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Drobner J, Fu MZ, Kaldany A, Velez-Leitner D. Historical Review of the Vasectomy: Antiquated Beliefs, Novel Techniques, and Contemporary Challenges. Urology 2023; 182:1-4. [PMID: 37783399 DOI: 10.1016/j.urology.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 10/04/2023]
Affiliation(s)
- Jake Drobner
- Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
| | - Melinda Z Fu
- Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Alain Kaldany
- Division of Urology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
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Service CA, Puri D, Hsieh TC, Patel DP. Emerging concepts in male contraception: a narrative review of novel, hormonal and non-hormonal options. Ther Adv Reprod Health 2023; 17:26334941221138323. [PMID: 36909934 PMCID: PMC9996746 DOI: 10.1177/26334941221138323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/20/2022] [Indexed: 03/14/2023] Open
Abstract
Access to reliable contraception is a pillar of modern society. The burden of unintended pregnancy has fallen disproportionately on the mother throughout human history; however, recent legal developments surrounding abortion have sparked a renewed interest in male factor contraceptives beyond surgical sterilization and condoms. Modern efforts to develop reversible male birth control date back nearly a century and initially focused on altering the hypothalamic-pituitary-testes axis. These hormonal contraceptives faced multiple barriers, including systemic side effects, challenging dosing regimens, unfavorable routes of delivery, and the public stigma surrounding steroid use. Novel hormonal agents are seeking to overcome these barriers by limiting the side effects and simplifying use. Non-hormonal contraceptives are agents that target various stages of spermatogenesis; such as inhibitors of retinoic acid, Sertoli cell-germ cell interactions, sperm ion channels, and other small molecular targets. The identification of reproductive tract-specific genes associated with male infertility has led to more targeted drug development, made possible by advances in CRISPR and proteolysis targeting chimeras (PROTACs). Despite multiple human trials, no male birth control agents have garnered regulatory approval in the United States or abroad. This narrative review examines current and emerging male contraceptives, including hormonal and non-hormonal agents.
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Affiliation(s)
- C Austin Service
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Dhruv Puri
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Darshan P Patel
- Department of Urology, University of California San Diego, 9333 Genesee Avenue, Suite 320, La Jolla, CA 92121, USA
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Fofana MO. Time and time again: the reincarnations of coerced sterilisation. JOURNAL OF MEDICAL ETHICS 2022; 48:805-809. [PMID: 34127527 DOI: 10.1136/medethics-2020-106924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 05/16/2021] [Indexed: 06/12/2023]
Abstract
The recently reported cases of coerced sterilisation of women at a privately operated immigration detention facility in the USA are egregious in their disregard for human dignity and professional ethics, but sadly not surprising. These abuses represent a continuation of efforts to control the reproductive capacity of women, fueled by racist and xenophobic motives. Physicians helped create and legitimise the pseudoscientific framework for the eugenics movement, which would implement forceful sterilisation as its tool of choice to eliminate undesirable traits that were thought to be biologically inherited and predominant among racial and ethnic minorities. Although state-endorsed forcible sterilisation programs have ended, incarcerated women have remained particularly vulnerable to sterilisation abuse. The intersectional vulnerabilities of racism, xenophobia and carcerality must be addressed to prevent such abuses from recurring.
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Affiliation(s)
- Mariam O Fofana
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
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Shahani SA, Marcotte EL. Landscape of germline cancer predisposition mutations testing and management in pediatrics: Implications for research and clinical care. Front Pediatr 2022; 10:1011873. [PMID: 36225340 PMCID: PMC9548803 DOI: 10.3389/fped.2022.1011873] [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: 08/04/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
As germline genetic testing capacities have improved over the last two decades, increasingly more people are newly diagnosed with germline cancer susceptibility mutations. In the wake of this growth, there remain limitations in both testing strategies and translation of these results into morbidity- and mortality-reducing practices, with pediatric populations remaining especially vulnerable. To face the challenges evoked by an expanding diversity of germline cancer mutations, we can draw upon a model cancer-associated genetic condition for which we have developed a breadth of expertise in managing, Trisomy 21. We can additionally apply advances in other disciplines, such as oncofertility and pharmacogenomics, to enhance care delivery. Herein, we describe the history of germline mutation testing, epidemiology of known germline cancer mutations and their associations with childhood cancer, testing limitations, and future directions for research and clinical care.
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Affiliation(s)
- Shilpa A Shahani
- Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | - Erin L Marcotte
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States.,Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
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Bruce K, Benno J, Kieltyka L. Variation in Postpartum Use of Most and Moderately Effective Contraceptive Methods Among Louisiana Women. Matern Child Health J 2020; 24:1151-1160. [PMID: 32613334 DOI: 10.1007/s10995-020-02971-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Women experiencing unintended and short-interval pregnancies are at increased risk for adverse outcomes. Nationally, researchers report disparities in women's use of effective contraceptive methods based on demographic, cultural, financial and system-level factors. Despite 58% of Louisiana births being unplanned, researchers have not reported on these relationships in Louisiana. METHODS We used Louisiana Pregnancy Risk Assessment Monitoring System data from 2015 to 2018. Among postpartum women who were not abstinent, pregnant, or trying to become pregnant, we estimated use of five categories of effective contraception versus no effective method. We used multivariable multinomial logistic regression to investigate the association between effective contraceptive use and race/ethnicity, postpartum insurance and education. RESULTS Among Louisiana postpartum women who were not abstinent, pregnant, or trying to become pregnant, 35.4% were not using effective contraception. Women with public insurance had greater odds of using long-acting reversible contraception than women with private insurance (adjusted odds ratio [AOR] 1.55; 95% confidence interval [CI] 1.11-2.16). Compared to women with a bachelor's or higher, women with less than high school (AOR 2.09; CI 1.22-3.56), high school (AOR 3.11; CI 2.01-4.82) or some college education (AOR 2.48; CI 1.64-3.75) had greater odds of using permanent contraception. Black (AOR 3.83; CI 2.66-5.54) and Hispanic (AOR 3.85; CI 2.09-7.11) women, women with less than high school (AOR 6.79; CI 2.72-16.94), high school (AOR 7.26; CI 3.06-17.21) and some college (AOR 7.22; CI 3.14-16.60), and women with public insurance (AOR 1.91; CI 1.28-2.87) had greater odds of using injectable contraception. DISCUSSION Results showed variation in effective contraceptive method use by race/ethnicity, insurance and education. These findings highlight the need for state-level research into the individual, provider, and policy-level factors that influence women's contraceptive choices.
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Affiliation(s)
- Katharine Bruce
- Bureau of Family Health, Office of Public Health, Louisiana Department of Health, 1450 Poydras Street, New Orleans, LA, 70112, USA. .,Council of State and Territorial Epidemiologists, 2635 Century Parkway NE, Atlanta, GA, 30345, USA.
| | - Jia Benno
- Bureau of Family Health, Office of Public Health, Louisiana Department of Health, 1450 Poydras Street, New Orleans, LA, 70112, USA
| | - Lyn Kieltyka
- Bureau of Family Health, Office of Public Health, Louisiana Department of Health, 1450 Poydras Street, New Orleans, LA, 70112, USA
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Muncey W, Murthy P, Fernstrum A, Ray A, Thirumavalavan N, Loeb A. Sterilization of Men with Developmental Disabilities: A Historical Perspective and Modern Conundrum. Urology 2020; 140:41-43. [PMID: 32209351 DOI: 10.1016/j.urology.2020.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 02/17/2020] [Accepted: 03/10/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Wade Muncey
- Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH
| | - Prithvi Murthy
- Cleveland Clinic Foundation, Glickman Urological and Kidney Institute, Cleveland, OH
| | - Austin Fernstrum
- Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH
| | - Al Ray
- Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH
| | - Nannan Thirumavalavan
- Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH
| | - Aram Loeb
- Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center, Urology Institute, Cleveland, OH
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Caponi S. [Degeneration and eugenics in the history of Brazilian psychiatry: Renato Kehl and hereditary degenerates]. HISTORIA, CIENCIAS, SAUDE--MANGUINHOS 2018; 25:159-178. [PMID: 30133588 DOI: 10.1590/s0104-59702018000300010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 12/06/2017] [Indexed: 06/08/2023]
Abstract
This article analyzes the notions of degeneration and eugenics in the field of psychiatry in the first decades of the twentieth century, stressing the existence of similarities and continuities, but also differences and conflicts between them. It analyzes a particular moment in the history of Brazilian psychiatry when arguments from degeneration theory and eugenic arguments and interventions became superimposed and mingled. It focuses, among other texts, on the work of Renato Kehl, "A esterilização dos grandes degenerados e criminosos".
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Affiliation(s)
- Sandra Caponi
- Professora, Departamento de Sociologia e Ciências Políticas/Universidade Federal de Santa Catarina. Florianópolis - SC - Brasil.
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Amy JJ, Rowlands S. Legalised non-consensual sterilisation - eugenics put into practice before 1945, and the aftermath. Part 1: USA, Japan, Canada and Mexico. EUR J CONTRACEP REPR 2018; 23:121-129. [PMID: 29624082 DOI: 10.1080/13625187.2018.1450973] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In the late 19th century, eugenics, a pseudo-scientific doctrine based on an erroneous interpretation of the laws of heredity, swept across the industrialised world. Academics and other influential figures who promoted it convinced political stakeholders to enact laws authorising the sterilisation of people seen as 'social misfits'. The earliest sterilisation Act was enforced in Indiana, in 1907; most states in the USA followed suit and so did several countries, with dissimilar political regimes. The end of the Second World War saw the suspension of Nazi legislation in Germany, including that regulating coerced sterilisation. The year 1945 should have been the endpoint of these inhuman practices but, in the early post-war period, the existing sterilisation Acts were suspended solely in Germany and Austria. Only much later did certain countries concerned - not Japan so far - officially acknowledge the human rights violations committed, issue apologies and develop reparation schemes for the victims' benefit.
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Affiliation(s)
- Jean-Jacques Amy
- a Faculty of Medicine & Pharmacy , Vrije Universiteit Brussel , Brussels , Belgium
| | - Sam Rowlands
- b Faculty of Health & Social Sciences , Bournemouth University , Bournemouth , UK
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Cosentino M, Peraza MF, Vives A, Sanchez J, Moreno D, Perona J, Ortiz G, Alcoba M, Ruiz E, Sarquella J. Factors predicting success after microsurgical vasovasostomy. Int Urol Nephrol 2018; 50:625-632. [PMID: 29423834 DOI: 10.1007/s11255-018-1810-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 01/27/2018] [Indexed: 11/27/2022]
Abstract
PURPOSE To identify factors predicting success and analyze critically the status of microsurgical double-layer vasovasostomy using predictive models. METHODS A cohort of 263 patients treated at our institution for vasectomy reversal between 1986 and 2010 was included in our study, and the literature was reviewed. Inclusion criteria were previous bilateral vasectomy and presence of at least two postoperative semen analyses; patients reporting pregnancy without a postoperative semen analysis were excluded. A double-layer, microscope-assisted, tension-free anastomosis vasovasostomy was performed approximating mucosa to mucosa and muscle to muscle with a 10-0 non-absorbable suture. A multivariate logistic regression backward stepwise model was used to predict combined success, and a predictive model was calculated with remaining variables. RESULTS Mean age was of 41.6 years (SD 7.1); mean duration of obstruction 7.2 years (SD 6.7). On multivariate analysis, uni- or bilateral granuloma and Silber grade of I-III were variable identified predicting higher probability to success (OR 3.105; 95% CI 1.108-8.702; p = 0.031 and OR 4.795; 95% CI 2.117-10.860; p < 0.001, respectively). CONCLUSIONS Based on our results, some factors predicting success after vasovasostomy surgery are known but others remain unknown; our predictive model may easily predict patency and success after this surgery and offers a concrete assistance in counseling patients.
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Affiliation(s)
- Marco Cosentino
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain.
| | - Maria F Peraza
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain
| | - Alvaro Vives
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain
| | - Josvany Sanchez
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain
| | - Daniel Moreno
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain
| | - Judith Perona
- Anaesthesia Department, Hospital de Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Gerardo Ortiz
- The American British Cowday Medical Center, Ciudad México, DF, Mexico
| | - Maria Alcoba
- Urology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Eduardo Ruiz
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain
| | - Joaquim Sarquella
- Andrology Department, Fundacio Puigvert, Universitat Autonoma de Barcelona, Carrer Cartagena 340-350, 08025, Barcelona, Spain
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Rowlands S, Ingham R. Long-acting reversible contraception: conflicting perspectives of advocates and potential users. BJOG 2017; 124:1474-1476. [DOI: 10.1111/1471-0528.14699] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/26/2022]
Affiliation(s)
- S Rowlands
- Centre of Postgraduate Medical Research and Education; Bournemouth University; Bournemouth UK
| | - R Ingham
- Centre for Sexual Health Research; University of Southampton; Southampton UK
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Affiliation(s)
- Ashwin Roy
- Medical Student, Manchester Medical School, UK
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Diekema DS. Involuntary sterilization of persons with mental retardation: an ethical analysis. MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES RESEARCH REVIEWS 2003; 9:21-6. [PMID: 12587134 DOI: 10.1002/mrdd.10053] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Legitimate concerns on the part of parents and guardians may lead to requests for sterilization of a mentally retarded person in their care. At the same time, mentally retarded persons must be protected from actions that do not serve their best interests. This paper will review the history of involuntary sterilization in the United States and evaluate the ethical arguments that are relevant to decisions about involuntary sterilization. While other, less permanent forms of contraception might be acceptable, involuntary sterilization ought not be performed on mentally retarded persons who retain the capacity for reproductive decision-making, the ability to raise a child, or the capacity to provide valid consent to marriage. Mentally retarded persons who lack capacity in those three areas should be considered for involuntary sterilization only when the procedure is necessary, sterilization would serve the best interests of the mentally retarded person, less intrusive and temporary methods of contraception or control of menstruation are not acceptable alternatives, and procedural safeguards have been implemented to assure a fair decision-making process.
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Affiliation(s)
- Douglas S Diekema
- Department of Pediatrics & Medical History and Ethics, University of Washington, Seattle, Washington, USA.
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