Vasectomy

输精管切除术
  • 文章类型: Journal Article
    输精管结扎术是美国最常见的泌尿外科手术,是一种非常有效的男性避孕方式。泌尿外科学会引入的指南已经标准化了输精管切除术护理。供应商应该意识到这些指导方针背后的理由,以及它们之间的主要差异。虽然在过去的40年中,输精管切除术技术几乎没有重大变化,新,可逆血管闭塞技术可能会影响未来男性避孕护理的实施。这里,我们对来自全球6个泌尿外科学会的输精管结扎术指南进行了比较回顾.此外,我们报告了在未来十年内可能出现的几种实验性血管闭塞方法的现状.
    Vasectomy is the most commonly performed urologic procedure in the United States and is a highly effective form of male contraception. The introduction of guidelines by urological societies has standardized vasectomy care. Providers should be awadre of the rationale behind these guidelines, as well as key differences among them. While few major changes to vasectomy technique have been adopted over the past 40 years, new, reversible vasal occlusive technologies may affect delivery of male contraceptive care in the future. Here, we perform a comparative review of vasectomy guidelines from six urological societies worldwide. In addition, we report on the status of several experimental vasal occlusion methods that may be available in the next decade.
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  • 文章类型: Journal Article
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  • 文章类型: Review
    越来越多的人支持男性参与生殖健康,并在资源较低的情况下将自愿输精管切除术服务纳入国家计划生育方案;然而,尼日利亚等非洲国家依赖输精管结扎术的育龄妇女的患病率,不到1%。进行这项审查是为了更广泛地了解当前的社会文化和卫生系统条件,需要解决这些条件,以扩大输精管切除术作为尼日利亚计划生育的一种选择的整合和可接受性。为了探索这个,对2009年至2021年间尼日利亚输精管结扎术的现有文献进行了范围调查.综述集中在定性研究和灰色文献上。研究结果表明,尼日利亚男性对输精管切除术的意识很强。然而,恐惧、宗教和文化信仰等几个因素阻止男性对输精管切除术的信心与对女性生物医学方法的信心相同。这些发现对未来的计划生育政策有影响,该国的战略和方案。
    There is growing support of male involvement in reproductive health and the integration of voluntary vasectomy services into national family planning programs in lower resource contexts; yet, the prevalence of women of reproductive age who rely on vasectomy in African countries such as Nigeria, is less than 1 percent. This review was conducted to gain a broader understanding of current sociocultural and health systems\' conditions that need to be addressed to expand the integration and acceptability of vasectomy as an option for family planning in Nigeria. To explore this, a scoping of existing literature on vasectomy in Nigeria between 2009 to 2021 was conducted. The review focused on qualitative studies and grey literatures. The findings reveal that there is a strong awareness of vasectomy among men in Nigeria. Yet, several factors such as fear and religious and cultural beliefs prevent men from having the same confidence in vasectomy as they have in female biomedical methods. These findings have implications for future family planning policies, strategies and programmes in the country.
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  • 文章类型: Journal Article
    输精管结扎术是男性绝育的一种外科手术。这是日常泌尿外科实践中非常常见的手术,并发症发生率低。血肿形成,伤口感染,慢性阴囊疼痛,和自发再通是众所周知的并发症。输精管切除术后瘘形成和睾丸梗塞较少见。在本文中,我们提供了有关输精管结扎术后罕见并发症的文献综述。
    对PubMedMedline和WebofScienceCoreCollection数据库进行了手动电子搜索,包括所有纳入的报告,直到2022年9月30日,以确定评估输精管结扎术后患者并发症的研究。
    尿道血管皮肤瘘是迄今为止最普遍的,而血管皮肤,血管静脉,很少报道动静脉瘘。在排出瘘管时,可以进行流体分析以区分不同的类型。在所有情况下,都进行了阴囊探查和瘘管结扎。如果存在,应治疗潜在的膀胱出口梗阻。阴囊梗塞是输精管结扎术的另一种罕见并发症。通过阴囊超声和彩色多普勒进行诊断。治疗通常是保守的,但对于较大的梗死应考虑睾丸切除术。简单的伤口感染在输精管切除术后的患者中很常见。更复杂的感染很少见,但可能导致严重甚至致命的并发症。
    输精管切除术后的常见并发症是众所周知的,通常与患者进行充分讨论。然而,可能会出现罕见的并发症,重要的是它们被临床医生认可。
    UNASSIGNED: Vasectomy is a surgical procedure for male sterilization. It is a very common procedure in daily urological practice with a low complication rate. Haematoma formation, wound infection, chronic scrotal pain, and spontaneous recanalization are well-known complications. Fistula formation and testicular infarction are less common following a vasectomy. In this article we provide a review of literature regarding rare complications after vasectomy.
    UNASSIGNED: A manual electronic search of the PubMed Medline and Web of Science Core Collection databases was performed encompassing all included reports until 30 September 2022 to identify studies that assessed patient complications after a vasectomy.
    UNASSIGNED: Urethrovasocutaneous fistulas are by far the most prevalent, while vasocutaneous, vasovenous, and arteriovenous fistulas are seldom reported. In discharging fistulas, a fluid analysis can be done to discriminate different types. In all cases scrotal exploration and ligation of the fistula was performed. If present, an underlying bladder outlet obstruction should be treated. Scrotal infarction is another infrequently reported complication of vasectomy. Diagnosis is made by scrotal ultrasound and colour Doppler. Treatment is usually conservative, but orchiectomy should be considered in larger infarctions. Simple wound infections are common in patients post vasectomy. More complex infections are rare but can result in serious and even fatal complications.
    UNASSIGNED: Common complications after vasectomy are well known and usually well discussed with patients. However, rare complications can occur, and it is important that they are recognized by clinicians.
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  • 文章类型: Journal Article
    背景:除输卵管绝育外,男性避孕方法还涉及输精管结扎术,并且由于许多优点,代表了发展中国家中年男性的选择方法。然而,由于所涉及的机制可能提供对更为复杂的情况的见解,因此对这种干预的辅助后果的探讨还不够充分。
    方法:因此,在这份手稿中,我们的目标是通过搜索三个独立的学术数据库(PubMed,WebofKnowledge,和Scopus)在过去的二十年中通过涵盖2000-2023间隔并使用涉及“氧化应激”(OS)的预定义关键字和字符串集,\"炎症\",和“精液微生物群”与“人类”相结合,\"老鼠\",和“老鼠”。
    结果:通过遵循所有符合pre的证据,post-,和输精管切除术逆转(VR)阶段,我们共确定了n=210项研究,其中只有n=21项最终纳入了两项资格评估程序.
    结论:由于目前的证据相互矛盾,围绕这一错综复杂的景观的话题引起了争论,limited,或不存在。从这个考虑出发,我们认为,进一步的研究是强制性的,以破译输精管结扎术可能如何干扰稳态。
    BACKGROUND: Male contraceptive approaches besides tubal sterilization involve vasectomy and represent the method of choice among midlife men in developing countries thanks to many advantages. However, the subsidiary consequences of this intervention are insufficiently explored since the involved mechanisms may offer insight into a much more complex picture.
    METHODS: Thus, in this manuscript, we aimed to reunite all available data by searching three separate academic database(s) (PubMed, Web of Knowledge, and Scopus) published in the past two decades by covering the interval 2000-2023 and using a predefined set of keywords and strings involving \"oxidative stress\" (OS), \"inflammation\", and \"semen microbiota\" in combination with \"humans\", \"rats\", and \"mice\".
    RESULTS: By following all evidence that fits in the pre-, post-, and vasectomy reversal (VR) stages, we identified a total of n = 210 studies from which only n = 21 were finally included following two procedures of eligibility evaluation.
    CONCLUSIONS: The topic surrounding this intricate landscape has created debate since the current evidence is contradictory, limited, or does not exist. Starting from this consideration, we argue that further research is mandatory to decipher how a vasectomy might disturb homeostasis.
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  • 文章类型: Journal Article
    获得可靠的避孕方法是现代社会的支柱。在整个人类历史上,意外怀孕的负担不成比例地落在母亲身上;然而,最近围绕堕胎的法律发展引发了人们对手术绝育和避孕套以外的男性因子避孕药的新兴趣。发展可逆男性节育的现代努力可以追溯到近一个世纪,最初集中在改变下丘脑-垂体-睾丸轴。这些荷尔蒙避孕药面临多重障碍,包括全身副作用,具有挑战性的给药方案,不利的交货路线,以及围绕类固醇使用的公众耻辱。新型激素剂试图通过限制副作用和简化使用来克服这些障碍。非激素避孕药是针对精子发生各个阶段的药物;如视黄酸抑制剂,支持细胞-生殖细胞相互作用,精子离子通道,和其他小分子靶标。与男性不育相关的生殖道特异性基因的鉴定导致了更有针对性的药物开发,CRISPR和蛋白水解靶向嵌合体(PROTACs)的进展使之成为可能。尽管进行了多项人体试验,在美国或国外,没有男性节育人员获得监管部门的批准。这篇叙述性综述研究了当前和新兴的男性避孕药,包括荷尔蒙和非荷尔蒙药物。
    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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  • 文章类型: Journal Article
    先前的报道显示输精管结扎术与前列腺癌(PCa)之间存在关联。然而,由于缺乏强因果关联和前列腺特异性抗原(PSA)筛查等残留混杂因素,研究与系统综述之间存在显著差异.
    为了评估输精管结扎术和PCa之间的关联,在未调整和PSA屏幕调整的研究中。
    我们根据系统评价和荟萃分析的首选报告项目进行了系统评价。PubMed,Scopus,和WebofScience数据库在2022年1月搜索了分析输精管结扎术和PCa之间关联的研究。
    共有37项研究符合我们的纳入标准,包括16.931.805例患者。所有研究的汇总分析表明,输精管结扎术与任何级别PCa之间存在显着关联(比值比[OR]1.23;95%置信区间[CI],1.10-1.37;p<0.001;I2=96%),局部PCa(OR1.08;95%CI,1.06-1.11;p<0.00001;I2=31%),或晚期PCa(OR1.07;95%CI,1.02-1.13;p=0.006;I2=0%)。当分析仅限于低偏倚风险的研究(OR1.06;95%CI,1.02-1.10;p=0.02;I2=48%)或队列研究(OR1.09;95%CI,1.04-1.13;p<0.0001;I2=64%)时,与PCa的相关性仍然显着。在针对PSA筛查进行调整的研究中,与局部PCa的相关性(OR1.06;95%CI,1.03-1.09;p<0.001;I2=0%)仍然显著.相反,输精管结扎不再与局部高级别相关(p=0.19),高级(p=0.22),和致死性(p=0.42)PCa。
    我们的荟萃分析发现输精管结扎术与任何,主要是局部的,PCa。然而,在检查稳健设计和高质量的研究时,该关联的效应估计越来越接近于零.在包括研究在内的探索性分析中,对PSA筛查进行了调整,侵袭性和/或晚期PCa的关联减弱。
    在这项研究中,我们发现输精管结扎术与发生局限性前列腺癌的风险之间存在关联,但我们无法确定该手术是否会导致更高的前列腺癌发病率.
    UNASSIGNED: Previous reports have shown an association between vasectomy and prostate cancer (PCa). However, there exist significant discrepancies between studies and systematic reviews due to a lack of strong causal association and residual confounding factors such as prostate-specific antigen (PSA) screening.
    UNASSIGNED: To assess the association between vasectomy and PCa, in both unadjusted and PSA screen-adjusted studies.
    UNASSIGNED: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The PubMed, Scopus, and Web of Science databases were searched in January 2022 for studies that analyzed the association between vasectomy and PCa.
    UNASSIGNED: A total of 37 studies including 16 931 805 patients met our inclusion criteria. A pooled analysis from all studies showed a significant association between vasectomy and any-grade PCa (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.10-1.37; p < 0.001; I2 = 96%), localized PCa (OR 1.08; 95% CI, 1.06-1.11; p < 0.00001; I2 = 31%), or advanced PCa (OR 1.07; 95% CI, 1.02-1.13; p = 0.006; I2 = 0%). The association with PCa remained significant when the analyses were restricted to studies with a low risk of bias (OR 1.06; 95% CI, 1.02-1.10; p = 0.02; I2 = 48%) or cohort studies (OR 1.09; 95% CI, 1.04-1.13; p < 0.0001; I2 = 64%). Among studies adjusted for PSA screening, the association with localized PCa (OR 1.06; 95% CI, 1.03-1.09; p < 0.001; I2 = 0%) remained significant. Conversely, vasectomy was no longer associated with localized high-grade (p = 0.19), advanced (p = 0.22), and lethal (p = 0.42) PCa.
    UNASSIGNED: Our meta-analysis found an association between vasectomy and any, mainly localized, PCa. However, the effect estimates of the association were increasingly close to null when examining studies of robust design and high quality. On exploratory analyses including studies, which adjusted for PSA screening, the association for aggressive and/or advanced PCa diminished.
    UNASSIGNED: In this study, we found an association between vasectomy and the risk of developing localized prostate cancer without being able to determine whether the procedure leads to a higher prostate cancer incidence.
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  • 文章类型: Case Reports
    Arteriovenous haemangioma of the vas deferens is an extremely rare entity in clinical practice. To date, there have been no clinical or pathological cases reported in Medline, Embase or other published English literature. Herein, a 50-year-old male who presented with right scrotal pain for 4 years after vasectomy was admitted to our hospital. One painful nodule was palpable in the right scrotum on physical examination. Color Doppler ultrasound merely showed dilation of the epididymis and no additional information concerning the painful nodule in the right scrotum. Moreover, the laboratory test results were all within normal limits. Ibuprofen was administered to the patient for 2 months with a poor effect, and then spermatic cord block significantly relieved his symptoms. This patient underwent resection of the right painful nodule of the vas deferens under medical advice. Postoperative pathological examinations showed arteriovenous haemangioma of the vas deferens. There were no obvious complications after arteriovenous haemangioma excision, and the right scrotal pain was significantly relieved 1 month later. This article reminds urologists and oncologists that haemangioma can involve the vas deferens and, in addition to spermatic granuloma, might be a cause of post-vasectomy pain syndrome. Cauterization of the vas deferens might have a potential relationship with haemangioma.
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  • 文章类型: Case Reports
    输精管重复是一种非常罕见的异常,在精索中发现了两个输精管。可以在尸检或尸体解剖以及需要精索解剖的几种外科手术中识别,包括腹股沟疝修补术,诊所,输精管切除术,精索静脉曲张切除术,输精管切除术逆转和前列腺癌根治术。识别重复的输精管对于避免手术并发症例如不成功的输精管切除术或输精管横切是重要的。自1959年以来,仅在3具尸体和31名患者中报告。在这项研究中,我们描述了一例66岁患者在常规腹股沟疝修补术中偶然发现的重复输精管的新病例。我们还回顾了文献中所有以前报道的病例,以引起人们对这种罕见但重要的异常的关注。
    Duplication of vas deferens is a very rare anomaly which two vasa deferentia are found in the spermatic cord. It can be recognised during autopsy or cadaveric dissection and also several surgical procedures which require spermatic cord dissection including inguinal hernia repair, orchiopexy, vasectomy, varicocelectomy, vasectomy reversal and radical prostatectomy. Recognition of the duplicated vas deferens is important to avoid surgical complications such as an unsuccessful vasectomy or transection of the vas. It was reported in only three cadavers and 31 patients since 1959. In this study, we describe a new case of duplicated vas deferens found incidentally during routine inguinal hernia repair in a 66-year-old patient. We also review all previously reported cases in the literature to draw attention to this rare but important anomaly.
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  • 文章类型: Journal Article
    BACKGROUND: Unintended pregnancy is popular all over the world, accounting for 40% to 50% of all pregnancies. The condition not only exerts pressure on the relationship of couples and severely impacts the quality of life, but also imposes a heavy burden on the health of women and child. Recently, more than 220 million couples have chosen to be sterilized to obtain contraception, 47.3% of married couples select sterilization, of which vasectomy accounts for 17.1%. Vasectomy is currently the most convenient and effective method of male contraception. We will perform the systematic review and meta-analysis to assess the correlation between vasectomy and male sex dysfunction and provide evidence-based evidence for the couple METHODS:: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org., China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry, and Cochrane Library will be retrieved before November 20, 2021. We will search English literature and Chinese literature with proper Medical Subject Heading or text key words. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement.
    UNASSIGNED: The aim of this study was to evaluate the effect of vasectomy on the sexual function of patients after operation. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions.
    UNASSIGNED: INPLASY202080014.
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