Vasectomy

Effect of long-term testosterone propionate or human chorionic gonadotrophin administration on reproductive glands in adult male rabbits

The study was aimed to investigate the effect of testosterone propionate (TP) or human chorionic gonadotrophin (hCG) treatment on reproductive glands in sexually mature male rabbits. A total 36 adult male rabbits were randomly distributed to six equal groups. The first control group (CON), the second treated with low-dose TP (TPL), the third treated with high-dose TP (TPH), the fourth treated with low-dose hCG (CGL), the fifth treated with medium-dose hCG (CGM) and sixth treated with high-dose hCG (CGH). At the 16th post-treatment week, the animals were sacrificed, and the testes and accessory sex glands dissected, weighted and stored at -20 °C until assay. Testosterone propionate treatment in both doses resulted in reduction (P < 0.01) in testicular weight and increase (P < 0.01) in weight of vesicular gland, paraprostate and proprostate glands. High-dose TP increased the weight of prostate and bulbouretheral gland (BUG). Testosterone propionate increased total androgen (P < 0.01) with Testosterone (T) predominating in serum, dihydrotestosterone (DHT) predominating in testes and most accessory sex glands. High dose of hCG increased the weight of proprostate and paraprostate glands. Androgen level in serum, testes and accessory sex glands increased (P < 0.01) after hCG treatment.

Update on vasectomy protocol

Vasectomy is a commonly practiced form of male contraception with over half a million procedures performed annually. Among urologists who perform the procedure, there is considerable variation in pre-procedure patient counseling, vasectomy technique, and post-procedure practices regarding confirmation of sterility. We report an overview of the vasectomy literature published within the past year with a focus on guidelines that have been recently published by two major organizations, the American Urological Association (AUA) and the European Association of Urology (EAU).

Are sexual problems more common in women who have had a tubal ligation? A population-based study of Australian women

OBJECTIVE

To investigate whether women who have had a tubal ligation are more likely to experience sexual problems than other women.

DESIGN

Population-based telephone survey.

SETTING

Australia-wide, including cities, regional towns, and rural areas.

POPULATION

A total of 3448 Australian women aged between 16 and 64 years.

METHODS

Women were surveyed using random-digit dialling throughout 2004 and 2005.

MAIN OUTCOME MEASURES

Prevalence of sexual problems and ratings of sexual satisfaction, relationship satisfaction, and sexual pleasure.

RESULTS

From a weighted sample of 2721 women, 447 (16.4%) reported having had a tubal ligation, with 85.0% currently aged between 40 and 64 years. Having a tubal ligation was not associated with any specific sexual problem, such as physical pain during sex or an inability to reach orgasm. In fact, after controlling for age and other sociodemographic differences, sterilised women were significantly less likely than non-sterilised women to lack an interest in having sex (OR 0.69, 95% CI 0.54-0.89), to take 'too long' to reach orgasm (OR 0.69, 95% CI 0.50-0.96), to experience vaginal dryness during sex (OR 0.70, 95% CI 0.50-0.96), and to find sex unpleasurable (OR 0.64, 95% CI 0.46-0.90). Sterilised women were also more likely to experience extremely high levels of sexual satisfaction (OR 1.66, 95% CI 1.27-2.18), relationship satisfaction (OR 1.29, 95% CI 1.01-1.67), and sexual pleasure (OR 1.59, 95% CI 1.20-2.12).

CONCLUSIONS

Our findings suggest no adverse effects, and possibly some benefits, for the sexual lives of women undergoing tubal ligation. These findings should be included with other educational material for couples considering sterilisation as a contraception option.

Sexual activity, fertility and contraceptive use in middle-aged and older men: Men in Australia, Telephone Survey (MATeS)

BACKGROUND

With limited information regarding fertility and sexual activity in the older population, men's behaviour, attitudes and concerns were explored in a representative population of middle-aged and older men using the Men in Australia, Telephone Survey (MATeS).

METHODS

A stratified random national sample of 5990 men participated in a standardized computer-assisted telephone interview. Equal numbers in the age strata 40-49, 50-59, 60-69 and >or=70 years were surveyed with findings census-standardized to the national population. Broad aspects of men's health and well-being, including reproductive health, were explored.

RESULTS

The majority of men were sexually active in the last 12 months (age-standardized proportion, 78.3%) with approximately 37% of men aged >or=70 years still continuing sexual activity. Overall, 12.2% of men had never fathered children, of whom most (7.7%) had chosen not to have children. Questioning on failed attempts to produce a pregnancy suggested an involuntary infertility rate of 7.6%. The age-standardized vasectomy rate was 25.1%, with 5.6% of vasectomized men having no children. Although 9.2% of vasectomized men regretted sterilization, only 1.4% had undergone vasectomy reversal.

CONCLUSIONS

Continuing sexual activity, fertility and contraception needs in middle-aged and older men suggests that education and service delivery must be more appropriately directed to an ageing population.

Vasectomy and the risk of prostate cancer: a meta-analysis examining vasectomy status, age at vasectomy, and time since vasectomy

The aim of this study was to conduct a quantitative review of prostate cancer studies to pool relative risk (RR) estimates on the association between prostate cancer and vasectomy, in an attempt to determine whether there is an association, and if so, its magnitude. Random-effects models were examined along with a linear model for time since vasectomy. The pooled RR estimate was 1.37 (95% CI=1.15-1.62) based on five cohort studies and 17 case-control studies. The RR estimate varied by study design with the lowest risk for population-based case-control studies. No difference was seen in risk by age at vasectomy. A linear trend based on the 16 studies reporting time since vasectomy suggested an 10% increase for each additional 10 y or a RR of 1.32 (95% CI=1.17-1.50) for 30 y since vasectomy. When null effects were assumed for the six studies not reporting information, the linear RR for the 22 studies was 1.07 (1.03-1.11) and 1.23 (1.11-1.37) for 10 and 30 y since vasectomy, respectively. These results suggest that men with a prior vasectomy may be at an increased risk of prostate cancer, however, the increase may not be causal since potential bias cannot be discounted. The overall association was small and therefore could be explained by bias. The latency effect shown here for time since vasectomy should be examined further.