Ten Percent of Men Change Their Mind on Vasectomy

Men and Vasectomy

One-tenth of men who get a vasectomy change their minds later, said a professor of urology at Baylor College of Medicine in Houston.
"This is most commonly because of remarriage," said Dr. Larry Lipshultz. "Vasectomy reversals are also requested by couples who have merely 'changed their minds,' as well as by couples who have lost a child and are attempting to initiate another pregnancy."
During the delicate procedure, surgeons find the two ends of the vas deferens and free them from the scar tissue. Once it's determined that the fluid in the vas contains sperm, the two ends are sutured together, thus reversing the vasectomy. The operating time is usually around three hours, said Lipshultz.
However, not every vasectomy is reversible, he said.
"When the vas is opened, fluid will flow from the testicular side of the vasectomy site," said Lipshultz. "If sperm are present, then we expect most patients to demonstrate a return of sperm with an associated 60 to 70 percent pregnancy rate. If no sperm are present, yet the vasectomy fluid looks abundant and appropriate for ultimate sperm production, then the reversal is performed with a successful outcome in approximately half of all patients."
If poor-quality fluid is present and sperm are absent, or no fluid at all is found, then a procedure called an epididymovasostomy (connection of the vas to the epididymis, or the chord along the border of the testes that provides storage and transport of sperm) is performed with a successful outcome of approximately 40 to 50 percent.
Sperm banking is routinely performed at the time of vasectomy reversal if whole sperm are present. Cryopreservation, or freezing the sperm, is performed as a backup in case inadequate sperm counts are present after surgery.

Pomegranate juice may improve erectile dysfunction

Pomegrante and Impotence

Research published in the International Journal of Impotence Research finds drinking 8 ounces of POM Wonderful 100% Pomegranate Juice daily may help the management erectile dysfunction and impotence.

According to a pilot study released in the International Journal of Impotence Research (www.nature.com/ijir), POM Wonderful 100% Pomegranate Juice was found to have beneficial effects on erectile dysfunction (ED), a disorder that affects 1 in 10 men worldwide and 10 to 30 million men in the United States alone. Erectile dysfunction can be caused by several factors, including arterial plaque, high blood pressure, heart disease, diabetes, nerve damage, endocrine imbalance or depression.Ultimately, erectile dysfunction is a condition that affects the blood flow to the penis during sexual stimulation.

This randomized, placebo-controlled, double-blind, crossover pilot study examined the efficacy of pomegranate juice versus placebo in improving erections in 61 male subjects. To qualify, participants had to experience mild to moderate ED for at least 3 months; be in a stable, monogamous relationship with a consenting female partner; and be willing to attempt sexual intercourse on at least one occasion per week during each study period.

Mild erectile dysfunction is defined as the mildly decreased ability to get and keep an erection, while moderate ED is the moderately decreased ability to get and keep an erection. The majority of men with ED have moderate erectile dysfunction.

For the first four weeks of the study, the subjects were assigned to drink either 8 oz. of POM Wonderful Pomegranate Juice or 8 oz. of placebo beverage daily with their evening meal or shortly after. After a two-week washout period during which the subjects did not consume any study beverage nor utilize any erectile dysfunction treatment, they were assigned to drink 8 oz. of the opposite study beverage every evening for another four weeks. At the end of each four week period, efficacy was assessed using the International Index of Erectile Function (IIEF) and Global Assessment Questionnaires (GAQ). The IIEF is a validated questionnaire that has been demonstrated to correlate with ED intensity. The GAQ elicits the patient's self-evaluation of the study beverages' effect on erectile activity.

Forty seven percent of the subjects reported that their erections improved with POM Wonderful Pomegranate Juice, while only 32% reported improved erections with the placebo (p=0.058). These results compare favorably to a recent 24-week study using a PDE5 inhibitor (such as Cialis), in which roughly 73% of subjects reported a benefit from the PDE5 inhibitor and 26% reported a "placebo effect" (i.e. experiencing improvement while on the placebo).

Although the study did not achieve overall statistical significance, the authors conclude that additional studies with more patients and longer treatment periods may in fact reach statistical significance. The strong directional results of this pilot study are encouraging because almost half of the test subjects experienced a benefit simply by adding pomegranate juice to their daily diet, without the use of erectile dysfunction drugs - generic cialis,viagra,cialis soft tabs.

Researchers believe that the results might be due to the potent antioxidant content of pomegranate juice, which can prevent free radical molecules from disrupting proper circulatory function. In several previously published medical studies, pomegranate juice has been shown to enhance blood flow and to slow or reverse arterial plaque growth. Because an erection requires significant blood flow, these potent pomegranate antioxidants may provide benefit by mitigating arterial plaque and promoting blood vessel dilation.

According to study co-author Harin Padma-Nathan, MD, FACS, FRCS, Clinical Professor of Urology at the Keck School of Medicine, University of Southern California, "These findings are very encouraging as they suggest there is a non-invasive, non-drug way to potentially alleviate this quality of life issue that affects so many men. For men with erectile dysfunction, it is important to maintain a healthy diet and exercise. Drinking pomegranate juice daily could be an important addition to the diet in the management of this condition."

Cause of Diabetes-Related Erectile Dysfunction is Clarified

Cause of Erectile Dysfunction

A new study from the Brady Urological Institute at Johns Hopkins suggests an over-supply of a simple blood sugar could be a major cause of erectile dysfunction in diabetic men.

Researchers have found that one particular simple sugar, present in increased levels in diabetics, interferes with the chain of events needed to achieve and maintain erection and can lead to permanent penile impairment over time. The results, which have implications for new types of erectile dysfunction treatments targeting this mechanism of erection, are described in the August 16 issue of the Proceedings of the National Academy of Sciences.

Previous research had shown that diabetic erectile dysfunction was partially due to an interruption in an enzyme that starts the chain of vascular events leading to an erection. The Hopkins team suspected O-GlcNAc, a blood sugar present in hyperglycemic (high blood sugar) circumstances, to be that interrupting factor.

"We were interested to determine whether high glucose in diabetes mellitus modifies the endothelial nitric oxide synthase (eNOS) enzyme, which is responsible for the achievement and maintenance of erection," says Biljana Musicki, Ph.D., lead investigator of the study and a research associate in the Brady Urological Institute.

Erectile dysfunction is a common problem for more than half of men with diabetes. Musicki says that an estimated "50 percent to 75 percent of diabetic men have erectile dysfunction to some degree, [a rate] about threefold higher than in non-diabetic men." This is not the same type of erectile dysfunction seen in non-diabetics, and it is less effectively treated with conventional drugs like Viagra.

The study examined rats with type 1 diabetes mellitus as well as the overall mechanism of erection. "Erection begins when a sexual stimulus activates the enzyme neuronal nitric oxide synthase (nNOS) that causes short-term release of nitric oxide (NO) at the nerve endings in the penis," Musicki explains.

This initial release of NO causes rapid and short-term increases in penile blood flow and short-term relaxation of the penile smooth muscle, initiating an erection. The resulting expansion of penile blood vessels and smooth-muscle relaxation allows more blood to flow into the penis. This increased blood flow (shear stress) activates the eNOS in penile blood vessels causing sustained NO release, continued relaxation and full erection.

O-GlcNAc hinders this normal chain of events by inhibiting the activation of eNOS, and consequently reducing the release of NO and preventing the smooth muscle in the penis from relaxing. Without this relaxation, there is no shear stress to stoke the production of more NO and therefore, no normal, sustained erection.

The team also found that in comparison with the controls, the diabetic rats' erectile response was 30 percent lower, full erections were 40 percent smaller and these erections took 70 percent longer to achieve.

The study emphasizes the reduced blood vessel function present in patients with diabetes. "The mechanism we describe here stresses the critical importance of vascular function in the erectile response. It may suggest new ways of treating erectile dysfunction by targeting specifically this mechanism in penile erection," notes Musicki.

Additionally, speaking to more than just the sexual issues related to erectile dysfunction, the research addresses implications related to the overall understanding of penile health. According to Arthur Burnett, M.D., a professor of urology and head of the research team, "eNOS plays roles in both immediate erectile response and the overall health and function of the penile tissue."