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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vasectomy is a rapid, inexpensive, 1-time method of birth control that has been chosen by 50 million men, 3/4 of whom live in the US, India, and South Korea. Although the operation has found little favor in Mediterranean countries, it is gaining interest in some countries of Latin America and the Middle East. Vasectomy can be performed on an ambulatory basis using local anesthesia and is associated with a very low rate of morbidity and almost no mortality. At present it is reversible in only about 25-35% of cases. A dialogue between the urologist and the patient is of the utmost importance to rule out any possible medical contraindication and to insure that the patient understands the permanence of the procedure and has chosen it voluntarily. The rate of complications of all types in different series varies from 1-122/1000 operations, with hematoma, infection, and epididymitis the most common. Spontaneous reanastomosis occurs in .1-.3% of cases. Some studies have minimized the probability of negative psychosocial consequences such as impotence or loss of libido resulting from the operation, stating that many couples have improved sexual relationships and that fewer than 1% of men express regret at not being able to father additional children, while other studies suggest more widespread reactions of insomnia, depression, hypochondriacal troubles, or sexual symptoms. Negative reactions occur most frequently in men who have not been adequately prepared psychologically for the procedure. Several prospective studies in men undergoing vasectomy have failed to demonstrate changes in testicular volume or in histologic status of the testicular parenchyma several years after operation, although changes at the epididymal level may occur. Although no absolute proof exists, it is likely that the presence of antisperm antibodies in the serum or seminal fluid after vasectomy plays a role in the persistent infertility of men undergoing sterilization reversal operations. The immunological effect of vasectomy on other organs and systems is a subject of controversy. The possible relationship between vasectomy and atherosclerotic disease also remains to be elucidated.
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PMID:[Vasectomy. Advantages, complications and consequences]. 685 68