-Vasectomy Secondary Contraception | Minneapolis & St. Paul

Last month, we published a post emphasizing the importance of using contraception even after a vasectomy, as patients are NOT completely sterile immediately following the procedure. Because “a series of follow-up tests is required to first confirm that sperm are no longer present in the patient’s semen,” using some form of birth control in the first few months post-surgery is strongly advised.

However, a study conducted within the Pregnancy Risk Assessment Monitoring System (PRAMS) found that over half of the study’s couples (57.8%) did NOT use secondary contraception after undergoing a vasectomy postpartum. All couples had recently given birth and had reported a partner vasectomy four months following the live birth. Conducted in 15 states and New York City, the study assessed both the election of post-vasectomy birth control and the method of birth control used.

Essentially, this means that the 57.8% of couples who chose not to use secondary contraception relied solely on the vasectomy itself as their birth control method. Of the remaining 42.4% who opted for secondary contraception, 50% used condoms, 26.5% used oral contraceptive pills, and 9.5% chose the withdrawal method.

Based on these results, it seems that doctors and clinics need to better communicate to patients the necessity of secondary contraception in the months immediately following a vasectomy. In order to reduce the chance of unintended pregnancy, it is also important to understand the complexities surrounding why some couples choose not to use secondary contraception, despite being advised to.

For more info on our vasectomy procedures, please refer to our FAQ page or schedule an Easy VasectomyⓇ consultation.

 

A Brief History of the Eugenics Movement in America | Minneapolis & St. Paul

If you haven’t heard of eugenics (meaning “well-born”), it is the study of or belief in societal and scientific intervention to bring about the “fittest” population through means such as forced sterilization, abortions, euthanasia and discriminatory marriage laws. The movement’s intent was to improve the quality of the human population by discouraging reproduction by people with genetic defects or what were thought to be inheritable undesired traits.

The origin of eugenics in the United States began in 1899 with Albert Ochsner, future Professor of Surgery at the University of Illinois. In his published paper Surgical Treatment of Habitual Criminals, Ochsner described a new procedure that sterilized a male subject by cutting his vas deferens, a procedure that became known as a vasectomy. He advocated for the use of vasectomies on criminals, believing that:

  • It would dispense with hereditary criminals from the father’s side
  • Aside from being sterile, the criminal would be unchanged (unlike after castration)
  • It would protect the community at large without harming the criminal
  • The height of the eugenics movement (1920s to mid-20th century) saw compulsory sterilization programs established in over 30 states, resulting in over 60,000 sterilizations of often healthy people. Criminals and prison inmates were especially targeted, as well as those deemed “feeble-minded,” mentally deficient, or simply capable of passing on undesirable genes.

    Planned Parenthood, a global reproductive health care provider, was actually a product of the eugenics movement. Its founder, Margaret Sanger, was a prominent eugenicist who argued that this “new weapon of civilization and freedom” could solve “race problems” and result in “racial regeneration.” This belief in ensuring “racial purity” typically involved laws that aimed to prevent interracial marriage, taking the concept of eugenics and population control another step further.

    If any of this sounds familiar, history’s most infamous admirer of America’s eugenics policies was Adolf Hitler, who modeled the Third Reich after American eugenic institutions. As he expressed in Mein Kampf, Hitler was determined to prevent “defective people” from “propagating equally defective offspring,” a mission that he firmly believed required a systematic execution. In response, the American Eugenics Society issued a statement of praise in 1937 to the Nazi scientists who hoped to cleanse the gene pool.

     

    What Exactly Is a Post-Vasectomy Scrotal Hematoma? | Minneapolis & St. Paul

    While a No-Scalpel Easy Vasectomy® is one of the safest procedures, there are still chances of minor complications, such as bleeding and infection. One potential post-surgery complication is a scrotal hematoma—a collection of blood inside the scrotum—and it occurs in approximately two to five percent of vasectomies.
     

    Symptoms

    Scrotal hematomas typically occur within a few days following a vasectomy procedure. They’re often accompanied by swelling, bruising and pain around the scrotum. The severity of one’s symptoms mainly depends on the size of the hematoma: a small hematoma may not have any symptoms at all or simply cause minimal swelling and discomfort, while a larger hematoma can result in extensive bruising and severe pain. After the swelling reduces, a hematoma generally feels like a hard lump in the scrotum.
     

    Treatment

    If you experience post-vasectomy discomfort such as significant bruising, swelling and unexpectedly intense pain, you may have developed a scrotal hematoma and will need to see your doctor immediately.

    Depending on size, hematomas may gradually resolve on their own after a few weeks, and symptoms should diminish as the hematoma shrinks. Your doctor may recommend pain medications, a scrotal supporter, and hot baths to alleviate discomfort and speed up recovery. Surgical intervention may be necessary in cases of very large hematomas or arterial hematomas.
     

    Prevention

    While it’s impossible to completely eliminate the risk of developing a hematoma after your vasectomy, there are two crucial factors that can potentially help minimize the odds of it occurring.

    Firstly, experience matters. In general, the more vasectomy operations a doctor has performed, the lower the chance of patients developing hematomas. One study found that “the incidence of hematomas was 4.6 percent for physicians performing 1–10 vasectomies annually, 2.4 percent for those performing 11–50 annually, and 1.6 percent for those performing >50 annually.”

    Secondly, the no-scalpel vasectomy technique offers a number of benefits over the traditional vasectomy method, one of those being a lower risk of developing a post-vasectomy hematoma.

     

    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.

    Male Birth Control: The 3 most promising new methods | Minnesota

    Traditionally, us guys don’t have a lot of options when it comes to contraception. There’s condoms, vasectomies, “pulling out”, and that’s about it. However, all of these methods have major setbacks. Condoms take a while to put on and can kill the mood. Vasectomies are convenient, but are not reversible without invasive surgery. And pulling out, well, is the hallmark of bad decision making.

    Every now and then, there are headlines that give hope to all the men looking to avoid children in their lives. Like the Italian guy who invented a magical “switch” implant that is now on permanent hiatus. Headlines like those, which never seem to go anywhere.

    Luckily, there are some new options in development for these men.

    Gel contraceptive

    This form of male birth control is closest to being put on the market. Called Nestorone-Testosterone, the gel contains two hormones, testosterone and progestin. The key ingredient here is the progestin, a synthetic version of the female sex hormone progesterone, which shuts down testosterone production by suppressing the gonadotropin hormones. Lower testosterone means lower sperm production, which means a lower chance of pregnancy.

    Of course messing with hormones can have very negative consequences, which is why the gel contains some testosterone to ensure levels are not too low, which can cause low libido and delayed ejaculation.

    A study funded by the National Institute of Child Health and human development revealed that 90% of men who used the gel had a sperm concentration lower than one million per milliliter, which is low enough to prevent pregnancy with minimal side effects.

    Still, there is a long road to go. Right now trails are being performed on 420 couples around globe- if successful, the contraceptive could move onto the next stage, which involves trials on an even larger scale. It might be another ten years- but it’s a start.

    Birth Control Pill

    The problem with male BC pills is the short half life of sperm-suppressing hormones, meaning the drug decays very quickly, and so do its effects. However, a new study featuring an experimental male BC pill seems to show promise.

    Dimethandrolone undecanoate, or DMAU, is a drug that works in a similar way to the gel contraceptive. Like the gel, it contains both testosterone and progestin. While its effectiveness and reducing sperm count is still unknown, the trials show that the drug is safe to take every day for a month, with minimal side effects.

    Researchers at the UCLA and University of Washington are beginning a joint study that tests the efficacy of a DMAU injection, which could work several months at a time, which would be more convenient and more similar to injectable female birth control methods.

    RISUG

    RISUG, which I have written about previously, is a promising new procedure that is like an advanced form of vasectomy. The method was pioneered by biomedical engineer Sujoy Guha from the Indian Institute of Technology, and involves injecting a gel into the vas deferens (the tube that carries sperm to the semen), preventing sperm flow without affecting production or hormone levels. Unlike a vasectomy, this process is (theoretically) easily reversible, requiring only one other injection to dissolve the block. This avoids the inconvenience and possible failure of a vasectomy reversal, which is like stitching together the ends of two wet noodles. Not to mention, it’ll be a lot cheaper

    It will be a considerable amount of time before this product hits the US market. The rights to the technology have been sold to the Parsemus Foundation, a nonprofit based in California, but there are unfortunately no human trials coming in the near future.

    Regardless, we can expect to see many of these inventive new technologies in pop up in the next decade or two. Adoption of new birth control methods could mean a major reduction in unplanned pregnancies, especially in more developed countries as birth controls cheaper and more convenient worldwide.

    More about Sperm Banking | Minnesota

    Sperm banking, in the simplest of terms, refers to the practice of storing sperm for future use. Sperm can be stored indefinitely when cryogenically frozen, and can be thawed and used to fertilize an woman’s egg. A pregnancy conceived using frozen sperm is no different from a normal pregnancy.

    There are two types of sperm banks- private sperm banks, and donor sperm banks. Donor sperm banks, which many of you may have heard of, purchase sperm provided by donors and sell it to those who want children. Donors are screened and added to a database, and buyers can select which donor they prefer.

    A private sperm bank, unlike a donor sperm bank, only cater to individual families. Private sperm banks may be associated with a fertility clinic, or may be a branch of a national corporation. The sperm sample is either collected locally, at a clinic, or mailed overnight through a home collection kit. Many doctors may recommend two samples taken on separate days, just to be safe.

    Before the sperm can be collected, the donor’s blood must be tested for diseases that could be transmitted through sperm. This includes HIV, hepatitis B and C, and many more. If the donor tests positive for any of these the sample may be unusable.

    Once collected, the a small portion of the sample is tested to see how well it holds up to freezing and thawing, and whether or not it will be viable for future use. If all goes well, the sperm is slowly frozen in liquid nitrogen tanks at -190C, where they can be kept stable almost indefinitely. Even twenty year old sperm can still be useable.

    When the time comes for the sperm to be used, the bank coordinates the transfer of the frozen sperm to the fertility clinic, where it is thawed and prepared for the insemination procedure. Usually, only a small amount of sperm is required. That way, if it doesn’t work the first time, there will be enough for future attempts.

    Why Sperm Banking?
    Private sperm banking is excellent for men who wish to conceive a child but have lost reproductive function or have issues with infertility. It is also great for men who are unsure if they want a child, but wish to have the option later on in life. Men who plan to undergo vasectomy are good candidates to have their sperm frozen. Sperm banking is highly effective and well established method of ensuring future reproductive success.

    5th World Vasectomy Day | Minnesota

    It might seem odd to dedicate an entire day to vasectomies, but for Dr. Shu and the other 1,000 doctors participating in World Vasectomy Day on November 17, it’s an important event that spreads awareness on the most effective but underutilized methods of contraception: the vasectomy.

    With industrialization and modern medicine making it safer and easier to give birth and raise children, the world population has skyrocketed- current projections predict the world population will plateau at 11 billion. High population puts a strain on resources like food, medicine, and energy. In many areas of the world that are seeing rapid population growth, sexual education and medical resources have not caught up to other areas in society. Vasectomies are excellent for family planning in areas that are not well developed and do not have the resources that most of us take for granted.

    At World Vasectomy Day, local Mexican and international doctors will provide free vasectomies, along with live-streamed interviews with family planning experts, patients, and their families. This will be Dr. Shu’s 5th year participating in the event, and the One Stop Medical Center will offer free large pizza.

    This year’s World Vasectomy Day is being held in Mexico. Doctors around the world participating in World Vasectomy Day will provide as many vasectomies as possible in a span of 24 hours. The goal of World Vasectomy Day is to spread awareness of vasectomies and to dispel myths associated with them through community outreach and open dialogue.

    Vasectomy and Sex Life | Minnesota

    Vasectomy is undeniably the most effective long term birth control for men, with half a million men undergoing the procedure in America every year, but some remain hesitant despite being assured of its safety and reliability. Faced with the idea of being infertile, the vasectomy can be a daunting proposition to many men. Fertility and sexual virility is heavily tied with the masculine identity, and to some vasectomy may be equivalent to surrendering some of it. Here’s why you shouldn’t worry.

    A fear of many men looking to get a vasectomy is the loss of sexual desire or satisfaction after getting snipped. What many people don’t seem to realize is that vasectomy rarely affects sexual pleasure physically- when men suffer erectile dysfunction or loss of sexual arousal after vasectomy, it is almost always psychological. Physically, vasectomy should not affect libido- vasectomy is simply the severance and obstruction of the vas deferens. Besides the semen containing no semen, there should be no difference in sexual function after a vasectomy. Of course, complications exist but with innovations such as no-scalpel vasectomy making the procedure increasingly less invasive, they are incredibly rare.

    Getting a vasectomy shouldn’t be seen as losing your manhood. Most men who are nervous about losing their manhood quickly realize that their sex is just as good as it was before, if not better. A study done on the effects of vasectomies on the sex lives of couples proved just that. In the study, a sample of 76 heterosexual couples were given a survey, one for the man and one for the woman, which score parameters such as sexual desire, coital satisfaction, erectile function, etc, before and after the procedure and the results were very interesting!

    In men, scores on the questionnaire revealed that quality of the sex was about the same before and after the procedure. Erectile function, orasm function, sexual desire, sexual satisfaction all either increased a slight amount or stayed level. The result, though unsurprising, should put some potential patients at ease. What was much more interesting was that in women, scores were higher in almost all areas, showing significant increase in sexual desire, arousal, lubrication, orgasm, and overall satisfaction. Women in relationships tend to be more satisfied sexually after their partner gets a vasectomy. This is further evidence that most issues with sex after vasectomy are psychological rather than physical.

    Another study examined the relationship between vasectomy and frequency of sexual intercourse in populations of vasectomized and non-vasectomized men. The results also seemed to support that sex is better after vasectomy- vasectomized men had sex an average of 5.9 times a month compared to 4.9 times per month in non vasectomized men. Furthermore, vasectomized men were 81% more likely to have at least once a week.

    So if the idea of losing sexual potency after a vasectomy scares you, don’t be- there’s really nothing to worry about. Studies have shown that vasectomy either has no effect or increases sexual satisfaction, and that vasectomy actually increases the frequency of intercourse.

    Introduction of Sperm Banking | Minnesota

    Cryopreservation (rapid freezing) is the method of preserving sperm for future use. There are many reasons an individual would choose to prepare for possible sterility, including

    1. Pending cancer treatments
    2. Elective vasectomy
    3. Infertility (use frozen donor semen)
    4. Initiating hormone therapy
    5. Having a high risk job.

    For some men, sperm banking is almost a necessity. Men diagnosed with cancer during their early 20’s face a course of chemotherapy likely to provide a cure but also likely to adversely affect sperm production. Their only hope of fathering children is with preservation and storage of sperm obtained prior to chemotherapy. For years, sperm banks have been providing this service.

    On occasion, a vasectomy candidate will ask about storing his sperm prior to undergoing vasectomy. The question is whether sperm freezing and storage (cryopreservation) might be considered a reasonable alternative to vasectomy reversal in the unlikely event that the individual wishes to father children in the future.

    For another group of men, infertility has necessitated use of donor semen. While these men may be infertile for a variety of reasons, use of donor sperm allows their wives to experience pregnancy and childbirth, obviously not part of the adoption process. Nearly all donor sperm used nowadays is obtained from frozen semen. Fresh semen is almost never used because infected donors may not test positive for hepatitis and AIDS until weeks after donation. Cryopreservation of semen provides the safety net needed to confirm that sperm donors are healthy and have negative tests weeks or months after donating.

    Frozen semen can be stored for an indefinite amount of time. It can be used effectively in different types of fertility treatments, including in vitro fertilization (IVF), intrauterine insemination (IUI), or gamete intrafallopian transfer (GIFT).

    What about Ejaculation After Vasectomy? | Minneapolis & St Paul

    Men in Minnesota who plan to have a vasectomy always wonder what their ejaculations will be like afterwards. This is not an unusual question’ many are simply curious, while others have anxiety about this sort of thing.

    Generally speaking, patients haven’t had any issues of ejaculation after vasectomy. Post-vasectomy ejaculation should be no different than it was before the procedure.
    This blog is going to address some common questions related to initial post-vasectomy ejaculations.

    1. When is the earliest time for the first ejaculation after the procedure?
    Most doctors recommend waiting for a week, other doctors recommend a few days. There is no “scientifically” correct answer. Regardless of when you start sexual activities, the most important thing is that you still use protection until you are cleared.

    2. Are the initial ejaculations painful after the vasectomy?
    Most patients should not have painful ejaculations after a vasectomy. A few patients reported mild discomfort in the first ejaculation. If the patient starts sexual activities very early (within a week), they may experience some discomfort due to local swelling, bruising, or tenderness.

    3. Do the ejaculations change after a vasectomy?
    No, the ejaculations after a vasectomy will be pretty much the same as they were before the vasectomy procedure. There are no noticeable changes in volume, color, or smell of semen. The force of your ejaculations will also remain same after your vasectomy.

    The only thing that really changes in post-vasectomy semen is that it no longer contain any sperm. Sperm only accounts for less than 5% of the volume of a man’s ejaculate, so the tiny change is not going to be noticeable. In fact, the volume of semen naturally varies at that rate based on fluid intake, diet, physical activities, frequency of ejaculation, etc.

    4. Should I be concerned about blood in ejaculations after a vasectomy?
    Blood in the ejaculate often causes great concern to the men who experience it after a vasectomy. This is due to a condition called hematospermia, or hemospermia. It could occasionally happen in the first month after a vasectomy. If you can imagine, the vas tube has been opened and any resultant blood from the wound or ruptured capillary vessels can pass through the tube during healing.

    Post vasectomy hematospermia is an uncommon finding after a vasectomy however it is not alarming. Most cases of hematospermia after vasectomy are generally self-limited, and it usually resolves within a few weeks. No further diagnostic workup is needed; however, in some patients, hematospermia may be the first indicator of other urologic diseases such as prostate or seminal vesicle (male sex glands). If it persists, it may be wise to consult with a urologist.

    Reasons of Vasectomy Failure | Minnesota

    While vasectomy has long been thought of as permanent, ending your ability to have kids, this is clearly not the case for Jets quarterback Antonio Cromartie, who had twins last year with his wife Terricka, conceived well after his vasectomy a couple years ago. The couple found out about the pregnancy completely on accident one day when his wife went to the ER with a bad stomach. However, it was clearly not an issue for the footballer and they kept the baby. He’s now welcoming their 14th child into their home.

    Why do vasectomies fail?
    Vasectomy failure is the occurrence of pregnancy or failure to achieve azoospermia after a reasonable period of time following vasectomy. The positive result of Post Vasectomy Semen Analysis (PVSA) can be stressful for couples looking forward to anxiety-free intercourse, without the threat of pregnancy.

    The most common reason is intercourse immediately after the vasectomy without protection. Even after the vas deferens (the tube that carries sperm) is cut and sealed, sperm will still be in the tube and it takes some time in order to ensure the vas is completely cleared out. Men typically have to ejaculate 20-25 times before all the sperm is gone. Unprotected sex before this time can definitely lead to unintentional pregnancy. This is the reason that you continue to use protection for three months after your vasectomy.

    The second most likely, though less common, is recanalization failure. Actually, recanalization is the most common reason for technical failure in vasectomy, and it could happen even in a experienced surgeon. In vasectomies, the vas deferens is cut and the ends are blocked. Recanalization occurs when the sperm is still allowed to pass and go into the ejaculate. Sperm try and often succeed in penetrating through the end of the blocked vas. After a couple months of this, there can be many tiny holes in end of the vas deferens where sperm may flow out through pseudo channels.

    Recanalization following vasectomy should be suspected if motile sperms or rising sperm concentrations are seen after a initial or routine PVSA has shown azoospermia or Rare Non-motile Sperms (RNMS). Recanalization can be either transient or persistent based on the results of serial PVSAs. Pregnancy due to recanalization is estimated to occur after approximately 1 in 2000 vasectomies or less often. The incidence of recanalization is very likely greater than the reported rate of pregnancy after post-vasectomy azoospermia because not all recanalizations result in pregnancy.

    About half of the recanalizations will close (seal by scarrring) by itself in 6 months and contraceptive success will be achieved, the patients don’t need to repeat vasectomy. Other 50% patients who have persistent recanalization need to repeat vasectomy.

    The third and least common is technical failure resulting from a surgical error such as occluding one vas twice without occluding the other vas or failure to identify the very rare situation of vas duplication on one side. An extra vas is a very rare condition. Very occationally, the wrong tube (unusual large blood vessels) can be mistakenly blocked. Technical failure is characterized by persistently normal or nearly normal motile sperm counts and sperm motility after vasectomy, as if the procedure was never done! It happens more often in a inexperienced family physicians or surgeons.

    It is recommended to get sperm tested three months after the vasectomy to ensure that it worked. But our patients usually don’t need to have a semen analysis periodically if the vasectomy performed in our clinic is confirmed to be successful. Dr. Shu has performed about 1500 cases of vasectomies, all of them being successful!

    Vasectomy is a big life decision. It is important to know if the vasectomy was successful or not, so get your sperm tested after your vasectomy!

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