Navigation Links
Specialist urologists should handle vasectomy reversal cases says 10-year study
Date:9/19/2012

Vasectomy reversals should be carried out by urology specialists with access to appropriate micro-surgical training and assisted reproductive technologies and not general urology surgeons, according to research published in the October issue of BJUI.

The findings are based on a series of surveys carried out among consultant members of the British Association of Urological Surgeons (BAUS) over a ten-year period.

"It is clear from our research that couples should not be seen by urologists with diverse interests, but by those with appropriate knowledge of all of the factors influencing the outcome of a vasectomy reversal" says co-author and consultant urologist Dr Stephen R Payne from Manchester Royal Infirmary, UK.

"Patient management after previous vasectomy is a complex process requiring detailed knowledge when it comes to the surgical techniques available and the options for maximising the chance of any subsequent pregnancy."

BAUS members were surveyed in 2001, 2005 and 2010, with a total of 835 replies to the three questionnaires and an overall response rate of 47%.

Every year some 20,000 vasectomies are performed in the UK. During the procedure, the vas deferens, the ducts that carry sperm from the testicles to the seminal vesicles, are cut and tied to interrupt sperm flow.

About 6% of men subsequently ask for the procedure to be reversed so that their partner can get pregnant. Various options are available to these couples, including vaso-vasostomy, a surgical reversal procedure where the ends of the vasa are identified and joined back together again. The other options are surgical retrieval of sperm, which then need to be used together with IVF, and the use of donated sperm or adoption.

The overall findings of the surveys showed that:

  • more than 80% of respondents performed vaso-vasostomy, but about three-quarters were only doing 15 or less procedures a year
  • only 50% of urologists counselled couples about alternatives to vasectomy reversal
  • less than half (41%) gave patients details on their personal outcomes for vaso-vasostomy.

However, the 2010 audit showed that members of the BAUS section of andrology, who specialise in problems relating to the male genital tract, were more likely than non-members to:

  • perform more than 15 vaso-vasotomies a year (25% versus 4%)
  • insist on seeing both partners (85% versus 80%)
  • discuss all options for parenting in detail (63% versus 44%)
  • be fully conversant with the criteria for in-vitro fertilisation (54% versus 23%)
  • provide their individualised information about expected outcome (86.5% versus 71%)
  • routinely retrieve sperm when carrying out a vaso-vasostomy (18% versus 10%)
  • use an operating microscope (40% versus 26%).

"The latest data showed significant differences between BAUS members with an andrological affiliation and those without, when it came to their ability to discuss options for having a child and local eligibility criteria for IVF treatment, give individualised outcomes from vasectomy reversal and perform a larger number of procedures" says Dr Payne.

"It can be inferred from these results that surgeons with an andrological sub-specialist interest give a more balanced view of the options couples might consider when counselling men presenting for vasectomy reversal.

"Further sub-analysis suggests that quality improves as surgeons handle an increased number of case each year. Although our data suggests a trend that quality improves after 15 procedures per year, a prospective study is required to determine the relationship between outcome measures, such as live birth rates, and annual case volume."


'/>"/>
Contact: Annette Whibley
annette.wizard@gmail.com
Wiley
Source:Eurekalert

Related medicine news :

1. Internal medicine physician specialists release policy paper on reforming Medicaid
2. U.S.A. Hurdle Specialist Kellie Wells has Joined Elite Athletes Tiger Woods, Hines Ward and Takaishi Saito in Using Cell Therapy
3. Texas Back Institute Becomes Official Spine Specialist for FC Dallas and the Frisco RoughRiders
4. Triggers study evaluates regular staff, ICU specialists
5. Leading cancer specialists from Europe and beyond recognized at ESMO 2012
6. Soaring U.S. Spinal Care Spending Due to Specialists: Study
7. Mayo Clinic urologists present findings at American Urological Association Annual Meeting
8. Canada should play a role in addressing the global cancer epidemic
9. New standards for treating traumatic shoulder injuries to improve patient care
10. Should oxygen be used for patients with chronic heart failure?
11. Men Can Still Ask for PSA Test, and Some Should, Doctors Say
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... Many women ... diagnosed with endometriosis. These women need a treatment plan to not only alleviate ... that can help for preservation of fertility and ultimately achieving a pregnancy. The ...
(Date:6/25/2016)... ... 25, 2016 , ... Austin residents seeking Mohs surgery services, can now turn ... to Dr. Russell Peckham for medical and surgical dermatology. , Dr. Dorsey brings specialization ... selective fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was under the direction ...
(Date:6/25/2016)... ... , ... "With 30 hand-drawn hand gesture animations, FCPX users can easily customize ... Pixel Film Studios. , ProHand Cartoon’s package transforms over 1,300 hand-drawn pictures into ... Simply select a ProHand generator and drag it above media or text in the ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern Californian, Dr. Omkar ... M.D from the David Geffen School of Medicine at UCLA. He trained in Internal ... complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program where he had ...
(Date:6/25/2016)... ... , ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department ... in recognition of their exemplary accomplishments in worksite health promotion. , The Wellness at ... Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one of 42 ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... Research and Markets has announced ... Type (Organic Chemical (Sugar, Petrochemical, Glycerin), Inorganic Chemical), Functionality ... - Global Forecast to 2021" report to their ... global pharmaceutical excipients market is projected to reach USD ... in the forecast period 2016 to 2021. ...
(Date:6/23/2016)... LOS ANGELES , June 23, 2016 /PRNewswire/ ... (NASDAQ: CAPR ), a biotechnology company ... first-in-class therapeutics, today announced that patient enrollment in ... progrEssion in Duchenne) has exceeded 50% of its ... its enrollment in the third quarter of 2016, ...
(Date:6/23/2016)... and INDIANAPOLIS , June ... receiving a Lilly Diabetes Tomorrow,s Leaders Scholarship is any ... scholarship winners, announced today online at www.diabetesscholars.org ... type 1 diabetes stand in the way of academic ... supported the Foundation,s scholarship program since 2012, and continues ...
Breaking Medicine Technology: