Male Contraception 3 Flashcards
The learner will be able to describe the risks and benefits associated with a vasectomy procedure.
1
Q
List the types of vasectomy procedures.
A
- “No Scalpel” Vasectomy
- Minimally Invasive Vasectomy
- Conventional Vasectomy
2
Q
What are some of the common complications that can arise from a vasectomy?
A
-
Hematoma Formation
- incidence is approximately 2%
- most common complication
- directly correlates with annual number of procedures performed by surgeon
- scrotum is expandable and as poor tamponading capability
- Infection: Incidence is approximately 1.0%.
- Chronic Pain: Incidence is approximately 0.1%; congestive epididymitis; elevated back pressure behind vasectomy occlusion site +/- inflammation. Most men respond to treatment with anti-inflammatory agents; rarely vasectomy reversal or epididymectomy can be employed.
- Sperm Granuloma: Inflammatory response to extravasation of sperm; feels like a pea or marble at the vasectomy site; typically does not cause bother, and usually it does not require therapy.
- Recanalization/Vasectomy Failure: Approximately 1/1000 rate. Simple division and ligature of vas deferens associate with ~ 8.7% failure rate. With addition of fascial interposition, failure rate drops to ~ 0.3%. Fascial interposition is the key step to decreasing the risk of vasal recanalization.
- Vasectomy is NOT causally linked to prostate cancer, testicular cancer, atherosclerosis, coronary artery disease, or dementia.
3
Q
After a vasectomy, when is a patient cleared to resume sexual activity without contraception?
A
- First semen test is performed at 8-16 weeks (or > 20 ejaculations) after vasectomy.
- 80% of men will have no sperm or rare nonmotile sperm by 12 weeks after the procedure.
- Clearance given if a single semen sample shows no sperm; OR
- A fresh, well-mixed, noncentrifuged sample shows no sperm or < 100,000 nonmotile sperm/mL.
- If any motile sperm persist at > 6 months post vasectomy, the procedure should be deemed a failure and a repeat vasectomy should be offered.