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Habli M, Belal D, Sharma A, Halawa A. Infertility, pregnancy and breastfeeding in kidney transplantation recipients: Key issues. World J Meta-Anal 2023; 11:55-67. [DOI: 10.13105/wjma.v11.i3.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/22/2023] [Accepted: 02/13/2023] [Indexed: 03/01/2023] Open
Abstract
Chronic kidney disease (CKD), especially in advanced stages, is an important cause of infertility. In CKD patients, infertility has been linked to multiple factors. The pathophysiology of infertility related to CKD is complex and forked. Correction of modifiable factors can improve fertility in both genders. In males as well as females, successful kidney transplantation offers good chances of restoration of reproductive function. In female renal allograft recipients, recovery of reproductive functions in the post-transplant period will manifest as restoration of normal menses and ovulation. Owing to this improvement, there is a significant risk of unplanned pregnancy, hence the need to discuss methods of contraception before transplantation. In kidney transplant recipients, different contraceptive options for pregnancy planning, have been used. The selection of one contraception over another is based on preference and tolerability. Pregnancy, in renal transplanted females, is associated with physiologic changes that occur in pregnant women with native kidneys. Immunosuppressive medications during pregnancy, in a recipient with a single functioning kidney, expose the mother and fetus to unwanted complications. Some immunosuppressive drugs are contraindicated during pregnancy. Immunosuppressive medications should be discussed with renal transplant recipients who are planning to breastfeed their babies. In addition to antirejection drugs, other medications should be managed accordingly, whenever pregnancy is planned.
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Affiliation(s)
- Mohamad Habli
- Department of Internal Medicine, Division of Nephrology, Kingdom Hospital, Riyadh 11564, Saudi Arabia
| | - Dawlat Belal
- Kasr El-Ainy School of Medicine, Cairo University, Cairo 11562, Egypt
| | - Ajay Sharma
- Royal Liverpool University Hospital, Royal Liverpool University Hospital, Liverpool L7 8YE, United Kingdom
| | - Ahmed Halawa
- Department of Transplantation, Sheffield Teaching Hospitals, Sheffield S10 2JF, United Kingdom
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Mihretie GS, Abebe SM, Abera M, Assefa DT. An Interpretative Study of LARCs Discontinuation in Ethiopia: The Experiences of Women Accessing Contraceptives in Selected Public Health Facilities. Open Access J Contracept 2023; 14:41-51. [PMID: 36824684 PMCID: PMC9942686 DOI: 10.2147/oajc.s394590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/04/2023] [Indexed: 02/19/2023] Open
Abstract
Background Discontinuation of contraception for reasons other than wanting to become pregnant is a public health concern as it affects women's autonomy in sexual and reproductive health decision making as well as gender equality. Studies identified various factors, including community perception and users' dissatisfaction that limited the reach and impact of contraceptives, primarily LARCs, on women's wellbeing. In Ethiopia, however, the reasons for early discontinuation of LARCCs are not adequately explored. Against this backdrop, this study explores the main reasons for the early discontinuation of LARCs among Ethiopian women in selected public health facilities. Methods This study used an institution-based qualitative study design and covered selected university hospitals and health centers in Addis Ababa, Gondar, Mekelle, and Jimma. It involved in-depth interviews with 29 women aged 15-49 to gather data and explore the decision-making processes involved in the early discontinuation of LARCs. It used description, narration and thematic interpretation as data analysis procedures. Results Interviewees reported several reasons for early discontinuation of LARCs, including side effects (eg, weight gain/loss, heavy menses, tiredness, and reduced libido), desire to conceive, and husbands' disapproval. This study found that women were sufficiently aware of alternative contraceptives, including LARCs. Many reported experimenting before deciding on an option. Conversely, others' reports reveal the influences of gender roles and community misconceptions on women's decisions to discontinue LARCs. Discussion and Implications The common threads in interviewees' narratives highlight the significance of traditional values, gender roles, community perception, and experience with side effects to women's early discontinuation of LARCs. This study concludes with remarks on how to improve the effectiveness of family planning programming by adopting the gender transformative approach (GTA) in their design and implementation.
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Affiliation(s)
- Getasew Sisay Mihretie
- Department of Obstetrics and Gynecology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Mekonnen Abebe
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,Correspondence: Solomon Mekonnen Abebe, University of Gondar, P.O.Box 196, Gondar, Ethiopia, Email
| | - Mikyas Abera
- Department of Sociology, College of Social Sciences and the Humanities, University of Gondar, Gondar, Ethiopia
| | - Daniel Tadesse Assefa
- Monitoring Evaluation Research and Quality(MERQ) Consultancy PLC, Addis Ababa, Ethiopia
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3
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Anderson DJ, Lucero M, Vining S, Daniel C, Hasoon J, Viswanath O, Kaye AD, Urits I. Vasectomy Regret or Lack Thereof. Health Psychol Res 2022; 10:38241. [PMID: 36118980 PMCID: PMC9476225 DOI: 10.52965/001c.38241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2023] Open
Abstract
Background Vasectomy is a procedure that results in permanent yet reversible sterility and remains a great contraceptive option for many. Previous research studies have highlighted frequency of vasectomy utilization, defining characteristics of individuals who opt for this method, various surgical techniques, and the risks and benefits associated with the procedure. What remains to be defined is why or why not individuals may experience post-vasectomy regret and whether the previous characteristics correlate. Objective The objective of this review is to synthesize information regarding reasons individuals may regret their vasectomy and seek reversal, what options exist for accomplishing the reversal, and patients' fertility prognosis post-vasovasostomy. Methods This review utilized a combination of secondary and tertiary data analysis across a wide scope of academic databases pertaining to the topic of interest. Results Typically, most males who have sought a vasectomy are satisfied with their decision, however, approximately 6% of this population seeks reversal. Key factors influencing vasectomy regret include age at the time of vasectomy, parental status, pre- and post-operative relationship status, unresolved physical and psychosexual problems, and development of chronic scrotal pain following the procedure. Few options exist for vasectomy reversal including microsurgical reconstructive vasectomy reversal (VR) and sperm extraction for in vitro fertilization. There is no guarantee that fertility will be restored in any case but a major predictive factor for success is the time interval prior to reversal. Conclusion Vasectomy is intended to be a permanent form of contraception; however, a minor chance remains that individuals may experience post-operative regret due to various factors. This warrants proper comprehensive counseling by the patient's provider regarding benefits and risks, procedural outcomes, opportunities for reversal, and fertility prognosis.
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Affiliation(s)
| | | | | | | | - Jamal Hasoon
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Valley Anesthesiology and Pain Consultants, Envision Physician Services; Department of Anesthesiology, University of Arizona College of Medicine Phoenix; Department of Anesthesiology, Creighton University School of Medicine
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health
| | - Ivan Urits
- Department of Anesthesiology, Louisiana State University Health Shreveport; Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
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Belardin LB, Légaré C, Sullivan R, Belleannée C, Breton S. Expression of the pro-inflammatory P2Y14 receptor in the non-vasectomized and vasectomized human epididymis. Andrology 2022; 10:1522-1539. [PMID: 36029226 DOI: 10.1111/andr.13284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/02/2022] [Accepted: 08/12/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Vasectomy causes spermatozoa accumulation in the epididymis, which may cause epididymitis. Inflammation is triggered by alert molecules released following tissue stress or injury. These include UDP-glucose, which activates the pro-inflammatory P2Y14 receptor (P2Y14), and induces immune cell recruitment. However, little is known about P2Y14 in the epididymis and its potential activation following vasectomy. OBJECTIVES (i) to localize P2Y14 in the human excurrent duct; and (ii) to examine the effect of vasectomy on P2Y14 protein and P2RY14 mRNA content, the production of selected cytokines and chemokines, and immune cell recruitment in the epididymis. MATERIAL AND METHODS in situ hybridization, qRT-PCR, western blotting, immunohistochemistry and immunofluorescence were performed in banked human epididymis samples. RESULTS P2RY14 mRNA and P2Y14 protein were detected in epithelial cells in the efferent duct, epididymis and vas deferens in non-vasectomized men. Keratin 5 (KRT5)-positive basal cells were strongly labeled for P2Y14 in all epididymal segments. A progressive apical localization was detected in principal cells (negative for the proton pump V-ATPase) from the corpus to the cauda. A subset of V-ATPase-positive clear cells also showed strong P2Y14 labeling. Vasectomy induced an increase in P2RY14 mRNA in the corpus and cauda, and stronger apical labeling in principal cells in the corpus. CXCL10 mRNA increased in the cauda and CCL2 mRNA decreased in the corpus of vasectomized versus non-vasectomized men. No change in IL-8 and IL-1β mRNA was detected. Numerous CD45+ leukocytes were detected in the interstitium of the corpus and cauda following vasectomy, while only a few were seen in non-vasectomized men. Several CD45+ leukocytes, some of which containing spermatozoa, were detected in the corpus lumen following vasectomy. DISCUSSION AND CONCLUSION Our study indicates that vasectomy-induced spermatozoa congestion may lead to an inflamed-prone local environment characterized by potential activation of P2Y14 and recruitment of immune cells in the epididymis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Larissa Berloffa Belardin
- Centre Hospitalier Universitaire de Québec - Research Centre, Department of Obstetrics, Gynecology and Reproduction, and Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Christine Légaré
- Centre Hospitalier Universitaire de Québec - Research Centre, Department of Obstetrics, Gynecology and Reproduction, and Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Robert Sullivan
- Centre Hospitalier Universitaire de Québec - Research Centre, Department of Obstetrics, Gynecology and Reproduction, and Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Clémence Belleannée
- Centre Hospitalier Universitaire de Québec - Research Centre, Department of Obstetrics, Gynecology and Reproduction, and Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Sylvie Breton
- Centre Hospitalier Universitaire de Québec - Research Centre, Department of Obstetrics, Gynecology and Reproduction, and Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle, Faculty of Medicine, Université Laval, Québec, QC, Canada
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Mihretie GS, Abebe SM, Abebaw Y, Gedefa L, Gure T, Alemayehu BA, Amenu D, Tadesse D, Fanta GA, Abubeker FA, Yemane A, G/Michael AD, Teklu AM, Damtew MH, Girma B. Factors associated with discontinuation among long-acting reversible contraceptive users: a multisite prospective cohort study in urban public health facilities in Ethiopia. BMJ Open 2022; 12:e059372. [PMID: 35918115 PMCID: PMC9351308 DOI: 10.1136/bmjopen-2021-059372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The study aims to determine discontinuation among long-acting reversible contraceptive users at 3, 6, 9 and 12 months after initiation and its associated factors among new long-acting reversible contraceptive (LARC) users. DESIGN A facility-based multicentre prospective cohort study was conducted with a sample size of 1766 women. SETTING The study was conducted in five large cities of Ethiopia (Addis Ababa, Gondar, Mekelle, Jimma and Harar) between March 2017 and December 2018. Various referral hospitals and health centres that are found in those cities are included in the study. PARTICIPANTS The study population was all women who were new users of LARCs and initiated LARCs in our selected public health facilities during the enrolment period. INTERVENTIONS A pretested structured questionnaire was administered at enrolment and at 6 and 12 months to determine discontinuation proportion and factors associated with discontinuation. RESULT From the total of 1766 women sampled for the study only 1596 (90.4%) participants completed all the questionnaires including the 12-month follow-up study. The overall proportion of discontinuation of LARCs at 12 months was 21.8% (95% CI 19.8 to 23.9). The overall discontinuation proportions at 3, 6, 9 and 12 months were 2.94%, 8.53%, 3.94% and 6.36%, respectively. Location of method initiation (adjusted HR (aHR)=5.77; (95% CI 1.16 to 28.69)) and dissatisfaction with the method (aHR=0.09; (95% CI 0.03 to 0.21)) were found to be the predictors of discontinuation among intrauterine contraceptive device users. Being satisfied with the method (aHR=0.21; (95% CI 0.15 to 0.27)), initiation after post abortion (aHR=0.48; (95% CI: 0.26, 0.89)) and joint decision with partner for method initiation (aHR=0.67; (95% CI: 0.50, 0.90)) were inversely associated with implant discontinuation. CONCLUSION The majority of LARC users discontinue the method in the first 6 months after insertion and dissatisfaction with the method increased the likelihood of removal during the first year of LARC use.
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Affiliation(s)
- Getasew Sisay Mihretie
- Department of Obstetrics and Gynecology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Solomon Mekonnen Abebe
- University of Gondar, Gondar, Ethiopia
- University of Gondar, Gondar, Ethiopia
- Human Nutrition, Institute of Public Halth, Gondar, Ethiopia
| | - Yeshiwas Abebaw
- University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
- Obstetrics and Gynecology, School of Medicine, Gondar, Ethiopia
| | - Leta Gedefa
- Haramaya University, Dire Dawa, Ethiopia
- Obstetrics and Gynecology, College of health and Medical Sciences, Haromaya, Ethiopia
| | - Tadesse Gure
- Obstetrics and Gynaecology, Hiwot Fana Specialized University Hospital, Harar, Ethiopia
- Obstetrics and Gynaecology, Haramaya University College of Health and Medical Sciences, Haramaya, Oromia, Ethiopia
| | - Birtukan Asmare Alemayehu
- Department of Obstetrics and Gynecology, Menelik II Referral Hospital, Ethiopia, Addis Ababa, Ethiopia
| | | | - Daniel Tadesse
- MERQ Consultancy PLC, Addis Ababa, Ethiopia
- Research and project unit, Addis Ababa, Ethiopia
| | - Girma Abraham Fanta
- Zewditu Memorial Hospital, Addis Ababa, Ethiopia
- Obstetrics and Gynecology, College of health and Medical Sciences, Addis Ababa, Ethiopia
| | - Ferid Abbas Abubeker
- Department of Obstetrics and Gynecology, Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Medical College, Addis Ababa, Ethiopia
| | - Awol Yemane
- Mekelle University, Mekelle, Ethiopia
- Obstetrics and Gynecology, College of health and Medical Sciences, Mekella, Ethiopia
| | - Amanuel Desta G/Michael
- Mekelle University College of Health Sciences, Mekelle, Tigray, Ethiopia
- College of Health Science, Mekelle, Ethiopia
| | - Alula M Teklu
- MERQ Consultancy PLC, Addis Ababa, Ethiopia
- Research, MERQ PLC LLC, Baltimore, Maryland, USA
- Research Unit, Addis Ababa, Ethiopia
| | - Mengistu Hailemariam Damtew
- University of Michigan Center for International Reproductive Health Training Ethiopia, Addis Ababa, Oromia, Ethiopia
- CIRHT, Addis Ababa, Ethiopia
| | - Bisrat Girma
- Jimma University, Jimma, Ethiopia
- College of health and Medical Sciences, Jimma, Ethiopia
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Cánovas E, Beric D, Jara R, Cazorla E. Intrauterine contraceptive device rupture. Follow-up of a retrospective cohort and clinical protocol. RUDIUS study. Heliyon 2022; 8:e08751. [PMID: 35071815 PMCID: PMC8762393 DOI: 10.1016/j.heliyon.2022.e08751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/06/2021] [Accepted: 01/10/2022] [Indexed: 10/26/2022] Open
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[Vasectomy : Current information]. Urologe A 2021; 60:523-532. [PMID: 33738559 DOI: 10.1007/s00120-021-01494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Abstract
Vasectomy is considered to be the simplest, most effective and cheapest method of fertility control in men, with a significantly lower risk of morbidity and mortality compared to tubal ligation in women. Patient informed consent is particularly important and should include potential irreversibility, surgical options, anesthesia, possible complications as well as postoperative behavior and the need for re-evaluation. There are different access routes available with conventional and no-scalpel vasectomy as well as different techniques for closing the ends of the vas deferens. To confirm sterility the European Association of Urology (EAU) recommends that an ejaculate analysis should be performed 3 months after the procedure and after approximately 20 ejaculations. Complications are relatively rare, although particularly vasectomy failure due to recanalization has to be considered. Approximately 3-6% of vasectomized men strive for a refertilization, which with experienced surgeons is successful in about 90% of cases.
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López García-Franco A, Baeyens Fernández JA, Bailón Muñoz E, Iglesias Piñeiro MJ, Ortega Del Moral A, Coello PA, Ruiz Cabello C, Landa Goñi J, Arribas Mir L. [Preventive activities in women's care]. Aten Primaria 2020; 52 Suppl 2:125-148. [PMID: 33388112 PMCID: PMC7801221 DOI: 10.1016/j.aprim.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 12/17/2022] Open
Abstract
A review is presented of the scientific evidence on preventive activities in women's care in relation to pregnancy follow-up, preventive activities in the planning and follow-up of contraceptive methods, preventive activities in menopause, and the prevention of osteoporotic fractures.
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Affiliation(s)
| | | | - Emilia Bailón Muñoz
- Medicina Familiar y Comunitaria, Centro de Salud Universitario de Albaycín, Granada, España
| | | | | | - Pablo Alonso Coello
- Medicina Familiar y Comunitaria, Centro Cochrane Iberoamericano (CIBERESP-IIB Sant Pau), Barcelona, España
| | - Cristina Ruiz Cabello
- Medicina Familiar y Comunitaria, Consultorio Castilléjar, zona básica de Benamaurel, Granada, España
| | - Jacinta Landa Goñi
- Medicina Familiar y Comunitaria, Centro de Salud Emisora, Pozuelo de Alarcón, Madrid, España
| | - Lorenzo Arribas Mir
- Medicina Familiar y Comunitaria, Centro de Salud Universitario La Chana, Granada, España
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Kern T, Artenstein D, Shapiro C. Postvasectomy Scrotal Pain and Hematospermia, a Possible Harbinger for Vasectomy Failure and Recanalization: A Case Report. Perm J 2019; 24:19.068. [PMID: 31710838 DOI: 10.7812/tpp/19.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Vasectomy is the most common and most effective method of achieving permanent male sterility. However, there is a low risk of vasectomy failure. To our knowledge, there is no symptom complex that has been identified and described that is predictive of early recanalization and vasectomy failure. CASE PRESENTATION A 44-year-old man underwent a routine bilateral vasectomy without complication. Two months after the procedure, the patient experienced an acute onset of scrotal pain and hematospermia. Several semen analyses were performed during the following months, the results of which demonstrated progressively rising numbers of motile sperm and were indicative of vasal recanalization. The patient underwent repeated vasectomy, during which he was found to have right vasal recanalization leading to vasectomy failure. DISCUSSION Delayed postvasectomy scrotal pain associated with hematospermia may be a sign of vasal recanalization. We propose that this symptom complex should prompt an investigation for vasal recanalization, during which the patient should be instructed to refrain from intercourse without the use of an additional method of contraception.
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Affiliation(s)
- Tyler Kern
- Department of Urology, Kaiser Permanente Los Angeles Medical Center, CA
| | - Daniel Artenstein
- Department of Urology, Kaiser Permanente Los Angeles Medical Center, CA
| | - Charles Shapiro
- Department of Urology, Kaiser Permanente Los Angeles Medical Center, CA
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Zhang P, Wang T, Yang L. Extensive intravesical benign hyperplasia induced by an extravesical migrated intrauterine device: A case report. Medicine (Baltimore) 2019; 98:e15671. [PMID: 31096500 PMCID: PMC6531109 DOI: 10.1097/md.0000000000015671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Intravesical migrated intrauterine devices (IUDs) have been reported to cause bladder perforation, stone formation, or malignant transition. However, such extensive intravesical benign hyperplasia caused by an extravesical migrated IUD is firstly reported. PATIENT CONCERNS A 38-year-old woman suffered from recurrent urinary urgency and dysuria and without macroscopic hematuria for about 1 month. DIAGNOSES Urinary ultrasound and abdominal contrast-enhanced computed tomography (CT) revealed thickening of the bladder walls. Diagnostic transurethral resection and pathology initially misdiagnosed the intravesical lesions as non-invasive urothelial carcinoma. Further diagnostic and therapeutic transurethral resections and pathology confirmed the intravesical lesions to be extensive benign hyperplasia, which was extremely likely caused by the extravesical migrated IUD. INTERVENTIONS The intravesical lesions received therapeutic transurethral resections. Then the migrated IUD was removed by open surgery. OUTCOMES After above treatments, the patient's lower urinary tract symptoms gradually disappeared. No recurrent lesion was found in the bladder through CT 3 months later. LESSONS Even an extravesical migrated IUD could silently cause extensive intravesical lesions. Whether symptomatic or not, any migrated IUD including extravesical and intravesical ones should be treated seriously, if possible, removed as soon as possible.
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Affiliation(s)
- Peng Zhang
- Department of Urology
- Institute of Urology, West China Hospital, Sichuan University, Chengdu
- Department of Urology, The First People's Hospital of Yibin, Yibin, Sichuan, PR China
| | - Ting Wang
- Department of Urology
- Institute of Urology, West China Hospital, Sichuan University, Chengdu
| | - Lu Yang
- Department of Urology
- Institute of Urology, West China Hospital, Sichuan University, Chengdu
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García-Franco AL, Baeyens Fernández JA, Bailón Muñoz E, Iglesias Piñeiro MJ, Cura González ID, Del Moral AO, Landa Goñi J, Alonso Coello P, Arribas Mir L. Actividades preventivas en la mujer. Actualización PAPPS 2018. Aten Primaria 2018; 50 Suppl 1:125-146. [PMID: 29866353 PMCID: PMC6836928 DOI: 10.1016/s0212-6567(18)30366-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
| | | | - Emilia Bailón Muñoz
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Universitario de Albaycín, Granada
| | | | - Isabel Del Cura González
- Especialista en Medicina Familiar y Comunitaria, Unidad de Investigación, Gerencia Asistencial de Atención Primaria, Madrid
| | | | - Jacinta Landa Goñi
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Emisora, Pozuelo de Alarcón, Madrid
| | - Pablo Alonso Coello
- Especialista en Medicina Familiar y Comunitaria, Centro Cochrane Iberoamericano (CIBERESP-IIB Sant Pau), Barcelona
| | - Lorenzo Arribas Mir
- Especialista en Medicina Familiar y Comunitaria, Centro de Salud Universitario La Chana, Granada
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12
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Oh YS, Na EJ, Gye MC. Effects of bilateral vasectomy on the interleukin 1 system in mouse epididymis. Am J Reprod Immunol 2016; 76:235-42. [PMID: 27476761 DOI: 10.1111/aji.12548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/13/2016] [Indexed: 11/26/2022] Open
Abstract
PROBLEM Regional difference in the inflammatory response in vasectomized (VAX) epididymis remains unraveled. METHOD OF STUDY Epididymal expression of interleukin 1α (IL1α), IL1β, IL1 receptor antagonist (IL1ra), IL1 receptor 1 (IL1R1), IL6, IL10, tumor necrosis factor α (TNF-α), and transforming growth factor-β1 (TGF-β1) was examined in bilateral VAX mice by real-time RT-PCR and immunohistochemistry. RESULTS IL1α, IL1β, IL1ra, and IL1R1 were expressed in the epididymal epithelia of normal mice. Following VAX, IL1R1 mRNA was not changed, but TNF-α, IL10, IL1α, IL1β, and IL1ra mRNA were significantly upregulated in whole epididymis, whereas IL6 and TGF-β1 mRNA were significantly increased in corpus and cauda but not in caput epididymis. Consistently, IL1α, IL1β, and IL1ra immunoreactivities were visibly increased in epididymis following VAX. CONCLUSION Following VAX, IL1α, IL1β, IL1ra, IL10, and TNF-α may mediate immune reaction in whole epididymis, whereas IL6 and TGF-β1 may mediate regionally different immune response primarily in the lower part of epididymis.
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Affiliation(s)
- Yeong Seok Oh
- Department of Life Science and Research Institute for Natural Sciences, Hanyang University, Seoul, Korea
| | - Eun Ju Na
- Department of Life Science and Research Institute for Natural Sciences, Hanyang University, Seoul, Korea
| | - Myung Chan Gye
- Department of Life Science and Research Institute for Natural Sciences, Hanyang University, Seoul, Korea
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13
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Quevedo M. Intrauterine Device Perforation. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479316645538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Intrauterine devices (IUDs) have had a controversial history but are regarded as a safe, effective form of contraception for all women. IUDs have many benefits, but at the same time, risks and complications may occur in a small percentage of women. The case study first presents a patient with an IUD that perforated the uterus and then offers a discussion of the risks and benefits of IUD contraception.
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Mesfin YM, Kibret KT. Practice and Intention to use long acting and permanent contraceptive methods among married women in Ethiopia: Systematic meta-analysis. Reprod Health 2016; 13:78. [PMID: 27329147 PMCID: PMC4915059 DOI: 10.1186/s12978-016-0194-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 06/08/2016] [Indexed: 11/13/2022] Open
Abstract
Background The long acting and permanent contraceptive methods (LAPCMs) has not used unlike that of short-acting methods in Ethiopia. Ethiopia is the second most populous country in Sub Saharan Africa with a high total fertility rate, and high maternal and child mortality rates. This study summarized the evidence of practice and intention to use long acting and permanent family planning methods among women in Ethiopia using systemic review and meta-analysis. Methods A systematic review and meta-analysis of the published and unpublished observational studies were conducted. Original studies were identified using databases of Medline/Pubmed, and Google Scholar. Heterogeneity across studies was checked using Cochrane Q test statistic and I2test. The pooled proportion of intention to use and the practice of long acting and permanent contraceptive methods were computed using a/the random effect model. Results Based on the ten observational studies included in the meta-analysis, the pooled prevalence of intention to use long acting and permanent contraceptive methods among married women according to the random effect model was 42.98 % (95 % CI 32.53, 53.27 %). On the other hand, the pooled practice of long acting and permanent methods of contraceptive among the study participants was 16.64 % (95 % CI 12.4 to 20.87 %). Conclusion This meta-analysis revealed that women’s intention to use LAPCMs is generally good but their utilization is low. It is recommended, therefore, that LAPMCs must be made more readily available and accessible to women at the lower level of health service delivery who are in need of it.
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Affiliation(s)
- Yonatan Moges Mesfin
- Department of Public Health, College of Medical and Health Science, Haramaya University, Harar, Ethiopia
| | - Kelemu Tilahun Kibret
- Department of Public Health, College of Medical and Health Science, Wollega University, Nekemte, Ethiopia.
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Body composition and bone mineral density in users of the etonogestrel-releasing contraceptive implant. Arch Gynecol Obstet 2015; 292:1387-91. [DOI: 10.1007/s00404-015-3784-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
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Saadat E, Abdollahi A, Dorkoosh FA. Fabrication and Characterization of Risperidone Implants as an Extended Antipsychotic Delivery System, Exploring the Role of Excipients. J Pharm Innov 2015. [DOI: 10.1007/s12247-015-9212-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Liu J, Rong CT, Li Y, Liu XX, Wang WT, Li N. Vasectomy Induces Oxidative Stress and Up-Regulates the Expression of Peroxiredoxins in Mouse Testis in Short and Early Periods after Surgery. J Urol 2014; 191:1920-6. [PMID: 24440237 DOI: 10.1016/j.juro.2014.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Juan Liu
- Central Laboratory, Yantai Yu-Huang-Ding Hospital, Yantai, Shandong Province, People's Republic of China
| | - Cheng T. Rong
- Department of Pharmacy, Fuyang People's Hospital, Fuyang, Anhui Province, People's Republic of China
| | - Yan Li
- College of Life Science, Yantai University, Yantai, Shandong Province, People's Republic of China
| | - Xue X. Liu
- Central Laboratory, Yantai Yu-Huang-Ding Hospital, Yantai, Shandong Province, People's Republic of China
| | - Wen T. Wang
- Central Laboratory, Yantai Yu-Huang-Ding Hospital, Yantai, Shandong Province, People's Republic of China
| | - Ning Li
- Central Laboratory, Yantai Yu-Huang-Ding Hospital, Yantai, Shandong Province, People's Republic of China
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Modesto W, Bahamondes MV, Bahamondes L. A randomized clinical trial of the effect of intensive versus non-intensive counselling on discontinuation rates due to bleeding disturbances of three long-acting reversible contraceptives. Hum Reprod 2014; 29:1393-9. [DOI: 10.1093/humrep/deu089] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Arrowsmith ME, Majeed A, Lee JT, Saxena S. Impact of pay for performance on prescribing of long-acting reversible contraception in primary care: an interrupted time series study. PLoS One 2014; 9:e92205. [PMID: 24694949 PMCID: PMC3973652 DOI: 10.1371/journal.pone.0092205] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/19/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the impact of Quality and Outcomes Framework (QOF), a major pay-for-performance programme in the United Kingdom, on prescribing of long-acting reversible contraceptives (LARC) in primary care. METHODS Negative binomial interrupted time series analysis using practice level prescribing data from April 2007 to March 2012. The main outcome measure was the prescribing rate of long-acting reversible contraceptives (LARC), including hormonal and non hormonal intrauterine devices and systems (IUDs and IUSs), injectable contraceptives and hormonal implants. RESULTS Prescribing rates of Long-Acting Reversible Contraception (LARC) were stable before the introduction of contraceptive targets to the QOF and increased afterwards by 4% annually (rate ratios = 1.04, 95% CI = 1.03, 1.06). The increase in LARC prescribing was mainly driven by increases in injectables (increased by 6% annually), which was the most commonly prescribed LARC method. Of other types of LARC, the QOF indicator was associated with a step increase of 20% in implant prescribing (RR = 1.20, 95% CI = 1.09, 1.32). This change is equivalent to an additional 110 thousand women being prescribed with LARC had QOF points not been introduced. CONCLUSIONS Pay for performance incentives for contraceptive counselling in primary care with women seeking contraceptive advice has increased uptake of LARC methods.
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Affiliation(s)
- Myat E. Arrowsmith
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom
| | - Azeem Majeed
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom
| | - John Tayu Lee
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom
| | - Sonia Saxena
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom
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Wilson S, Tan G, Baylson M, Schreiber C. Controversies in family planning: how to manage a fractured IUD. Contraception 2013; 88:599-603. [PMID: 24028753 DOI: 10.1016/j.contraception.2013.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/23/2013] [Accepted: 07/24/2013] [Indexed: 11/18/2022]
Affiliation(s)
- Susan Wilson
- Division of Family Planning in the Department of Obstetrics and Gynecology at the Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
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Takele A, Degu G, Yitayal M. Demand for long acting and permanent methods of contraceptives and factors for non-use among married women of Goba Town, Bale Zone, South East Ethiopia. Reprod Health 2012; 9:26. [PMID: 23102166 PMCID: PMC3538527 DOI: 10.1186/1742-4755-9-26] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 10/23/2012] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Contraceptive use including short acting, long acting and permanent methods positively influence the socio-economic development of a nation by allowing families to space and limit their family size to their economic capacity. Demand for LAPMs of contraception as detrmined by utilization and unmet need for LAPMs of contraception can provide realiable information for providers. OBJECTIVE To determine the utilization of long acting and permanent contraception and its associated factors among married women of Goba town, South East Ethiopia. METHODS A cross sectional community based study was conducted among 734 systematically selected married women of reproductive age in Goba town in September/ 2009. A structured and pretested, interview questionaire was used to collect data on socio-demographic, behavioral factors and data related to demand for LAPMs of contraception. Data were analyzed using EPI INFO and SPSS version 16. RESULT The demand for Long Acting and Permanent Methods (LAPMs) of contraception was 18.1%. Utilization of LAPMs of contraception in the town was 64 (8.7%) and the unmet need for LAPMs was 69 (9.4%). Information on LAPMs in the town was 636 (86.6%). Media (radio and television) was the major sources of information 641 (87.3%). The use of LAPMs was significatly associated with ever use AOR[17.43, 95% CI:9.19, 33.03], number of times discussions made on methods AOR[4.6, 95% CI: 1.72,12.17] and main decider of using methods AOR[ 2.2, 95% CI:1.03, 4.65]. It was not associated with socio-demographic variables. CONCLUSION AND RECOMMENDATION The utilization of LAPMs in the town was less although higher than the Ethiopian demographic and health survey 2005 result. Moreover, there was a considerable unmet need. Increase the method mix of LAPMs by incorporating varaies of implnats in order to increase utilization. Proper counseling of client and partners discussion were some of the recommendation forwarded.
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Affiliation(s)
- Abulie Takele
- College of Medicine & Health Sciences, Madawalabu University, Robe, Bale, Ethiopia
| | - Getu Degu
- School of Public Health, Gondar College of Medical Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- School of Public Health, Gondar of University, Gondar, Ethiopia
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Nelson AL. Safety, Efficacy, and Patient Acceptability of the Copper T-380A Intrauterine Contraceptive Device. CLINICAL MEDICINE INSIGHTS. WOMEN'S HEALTH 2011. [DOI: 10.4137/cmwh.s5332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The ParaGard Copper T 380A intrauterine device (CuT380A) provides reversible contraception that is as effective as sterilization for up to 20 years. The CuT380A is a mainstream, first-line contraceptive option for most healthy women, including nulligravid women, as well as many women who have serious medical problems. Because it is the most cost-effective method of birth control, the CuT380A is the preferred IUD, except for women who desire lighter or no menstrual blood loss. Surveys reveal that 95% of US CuT380A users are “very” or “somewhat” satisfied with their method. This article describes current candidates for IUD use, discusses the mechanisms of action of the CuT380A, provides guidance to reduce barriers to IUD access, suggests counseling points for patients, and outlines techniques to reduce the risks and side effects that can be associated with use of the CuT380A.
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Affiliation(s)
- Anita L. Nelson
- Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, Torrance, CA, USA
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23
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Spies EL, Askelson NM, Gelman E, Losch M. Young Women’s Knowledge, Attitudes, and Behaviors Related to Long-Acting Reversible Contraceptives. Womens Health Issues 2010; 20:394-9. [DOI: 10.1016/j.whi.2010.07.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Revised: 07/15/2010] [Accepted: 07/15/2010] [Indexed: 11/29/2022]
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Bednarek PH, Jensen JT. Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS. Int J Womens Health 2010; 1:45-58. [PMID: 21072274 PMCID: PMC2971715 DOI: 10.2147/ijwh.s4350] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Indexed: 11/23/2022] Open
Abstract
Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 μg daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% - similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device's strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia.
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Affiliation(s)
- Paula H Bednarek
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
| | - Jeffrey T Jensen
- Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR, USA
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Karsmakers R, Weis-Potters AE, Buijs G, Joustra EB. Chronic kidney disease after vesico-vaginal stone formation around a migrated intrauterine device. BMJ Case Rep 2010; 2010:2010/jul22_1/bcr1220092547. [PMID: 22767627 DOI: 10.1136/bcr.12.2009.2547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Although the intrauterine device (IUD) seems a reliable and relatively safe method of contraception, it may cause serious complications. A rare complication is uterus perforation. Intravesical migration and secondary calculus formation is exceptionally uncommon. The authors report on a 75-year-old woman in whom a 'forgotten' migrated IUD resulted in vesico-vaginal fistula formation and chronic kidney disease, 39 years after insertion.
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Affiliation(s)
- R Karsmakers
- Department of Urology, Deventer Hospital, Deventer, The Netherlands.
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26
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Gökce MI, Süer E, Tangal S, Bedük Y. Squamous cell carcinoma of the bladder associated with chronic irritation related to a migrated intrauterine device. SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY 2010; 44:183-5. [PMID: 20367452 DOI: 10.3109/00365591003639210] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Intrauterine devices (IUDs) are one of the most commonly used methods for reversible contraception. This article reports a case of squamous cell carcinoma of the bladder which exhibited a migrated IUD into the bladder. A 66-year-old woman with a 26-year history of IUD use admitted to the clinic with the chief complaint of intermittent macroscopic haematuria. Clinical examination raised a suspicion bladder carcinoma, so cystoscopy and histological sampling were performed and squamous cell carcinoma of bladder was diagnosed, which was related to chronic irritation by a migrated IUD.
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Affiliation(s)
- Mehmet Ilker Gökce
- Department of Urology, Faculty of Medicine, Ankara University, Ankara, Turkey.
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Kovalevsky G, Ballagh SA, Stanczyk FZ, Lee J, Cooper J, Archer DF. Levonorgestrel effects on serum androgens, sex hormone–binding globulin levels, hair shaft diameter, and sexual function. Fertil Steril 2010; 93:1997-2003. [DOI: 10.1016/j.fertnstert.2008.12.095] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 10/29/2008] [Accepted: 12/18/2008] [Indexed: 11/26/2022]
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Warner P, Guttinger A, Glasier AF, Lee RJ, Nickerson S, Brenner RM, Critchley HOD. Randomized placebo-controlled trial of CDB-2914 in new users of a levonorgestrel-releasing intrauterine system shows only short-lived amelioration of unscheduled bleeding. Hum Reprod 2010; 25:345-53. [PMID: 19897857 PMCID: PMC2806180 DOI: 10.1093/humrep/dep377] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The levonorgestrel-releasing intrauterine system (LNG-IUS) is a highly effective contraceptive. However, during early months of use unscheduled vaginal bleeding is common, sometimes leading to discontinuation. This study aimed to determine whether intermittent administration of progesterone receptor modulator CDB-2914 would suppress unscheduled bleeding during the first 4 months after insertion of the LNG-IUS. METHODS CDB-2914 150 mg, in divided doses, or placebo tablets, were administered over three consecutive days starting on Days 21, 49 and 77 after LNG-IUS insertion, in a double-blind randomized controlled trial of women aged 19-49 years, newly starting use of LNG-IUS. Daily bleeding diaries were completed for 6 months, and summarized across blocks as percentage days bleeding/spotting (BS%). RESULTS Of 69 women randomized to receive CDB-2914, and 67 placebo, 61 and 55, respectively, completed the trial. BS% decreased with time in both arms, but showed a much steeper treatment-phase gradient in the placebo arm (P < 0.0001), so that a benefit of CDB-2914 in the 28 days after first treatment (-11% points, 95% CI -19 to -2), converted to a disadvantage by 64 days after the third treatment (+10% points, 95% CI 1-18). CONCLUSIONS The effect of CDB-2914 on BS% was initially beneficial but then by third treatment was disadvantageous. Nevertheless, only 3% (4/136) of all women discontinued LNG-IUS. These findings give insight into possible mechanisms and suggest future research directions. ISRCTN Trial no. ISRCTN58283041; EudraCT no. 2006-006511-72.
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Affiliation(s)
- P Warner
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK
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Affiliation(s)
- C Stanley Chan
- Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA.
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Glasier A. Should healthcare professionals be advocating long-acting reversible contraception? ACTA ACUST UNITED AC 2009; 5:1-4. [PMID: 19102633 DOI: 10.2217/17455057.5.1.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Munro NP, Kotwal S, Gogoi NK, Weston PMT, Browning AJ, Harrison SCW, Biyani S, Chahal R, Sundaram SK. Fulguration of the lumen does not improve vasectomy sterilization rates. BJU Int 2009; 104:371-5. [PMID: 19239454 DOI: 10.1111/j.1464-410x.2009.08416.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the effect of adding lumen diathermy fulguration to our standard technique of vas ligation with polyglactin 910 (Vicryl(TM), Ethicon, Sommerville, NJ, USA) excision and fascial interposition, in an attempt to improve our sterilization rates. We previously reported the effect of changing suture material on vasectomy success rates; 3005 post-vasectomy semen analyses (PVSA) revealed a decrease in sterilization rates after surgery on changing from chromic catgut to polyglactin 910. PATIENTS AND METHODS We retrospectively reviewed PVSA undertaken for vasectomies performed by urological surgeons at the Mid-Yorkshire NHS Trust for 18 months from September 2005 to February 2007. RESULTS There were 592 vasectomies in all; the age distribution of patients between the groups treated with the standard and new method was similar. Overall, 166 patients (28%) failed to provide two semen samples as instructed, and so were excluded from further analyses. Sterility was achieved in 367 patients (86%); a further 28 (7%) have indeterminate analyses to date, with one of the last two PVSAs showing sperm, with the PVSA of 32 (7%) patients showing persisting sperm. For the eight surgeons reviewed the sterility rates were broadly similar. CONCLUSIONS The introduction of diathermy fulguration of the lumen has not improved vasectomy sterilization rates, with up to 14% having sperm on PVSA.
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Affiliation(s)
- Nicholas P Munro
- Mid Yorks NHS Trust, Pinderfields General Hospital, Wakefield, Leeds, UK.
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Kase NG. Impact of hormone therapy for women aged 35 to 65 years, from contraception to hormone replacement. ACTA ACUST UNITED AC 2009; 6 Suppl 1:37-59. [DOI: 10.1016/j.genm.2009.02.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2008] [Indexed: 11/16/2022]
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Thimon V, Calvo E, Koukoui O, Légaré C, Sullivan R. Effects of Vasectomy on Gene Expression Profiling along the Human Epididymis1. Biol Reprod 2008; 79:262-73. [DOI: 10.1095/biolreprod.107.066449] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Feasibility of Essure Placement in Intrauterine Device Users. J Minim Invasive Gynecol 2008; 15:485-90. [DOI: 10.1016/j.jmig.2008.04.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Revised: 04/14/2008] [Accepted: 04/19/2008] [Indexed: 11/23/2022]
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Abstract
Despite significant advances in contraceptive options for women over the last 50 yr, world population continues to grow rapidly. Scientists and activists alike point to the devastating environmental impacts that population pressures have caused, including global warming from the developed world and hunger and disease in less developed areas. Moreover, almost half of all pregnancies are still unwanted or unplanned. Clearly, there is a need for expanded, reversible, contraceptive options. Multicultural surveys demonstrate the willingness of men to participate in contraception and their female partners to trust them to do so. Notwithstanding their paucity of options, male methods including vasectomy and condoms account for almost one third of contraceptive use in the United States and other countries. Recent international clinical research efforts have demonstrated high efficacy rates (90-95%) for hormonally based male contraceptives. Current barriers to expanded use include limited delivery methods and perceived regulatory obstacles, which stymie introduction to the marketplace. However, advances in oral and injectable androgen delivery are cause for optimism that these hurdles may be overcome. Nonhormonal methods, such as compounds that target sperm motility, are attractive in their theoretical promise of specificity for the reproductive tract. Gene and protein array technologies continue to identify potential targets for this approach. Such nonhormonal agents will likely reach clinical trials in the near future. Great strides have been made in understanding male reproductive physiology; the combined efforts of scientists, clinicians, industry and governmental funding agencies could make an effective, reversible, male contraceptive an option for family planning over the next decade.
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Affiliation(s)
- Stephanie T Page
- Center for Research in Reproduction and Contraception, Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98195, USA.
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Abstract
Women have many options regarding contraception. A patient's desire for a long- or short-term method, for one that is reversible or permanent, and her belief that she can be compliant with the method all factor into the choice of contraceptive method. Practitioners must discuss coexisting conditions, contraindications, and whether the patient desires scheduled monthly bleeding or if she will tolerate unscheduled bleeding. Finally, cost and coverage by insurance tends to be one of the most important factors in choosing the method of contraception.
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Affiliation(s)
- Kristen A Plastino
- Department of Obstetrics & Gynecology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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Critchley HOD, Baird DT. Endometrial effects of hormonal contraception. REPRODUCTIVE MEDICINE AND ASSISTED REPRODUCTIVE TECHNIQUES 2008. [DOI: 10.3109/9780203091500.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Affiliation(s)
- Andrew M Kaunitz
- Department of Obstetrics and Gynecology, University of Florida College of Medicine-Jacksonville, Jacksonville, USA
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Nozawa H, Yamada Y, Muto Y, Arita S, Aisaka K. Pelvic actinomycosis presenting with a large abscess and bowel stenosis with marked response to conservative treatment: a case report. J Med Case Rep 2007; 1:141. [PMID: 18031582 PMCID: PMC2194704 DOI: 10.1186/1752-1947-1-141] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Accepted: 11/21/2007] [Indexed: 11/12/2022] Open
Abstract
Pelvic actinomycosis is a rare disease that can result in abscess formation, bowel obstruction, and other serious complications. Moreover, the correct diagnosis can seldom be established before radical surgery because the disease often mimics pelvic neoplasms. It has been recently recognized that pelvic actinomycosis is associated with long-term use of an intrauterine contraceptive device. We report a woman with a long-standing intrauterine contraceptive device who visited our hospital complaining of symptoms mimicking large bowel ileus with a subacute course. X-ray fluorography and sigmoidoscopy showed marked stenosis in the sigmoid colon but rejected the possibility of colon cancers. Abdomino-pelvic CT and MRI revealed a huge abscess lying over the urinary bladder and anterior to the uterus. Furthermore, a cervical Papanicolaou smear disclosed Actinomyces species. We removed the intrauterine device from the patient. Subsequent high-dose ampicillin administration led to dramatic shrinkage of the abscess and improved the management of the bowel movement quickly. This is a successful case of symptomatic pelvic actinomycosis that was correctly diagnosed and treated without unnecessary surgical intervention.
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Affiliation(s)
- Hiroaki Nozawa
- Department of Surgery, Odaira Memorial Tokyo Hitachi Hospital, Tokyo, Japan.
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Abstract
PURPOSE OF REVIEW To help clinicians guide adolescent patients to sound choices regarding long-acting contraceptives. The safety, side effects and non-contraceptive benefits of injectable, implantable and intrauterine contraception are detailed. RECENT FINDINGS The use of depot medroxyprogesterone acetate contraceptive injections has been associated with declines in teenage pregnancies in the United States. Although the US Food and Drug Administration has placed a black box warning concerning skeletal health and depot medroxyprogesterone acetate, data in adolescents confirm that declines in bone mineral density with depot medroxyprogesterone acetate are fully reversible. Concerns regarding skeletal health should not restrict the initiation or continuation of depot medroxyprogesterone acetate in adolescents. A highly effective, convenient, and easy to insert/remove single rod progestin-only contraceptive implant (Implanon) is now available in the United States. Although not widely used in adolescents, intrauterine devices offer selected adolescents convenient, highly effective, safe birth control. Use of the progestin-releasing intrauterine device (Mirena) is also associated with important non-contraceptive benefits. SUMMARY The efficacy and convenience associated with long-acting contraceptives make them indispensable for adolescent patients. This review will help clinicians guide teenage patients towards sound contraceptive choices and the successful long-term use of injectable, implantable and intrauterine methods of birth control.
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Affiliation(s)
- Lama L Tolaymat
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, Florida 32207, USA.
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Campbell SJ, Cropsey KL, Matthews CA. Intrauterine device use in a high-risk population: experience from an urban university clinic. Am J Obstet Gynecol 2007; 197:193.e1-6; discussion 193.e6-7. [PMID: 17689646 DOI: 10.1016/j.ajog.2007.04.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2006] [Revised: 03/19/2007] [Accepted: 04/19/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the acceptability, efficacy, and complication rates of the ParaGard intrauterine device (IUD; Duramed Pharmaceuticals Inc, Cincinnati, OH) and the Mirena intrauterine system (IUS; Berlax Laboratories, Wayne, NJ) in a cohort of women who attended an urban university-based obstetrics and gynecology resident clinic. STUDY DESIGN A retrospective chart review was conducted for 194 women who had an IUD/IUS inserted between January 2000-December 2005. RESULTS One-third of the women who received an IUD had a history of sexually transmitted disease before the insertion. No differences were found between women with an IUD or an IUS regarding demographics and obstetric and gynecologic history before IUD insertion. The IUD was associated with significantly higher rates of herpes simplex and Neisseria gonorrhea infections, complaints of expulsion, and unintended pregnancy after the insertion. No increased risk of pelvic inflammatory disease was associated with IUD use. CONCLUSION IUD/IUS use appears to be safe, acceptable, and feasible in high-risk patients. The IUS had lower rates of complications and greater acceptability than the IUD.
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Affiliation(s)
- Samuel J Campbell
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA
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Abstract
Despite recent improvements in rates of teen pregnancy, abortion, birth,and contraceptive use, effective contraceptive counseling for adolescents should be a high priority for the primary care provider in the office setting. Adolescent psychosocial risk screening and appropriate counseling about sexual decision-making is necessary. Contraceptive services visits include, relevant history, limited physical examination, provision of information, anticipatory guidance about sexual behaviors, and the provision of contraceptive methods. Teens should always be encouraged to use a male condom during sex to reduce STI risk. A variety of barrier and hormonal contraceptive methods are available for the adolescent population. Education about and provision of EC is effective in reducing the rate of unintended pregnancy and abortion in the United States. Contraceptive care for adolescents is a rewarding experience for primary care providers.
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Affiliation(s)
- Elizabeth Feldman
- Department of Family Medicine, University of Illinois at Chicago, USA.
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Greenberg JA. Long-acting methods of contraception. N Engl J Med 2006; 354:645-6; author reply 645-6. [PMID: 16467557 DOI: 10.1056/nejmc053433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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