Based on the current understanding of a preventive effect of bilateral salpingectomy on ovarian/fallopian/peritoneal cancers, the Korean Society of Obstetrics and Gynecology, Korean Society of Gynecologic Endocrinology, Korean Society of Gynecologic Oncology, Korean Society of Maternal Fetal Medicine, and Korean Society for Reproductive Medicine support the following recommendations:• Women scheduled for hysterectomy for benign gynecologic disease should be informed that bilateral salpingectomy reduces the risk of ovarian/fallopian/peritoneal cancer, and they should be counseled regarding this procedure at the time of hysterectomy.• Although salpingectomy is generally considered as a safe procedure in terms of preserving ovarian reserve, there is a lack of evidences representing its long-term outcomes. Therefore, patients should be informed about the minimal potential of this procedure for decreasing ovarian reserve.• Prophylactic salpingectomy during vaginal hysterectomy is favorable in terms of prevention of ovarian/fallopian/peritoneal cancer, although operation-related complications minimally increase with this procedure, compared to the complications associated with vaginal hysterectomy alone. Conversion to open or laparoscopic approach from vaginal approach to perform prophylactic salpingectomy is not recommended.• Women who desire permanent sterilization at the time of cesarean delivery could be counseled for prophylactic salpingectomy before surgery on an individual basis.
Endocrinology ; Fallopian Tubes ; Female ; Genital Diseases, Female ; Gynecology* ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Obstetrics* ; Ovarian Neoplasms ; Ovarian Reserve ; Prophylactic Surgical Procedures ; Reproductive Medicine ; Salpingectomy* ; Sterilization

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

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

OBJECTIVETo investigate the effects of Gukang on bone-source alkaline phosphatase (BALP) and insulin-like growth factor 1 (IGF-1) in serum of spaying rats and the mechanism of curative effect of Gukang on osteoporosis.

METHODSSixty-eight 6-month-old SD rats were chosen and randomly divided into blank control group (22 rats with sham operation) and operation group (46 rats with spaying operation). Three months after operation, 10 rats were randomly chosen from each group and tested with bone mineral density in order to determine models of osteoporosis made. After modeling, operation group was divided into 3 sub-groups: operation model group, estrogen group and Gukang group, 12 rars in each group. Twelve rats remained in blank control group. Every group were treated through intragastric administration therapy (volume 10 ml/kg). Blank control group and operation model group were irrigated with distilled water,estrogen group with estrogen and Gukang group with Gukang. Three months after treatment, serum of all groups were collected and tested for E2, BALP and IGF-1 with ELISA.

RESULTSThe concentration of serum E2, BALP in estrogen group and Gukang group were higher than operation model group, there were significant difference (P < 0.05), but no significant difference in serum E2 between estrogen group and Gukang group (P > 0.05). The concentration of serum IGF-1 in Gukang group was higher than operation model group and blank control group, there were significant difference (P < 0.05).

CONCLUSIONGukang can increase the level of E2, BALP and IGF-1 in serum of spaying rats. Thus, it can indirectly promote reproduction of osteoblasts, inhibit activity of osteoclasts and promote bone formation.

Alkaline Phosphatase ; blood ; Animals ; Bone Density ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Estrogens ; blood ; Female ; Humans ; Insulin-Like Growth Factor I ; metabolism ; Osteoporosis ; drug therapy ; metabolism ; physiopathology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Sterilization, Reproductive

OBJECTIVES: The purpose of this study was to examine the determinants of sterilization in South Korea. METHODS: This study was based on the data from the Korea National Fertility Survey carried out in the year 2000 by the Korea Institute of Health and Social Affairs. The subjects of the analysis were 4,604 women and their husbands who were in their first marriage, in the age group of 15-49 years. The data were analyzed by multiple logistic regression analysis. RESULTS: Consistent with the findings of previous studies, the woman's age and the number of total children increased the likelihood of sterilization. In addition, the year of marriage had a strong positive association with sterilization. Interestingly, the number of surviving sons tended to increase the likelihood of sterilization, whereas the woman's education level and age at the time of marriage showed a negative association with sterilization. Religion, place of residence, son preference, and the husband's education level, age and type of occupation were not significant determinants of sterilization. CONCLUSIONS: The sex of previous children and lower level of education are distinct determinants of sterilization among women in South Korea. More studies are needed in order to determine the associations between sterilization rate and decreased fertility.
Adolescent ; Adult ; *Decision Making ; Female ; Health Surveys ; Humans ; Korea ; Male ; Middle Aged ; Spouses/psychology/*statistics & numerical data ; *Sterilization, Reproductive

The article gives a detailed introduction of the process of marking flat tube needle for vas deferens puncture and a brief explanation of its application. This kind of tube needle can be easily made of readily available material, convenient to be cleaned and sterilized, with high success rate of puncturing and good effect. Other tube needles can be made by imitating it.
Equipment Design ; Humans ; Male ; Needles ; Punctures ; instrumentation ; Sterilization, Reproductive ; instrumentation ; Vas Deferens

OBJECTIVETo study the effect of Ar(+) laser on human vas deferens and to compare the effects of using different radiation levels with varying thickness of tissue and varying levels of injury.

METHODSAfter initial tests on animals, four human scrotums were opened and treated directly with Ar(+) laser radiation. Then 58 human individual scrotums were treated with radiation by the method of trans-skin puncture. The rate of sperm reduction and elimination was tested.

RESULTSIn 60 cases, the sperms were found to be eliminated completely after six months of radiation treatment. In 2 cases the sperms were found not to be eliminated completely due to the insufficient radiation.

CONCLUSIONAr(+) laser is one of the best forms of radiation for coagulation of vas deferens. It can be used to coagulate vas deferens without any complications or sequelae.

Adult ; Follow-Up Studies ; Humans ; Laser Coagulation ; Male ; Sterilization, Reproductive ; methods ; Vas Deferens ; surgery

PURPOSE: In the 1970s, male sterilization (vasectomy) has been performed on a large scale as an accepted method of family planning in Korea. Since then, especially during last decade, there has been an increase in the number of patients requesting vasovasostomy after a long term interval following a vasectomy. MATERIALS AND METHODS: We evaluated 153 cases of vasovasostomy performed, 10 years or more after a vasectomy, at the Pusan National University Hospital between March 1983 and March 2002. Clinical data were collected through telephone interviews and a survey of medical records. RESULTS: The ages at the time of reversal ranged from 30 to 57, with an average of 41.6 years. The obstructive intervals ranged from 10 to 24, with an average of 17.0 years. To the cases were divided into 3 the obstructive intervals; 10 to 14, 15 to 19 and 20 to 24 years, with 130 (85.0%), 15 (9.8%) and 8 cases (5.2%), respectively. The overall patency and pregnancy rates were 81.6 and 36.0%, respectively. There were no significant differences according to the methods of vasovasostomy, suture materials, ooze from the proximal vasal end, the presence of sperm granuloma, the levels of anastomosis or the age of patients, with the exception of the ages of the partners in the patency and pregnancy rates for the patients with vasovasostomy 10 years or more after vasectomy. CONCLUSIONS: Our results suggest that the pregnancy rates after vasovasostomies, following at least a 10 years long term obstruction, are very low, despite the desirable patency rates. Therefore, it is important that we should apply the assisted reproductive technology, as well as advanced surgical skills, to improve the pregnancy rates.
Busan ; Family Planning Services ; Granuloma ; Humans ; Interviews as Topic ; Korea ; Medical Records ; Pregnancy Rate ; Reproductive Techniques, Assisted ; Spermatozoa ; Sterilization, Reproductive ; Sutures ; 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

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*