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Chapter 27 - Male contraception and vasectomy

Published online by Cambridge University Press:  19 May 2010

Larry I. Lipshultz
Affiliation:
Baylor College of Medicine
Stuart S. Howards
Affiliation:
University of Virginia
Craig S. Niederberger
Affiliation:
University of Illinois, Chicago
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Summary

Vasectomy is typically performed as an outpatient procedure using local anesthetics. The technique employed for occlusion of the vasal lumina may influence the incidence of recanalization. Suture ligature, still the common method employed worldwide, may result in necrosis and sloughing of the cut end distal to the ligature. Hematoma is the common complication of vasectomy, with an average incidence of 2%. Sperm granulomas form when sperm leak from the testicular end of the vas. Sperm are highly antigenic, and an intense inflammatory reaction occurs when sperm escape outside the reproductive epithelium. The concept of male hormonal manipulation for contraception predated the era of female hormonal contraception by 20 years. Progestins have been used in multiple small studies for suppression of spermatogenesis and testosterone production in men. Along with hormonal manipulation, immunocontraception appears to offer reasonable hope for a nonsurgical contraceptive option in men.
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Infertility in the Male , pp. 474 - 492
Publisher: Cambridge University Press
Print publication year: 2009

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