The Korean family planning program began in 1962, originating both in a concern for fmaily well-being and in a concern over a high population growth rate which was cancelling advances in economic capacity, The new program was frank and vigorous in its advocacy of birth control. In recent years, voluntary sterilization as a family planning method has many attributes that cause users of contraceptives to regard it as an ideal method in Korea. A point of these view, author performed a follow-up study on effects of vasectomy and tubal ligation on sociomedical aspects of total 136 men sterilized and 96 women sterilized in SunSan Gun, Kyungpook Province as of Jul6y, 1977. The results were summarized as follows : An average age of vasectomized men was 37.0 and that of tubal ligated women, 34.9. The average duration of marital life was 13.9 years in men sterilized and 14.6 years in women sterilized. An average number of living children at the time of sterilization was 3.6 in men sterilized and that of living children, 3.7 in women sterilized. The most predominant reason for the sterilization was birth control in both (91% in men, 52% in women) and the most common motivating socilitator was family planning field workers (71% in men, 48% in women). About 51 percent of men sterilized and 50 percent of women sterilized were used contraceptive methods before the operation. Experience of induced abortion is reported in 65 percent of wives of men sterilized and 64 percent of women sterilized. In sexual feeling after sterilization, respondents showed increasing coital frequency 21 percent in men sterilized and 10 percent in women sterilized. Sixty-five percent in men sterilized and 64 percent in women sterilized would recommend the operation to others.
Abortion, Induced ; Child ; Coitus ; Contraception ; Contraceptive Agents ; Surveys and Questionnaires ; Family Planning Services ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Health Personnel ; Humans ; Korea* ; Male ; Population Growth ; Spouses ; Sterilization ; Sterilization, Reproductive* ; Sterilization, Tubal ; Vasectomy

Vasectomy as a male sterilization has been performed popularly in the world including Korea from 1962. In recent demand for reversal of reproduction increases more than past times due to sudden loss of offspring or change of mind. In this presentation, we report 13 cases of vasovasostomy operated from December in l983 to June in 1985 and observe the results after operation & technics used at our department of urology. The results after operation is described anatomically & functionally with ratio.
Korea ; Reproduction ; Sterilization, Reproductive ; Urology ; Vasectomy ; Vasovasostomy*

No abstract available.
Humans ; Male* ; Sterilization ; Sterilization, Reproductive*

Vasectomy as a male sterilization has become increasingly popular as one of methods of planned parenthood in many countries including Korea. In this presentation the subject of an overview of male sterilization consists of mainly technical aspects of the ordinary vasectomy and vasovasostomy. the principle of vasectomy is same but some many different technics have been reported and utilized. specific differences are found in technics for immobilizing the vas for making the scrotal incision. for treating the cut ends of vasa, and for removing segments of vas Therefore the author discusses some important factors so as to provide complete protection against the passage of sperm without any failure and to improve the chances of later reversibility according to his experiences of over 7000 vasectomies and 200 vasovasostomis. In the part of ordinary vasectomy procedure, various items such as ideal operative level local anesthesia immobilization of the vas skin incision isolation for the vas treatments of the cut ends of vas prevention of hematoma formation disappearance rate of residual sperm immediate sterility technic complication psychological effects and antibodies following vasectomy are reviewed. In the part of vasovasostomy numerous factors such as operative technics splint various factors for the successful operation overall success rates and low pregnancy rates are discussed and compared with the author's series.
Anesthesia, Local ; Antibodies ; Hematoma ; Humans ; Immobilization ; Infertility ; Korea ; Male* ; Pregnancy Rate ; Skin ; Spermatozoa ; Splints ; Sterilization ; Sterilization, Reproductive* ; Vasectomy ; Vasovasostomy

PURPOSE: Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patient requiring vasectomy reversal. Recently, many authors have reported high success rates of vasovasostomy using microsurgical techniques. The purpose of this study was to compare patency and pregnancy rates and operation time of a new method for vasovasostomy developed at the Department of Urology, Dong-A University Hospital with those of other methods, and to find out other factors influencing patency and pregnancy rates. MATERIALS AND METHODS: Microscopic vasovasostomy was performed in 149 patients from June 1990 to September 1997 at our department. Among 89 patients who could be followed up post-operatively, standard two layer vasovasostomy was performed in 22 patients, modified one layer vasovasostomy with 4 full thickness sutures in 32 patients and modified one layer vasovasostomy with 5 full thickness sutures developed at our department in 35 patients. We compared mean operation times and patency and pregnancy rates between the techniques and examined patency and pregnancy rates according to age, vasal obstruction interval, presence of sperm in vas fluid and sperm granuloma. RESULTS: Success rates were 95.5% for patency and 68.2% for pregnancy in standard two layer vasovasostomy, 87.5% for patency and 59.42% for pregnancy in modified one layer vasovasostomy with 4 full thickness sutures and 97.1% for patency and 65.7% for pregnancy in modified one layer vasovasostomy with 5 full thickness sutures and there was statistical significance in the patency rates between each method (p<0.05). Mean operation times were 136.6+/-19.2 minutes in standard two layer vasovasostomy, 86.6+/-16.8 minutes in modified one layer vasovasostomy with 4 full thickness sutures and 96.7+/-18.4 minutes in modified one layer vasovasostomy with 5 full thickness sutures (p<0.001). With regard to factors influencing operation, the pregnancy rates were slightly higher in cases of younger patients, presence of sperm in vas fluid and presence of sperm granuloma (p>0.05) and significantly lower in case of longer vasal obstruction interval (p<0.0005). CONCLUSIONS: We found little difference in success rates between standard double layer vasovasostomy and modified one layer vasovasostomy with 5 full thikness sutures and the latter was easier and more time saving technique.
Granuloma ; Humans ; Korea ; Pregnancy ; Pregnancy Rate ; Spermatozoa ; Sterilization, Reproductive ; Sutures ; Urology ; Vasectomy ; Vasovasostomy*

PURPOSE: Because of the volume of elective sterilizations performed in the world during the past decade, the vasectomy was a popular method for male sterilization in Korea and this, in turn, had been followed by an increase in the number of patient requiring vasectomy reversal with the high rate of subsequent divorce and remarriage. Recently, many authors have reported high success rates of vasovasostomy using microsurgical techniques and we performed modified two layer vasovasostomy with intravasal silicone tube to increase postoperative patency and pregnacy rate. METHODS: Microscopic vasovasostomy was performed in 9 patients at our department using modified two layer vasovasostomy with silicone tube insertion. Their ages ranged from 28 to 44 with an average of 35.78+/-1.36 years. Standard Guibor silicone tube, consisting of two 17.7cm, 0.064cm diameter, malleable, stainless steel probes connected by 29cm of silicone tubing wedged onto disposable probes, were used in all cases. RESULTS: Success rates were 88.8% for patency and pregnancy 44.4% for pregnancy in modified two layer vasovasostomy with silicone tube insertion. The patency rates were higher in cases of long postoperative day and in cases of short duration of vasectomy and vasovasostomy. CONCLUSION: We used a modified method to correspond the patency and pregnancy rate in microscopical modified two layer vasovasostomy using the intravasal silicone tube permanently. This method brings normal patency in microsurgical vasovasostomy because the silicone tube prevent obstruction of anastomosed site of the vas permanently.
Divorce ; Humans ; Korea ; Marriage ; Microsurgery ; Pregnancy ; Pregnancy Rate ; Silicones ; Stainless Steel ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy

Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patients requesting vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy persist between the patency and pregnancy rate despite improvements in surgical techniques. A total of 200 patients undergoing vasovasostomy from May 1983 to April 1990 were reviewed. Of these 200 patients, only 130 patients (98 patients by two-layer, 32 patients by modified two-layer technique) could be followed up and analyzed as to pregnancy rate related to age, vasal obstructive interval, gross appearance and sperm quality of the vas fluid, operative method, and presence or absence of sperm granuloma. Success rates were 90.3% for patency and 65.4% for pregnancy. With regard to factors influencing to operation, it seemed that the results were better when there was a shorter vasal obstructive interval, watery vas fluid, presence of normal morphologic sperm quality, presence of sperm granuloma, and when the operation was done using the two-layer technique. However, no statistically significant difference was found, except between the bilateral presence and absence of sperm granuloma at the vasectomy site. Thus it is suggested that the most important single factor influencing the success rate of vasovasostomy is a meticulous and skillful operative technique itself, althought other factors may affect the outcome. More effort and research are needed to find the factors affecting the success rate of vasovasostomy.
Granuloma ; Humans ; Infertility* ; Korea ; Pregnancy Rate ; Pregnancy* ; Spermatozoa ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy*

AIMTo study the histologic changes of the vas deferens following Nd: YAG laser irradiation.

METHODSIntravasal laser irradiation was given to (i) 52 segments of rabbit (laser dosage: 2 seconds at 40 W approximately 50 W) and 16 segments of human (3 seconds at 45 W approximately 55 W) vas deferens in vitro, (ii) 25 rabbit vasa (2 seconds approximately 2.5 seconds at 40 W approximately 45 W) in vivo and (iii) 2 human vasa (3 seconds at 55 W) in vivo. Segments of vasa were removed from the in vivo irradiated vasa deferentia 15 days approximately 180 days (rabbit) or 15 days (man) after the exposure. All vas segments were embedded in methacrylate resin. Serial sections (thickness 25 microm approximately 30 microm) were obtained and observed under a light microscope.

RESULTS(i) Laser-induced damage reached the muscularis layer in 27% and 94% of the rabbit and human vas segments in vitro, respectively. (ii) Fourteen of the 25 in vivo rabbit vasa were completely occluded by fibrous tissue and the longer the time interval after treatment, the more likely was the vas occluded. Those unoccluded vasa had either a normal histology or a mucosal damage. (iii) One in vivo human vas was almost completely occluded by the fibrous tissue but the other had a relatively large lumen packed with sperm granulomatous tissue and partial destruction of the smooth muscle layer.

CONCLUSIONLaser irradiation can induce long-term vas occlusion; for rapid occlusion, laser doses just completely destroying the mucosal layer will be advisable.

Animals ; Humans ; Laser Coagulation ; Male ; Rabbits ; Sterilization, Reproductive ; methods ; Vas Deferens ; anatomy & histology ; Vasectomy

About 60,000 men were undergone voluntary sterilization by the 497 designated doctors during the period from 1962 to October 1965 by the government subsidy program. Besides these numbers more than 15,000 private cases were sterilized by private doctors during the period from 1960 to 1964 in Korea. A general comprehension of the sterilization operation for motivation of customers was illustrated. An analysis of the social history and background of the sterilized men were made on the author's private group and the subsidized group. The most common occupation of the private group was commerce and that of the subsidized group was africulture. The duration intervening between marriage and sterilization indicated 13.6 years in the private group and 16.7 years in the subsidized group. An average age of the sterilized men showed 40 and that of their wives 35. An average number of children of the private group showed 4.7 while that of subsidized group indicated 5.3. Sexual drive following the sterilization was not changed in 81 per cent of the private group and in 71 per cent of the subsidized group. Decrease in sexual activity was revealed in 5 per cent of the private group but in 11 per cent of the subsidized group. General health after the sterilization was not changed in 83 per cent of the private group and in 70 per cent of the subsidized group. Decrease in general health was noted in only 6 per cent of the private group but in 11 per cent of the subsidized group. Frequency of sexual intercourse per week of the private group indicated 1.95 times preoperatively and 1.88 times postoperatively whereas that of the subsidized group revealed 2.27 times preoperatively but 1.99 times postoperatively. In regarding the sexual feeling of their wives, more than 87 per cent of the private group showed no change before and after the operation while 71 per cent of the wives of the subsidized group were not changed. Very few wives of the private group complained of some decrease, but 10 per cent of the subsidized group complained decrease. The time lost from work after the sterilization was about 2 days in the private group while about 8 days in the subsidized group. About 93 per cent of the private group were satisfied with the sterilization but 2 per cent of them did not feel happy after the operation. In the subsidized group 88 per cent were satisfied with the operation but 10 per cent were not satisfied. All of the private group and 80 per cent of the subsidized group would recommend the sterilization method to their friends. Untoward effects on sexual drive and general health are found to be higher in the subsidized group than in the private group. These outcomes are partly due to low edcation and low income of the subsidized group compared with the private group and partly due to unsatisfactory operative technique of the designated doctors. Psychological studies by means of MMPI conducted on 20 sterilization neurosis patients and the results were compared with the control nonvasectomized group. The sterilized group had definite psychological instability so that a preoperative psychological interview is found to invariably be necessary to prevent the sterilization neurosis. It is concluded by this preliminary clinical survey of the vasectomized cases through the author's private system and the government subsidy program that the few who told to decrease in sexual capacity and general health were outnumbered by those reporting an increase. The majority of the cases told of no change. The changes noted by a small proportion of patients appeared to be chiefly of psychological origin because there was no physiologic reason why the operation of vasectomy should causes sexual excess or decrease.
Child ; Coitus ; Commerce ; Comprehension ; Financing, Government ; Friends ; Humans ; Interview, Psychological ; Korea ; Male ; Marriage ; MMPI ; Motivation ; Occupations ; Sexual Behavior ; Spouses ; Sterilization ; Sterilization, Reproductive ; Vas Deferens ; Vasectomy*

OBJECTIVE: This study aimed to determine the knowledge, attitudes and beliefs of adult Filipino males consulting in the Philippine General Hospital on vasectomy, and the affect of marital status, length of marriage, number of children, level of education, economic status, religion and type of mass -media exposure on these attitude and beliefs.

MATERIALS AND METHODS: This is a descriptive cross-sectional study. A total of 1120 adult male patients were included in the study. Data were collected using a standardized, self-administered questionnaire. Percentages and means were calculated for all variables. Analysis was done using multiple regression models.

RESULTS: The mean age of the participants was 50.7 years (SD 16.5) and the mean number of children was 2.5 (SD 2.2). Of the whole sample, 363 (32.4%) have used or are currently using one from of contraception. Among the 518 (46.2%) of men who knew about vasectomy as a form of contraception, 451(87.1%) knew that vasectomy involves ligation of the vas deferens. Higher educational status, previous or current use of contraceptive and not being a Roman Catholic were shown to be statistically significantly associated with knowing about vasectomy as a form of contraception. Only knowledge about the safety of vasectomy was shown to influence men's willingness to undergo the procedure.

CONCLUSION: Improved awareness of the safety and reversibility of vasectomy may lead to increased acceptance of the procedure amongst Filipino men. Physicians play an important role in the dissemination of information about contraception, alongside the mass media, and should make efforts to ensure that adequate and accurate information is made available.

Human ; Male ; Vasectomy ; Psychology ; Contraception ; Sterilization, Reproductive ; Health Knowledge, Attitudes, Practice ; Attitude to Health ; Culture ; Information Dissemination ; Awareness ; Safety