BACKGROUND: Vasectomy is a permanent contraceptive method that is increasingly appealing to French men with diverse patient profiles. An important question is the impact on sexual life. We aimed to specify the profile of men seeking vasectomy and its impact on their lives.
METHODS: Based on a consecutive series of 446 men undergoing vasectomy at a university center between April 2010 and March 2022, an online survey was launched in April 2022. In total, 177 patients responded to the questionnaire. The median time between surgery and questionnaire response was 33 months (15, 50). At the time of vasectomy, the main age group was 36-45 years (55%).
RESULTS: The reflection period before consultation exceeded 1 year for 69%. At the time of surgery, only 8% of men were single and 18% were childless. Vasectomy was a couple\'s decision in 45% of cases. The main motivation was the shift in contraceptive burden for 76% of patients. Harmony in the couple was unchanged for 58% and improved for 33%. Libido remained stable for 79% and improved for 13%; 97% of men reported being satisfied with having undergone vasectomy; 96% had no regrets about surgery; 98% never considered having corrective surgery, and 99% never had a childbearing plan after the intervention.
CONCLUSIONS: Men increasingly share contraceptive burden. Vasectomy has no significant deleterious impact on sexual life. Satisfaction is high, and the vast majority of men undergoing vasectomy have no regret of their decision. Consequently, vasectomy should continue to expand in France.

For the preparation of embryo transfer recipients, surgically vasectomized mice are commonly used, generated by procedures associated with pain and discomfort. Sterile transgenic strains provide a nonsurgical replacement, but their maintenance requires breeding and genotyping procedures. We have previously reported the use of naturally sterile STUSB6F1 hybrids for the production of embryo transfer recipients and found the behavior of these recipients to be indistinguishable from those generated by vasectomized males. The method provides two substantial 3R impacts: refinement (when compared with surgical vasectomy) and reduction in breeding procedures (compared with sterile transgenic lines). Despite initial promise, the 3Rs impact of this innovation was limited by difficulties in breeding the parental STUS/Fore strain, which precluded the wider distribution of the sterile hybrid. The value of a 3R initiative is only as good as the uptake in the community. Here we, thus, select a different naturally sterile hybrid, generated from strains that are widely available: the B6SPRTF1 hybrid between C57BL/6J and Mus spretus. We first confirmed its sterility by sperm counting and testes weight and then trialed the recovery of cryopreserved embryos and germplasm within three UK facilities. Distribution of sperm for the generation of these hybrids by in vitro fertilization was found to be the most robust distribution method and avoided the need to maintain a live M. spretus colony. We then tested the suitability of B6SPRTF1 sterile hybrids for the generation of embryo transfer recipients at these same three UK facilities and found the hybrids to be suitable when compared with surgical vasectomized mice and a sterile transgenic strain. In conclusion, the potential 3Rs impact of this method was confirmed by the ease of distribution and the utility of sterile B6SPRTF1 hybrids at independent production facilities.

Three adult black howler monkeys (Alouatta pigra) were vasectomized for the purpose of population control. Two different surgical approaches (inguinal and pelvic) were used to vasectomize the animals under general anesthesia. One monkey was vasectomized with a pelvic approach, and the other two monkeys were vasectomized with an inguinal approach. The inguinal approach was minimally invasive and proved to be an effective field procedure, utilizing minimal surgical equipment with a mean operative time of 35 min. The inguinal approach allowed for better visualization of the spermatic cord, which prompted easier ligation and transection of the ductus deferens. Identification of the ductus deferens was successfully performed intraoperatively using a tuberculin syringe to aseptically aspirate cord contents, as histopathology was not available. All howler monkeys fully recovered without complication. The social hierarchy of the troop and mating behavior has not been affected. There have been no new pregnancies reported in the troop since the vasectomies were performed. The inguinal approach is preferred as it is minimally invasive and can be performed confidently in a field setting.

The Supreme Court ruling Dobbs v. Jackson Women\'s Health Organization (June 2022) overturned federal protection of abortion rights, resulting in significant impact on both male and female reproductive rights and health care delivery. We conducted a retrospective review of all patients who underwent vasectomy at a single academic institution between June 2021 and June 2023. Our objective was to compare the rates of childless and partnerless vasectomies 1 year before and after this ruling, as these men may be more susceptible to postprocedural regret. Of total, 631 men (median age = 39 years, range = 20-70) underwent vasectomy consultation. Total vasectomies pre- and post-Dobbs were 304 (48%) versus 327 (52%). Total childless and partnerless vasectomies pre- and post-Dobbs were 44 (42%) versus 61 (58%) and 43 (46%) versus 50 (54%). Vasectomy completion rate was slightly increased post-Dobbs (90% vs. 88%; p = .240). The post-Dobbs cohort had significantly less children (1.8 vs. 2.0; p = .031). Men in the post-Dobbs era were significantly more likely to be commercially insured (72% vs. 64%) and less likely to be uninsured (1% vs. 6%; p = .002). Men who underwent childless vasectomy were significantly more likely to be younger (36.4 vs. 39.8 years; p < .001). There was a significantly greater proportion of Hispanic and Black men in the partnerless cohort compared to the cohort with partners (24% vs. 19% and 9% vs. 2%; p = .002). In conclusion, patients should be counseled on the permanent nature of this procedure, underscoring need for effective and reversible male contraception.

BACKGROUND: In the United States (US) men who undergo vasectomy and/or vasectomy reversal (vasovasotomy) are likely to pay out-of-pocket for these procedures. We characterized the publicly disclosed pricing of both procedures with a focus on variability in self-pay prices.
METHODS: We queried all US hospitals for publicly disclosed prices of vasectomy and vasovasotomy. We assessed interhospital variability in self-pay pricing and compared hospitals charging high (≥75th percentile) and low (≤25th percentile) self-pay prices for either procedure. We also examined trends in pricing after the 2022 US Supreme Court decision that allowed individual states to ban abortion.
RESULTS: Of 6692 hospitals, 1375 (20.5%) and 281 (4.2%) disclosed self-pay prices for vasectomy and vasovasotomy, respectively. There was a 17-fold difference between the 10th and 90th percentile self-pay prices for vasectomy ($421-$7147) and a 39-fold difference for vasovasotomy ($446-$17,249). Compared with hospitals charging low (≤25th percentile) self-pay prices for vasectomy or vasovasotomy, hospitals charging high (≥75th percentile) prices were larger (median 150 vs. 59 beds, p < 0.001) and more likely to be for-profit (31.2% vs. 7.8%, p < 0.001), academic-affiliated (52.7% vs. 23.1%, p < 0.001), and located in an urban zip code (70.1% vs. 41.3%, p < 0.001). From October 2022 to April 2023, the median self-pay price of vasectomy increased by 10% (from $1667 to $1832) while the median self-pay price of vasovasotomy decreased by 16% (from $3309 to $2786).
CONCLUSIONS: We found large variability in self-pay pricing for vasectomy and vasectomy reversal, which may serve as a barrier to the accessibility of male reproductive care.

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.

OBJECTIVE: Present an approach to the safe and efficient provision of anesthesia and birth control measures to a large group of primates.
METHODS: 98 hamadryas baboons (Papio hamadryas) held in a German zoological institution.
METHODS: A group of 12 veterinarians, 2 zookeepers, and 6 volunteers anesthetized all animals within 2 days. The baboons were orally premedicated with midazolam (0.1 to 0.5 mg/kg) and anesthetized with medetomidine (40 to 60 µg/kg, IM) and ketamine (2 to 4 mg/kg, IM); isoflurane at rates of 1.5% to 2% was used for maintaining anesthesia if necessary. All animals received a physical examination, prophylactic medication, and tuberculin testing. For population management, the animals received a contraceptive implant (adult females), orchiectomy (young males), or vasectomy (breeding males). Young males received intratesticular blocks with lidocaine. All animals received atipamezole (125 to 150 µg/kg) before recovery.
RESULTS: Premedication resulted in anxiolysis, which facilitated separating and darting. Median time from darting to access to the animal was 10 minutes. Mean anesthetic times were 25 minutes for females and 55 minutes for males. The depth of anesthesia was appropriate for the procedures. No fatalities were recorded. One animal was injured by other baboons but recovered after treatment.
CONCLUSIONS: Health management and birth control measures are necessary in baboon troops under human care. Anesthesia and/or contraception of individual animals often leads to intraspecific aggression. This case series describes how to provide anesthesia and contraception to an entire troop as an alternative approach that can be adopted to future similar interventions.

暂无摘要。

BACKGROUND: Andrology and urogenital reconstruction are emerging disciplines in French urology. The aim of our study was to evaluate the evolution of andrological surgical procedures over the period 2013-2022 using national data.
METHODS: We collected national common classification of medical acts (CCAM) coding data for all procedures involving andrological surgery from the Scansanté internet platform set up by the Technical Agency for Information on Hospitalisation, which collects prospectively from healthcare structures all procedures coded according to CCAM coding. All surgical procedures in andrology were selected. The inclusion period extended from 2013 to 2022.
RESULTS: In 10 years, the number of vasectomies has increased tenfold, with 29,890 cases in 2022. Vaso-vasostomies remain marginal, with 80 cases per year. Trans-identity surgeries are rising sharply. Vaginoplasties have multiplied by 4 (333 in 2022) and masculinising surgeries have multiplied by 10 (234 in 2022). Penile prosthesis surgery has increased slightly over 10 years. The number of testicular biopsies has remained stable over time, as has the number of surgeries for curvature of the penis.
CONCLUSIONS: Two andrological surgeries are showing very strong growth: vasectomy and transgender surgery. The emergence of these 2 activities is linked to societal aspirations. Urologists need to be trained to meet this demand.
UNASSIGNED: Grade 4.

BACKGROUND: Currently, approximately half of all pregnancies worldwide are unintended. Contraceptive use significantly reduces the risk of unintended pregnancy; however, options for men are particularly limited. Consequently, efforts are underway to develop novel, safe, and effective male contraceptives.
RESULTS: This review discusses research into emerging male contraceptive methods that either inhibit sperm production or impair sperm function. It focuses on those in the preclinical or early clinical stages of development.