Pain and anxiety during vasectomies while distracting patients with video glasses or virtual reality glasses.

OBJECTIVE: To determine whether it is possible to reduce the amount of pain and anxiety experienced during a vasectomy by use of two-dimensional (2D) video glasses or virtual reality (VR) glasses during the vasectomy. PATIENTS AND METHODS: A non-randomised controlled trial was performed between October 2017 and March 2018. A total of 176 patients were planned for a vasectomy in an outpatient setting and 141 of these patients were divided sequentially into three groups: Control, 2D video glasses and VR glasses. Follow-up lasted 7 days. One patient was lost to follow-up. The main outcomes were pain (visual analogue scale [VAS] score 0-10) and anxiety ((VAS score 0-10), and State-Trait Anxiety Inventory for Adults [STAI-AD] score 20-80) during the vasectomy. Data were compared using analysis of variance or chi-square measurements. RESULTS: No significant differences in pain were found (VAS score of 2 in all groups). The odds ratio (OR) and (95% confidence interval [CI]) in the 2D video glasses group was 1.15 (0.92-1.48) and in the VR group was 0.98 (0.76-1.26). Patients in the VR group experienced significantly more anxiety during the procedure (OR 1.40, 95% CI 1.07-1.85). Also, patients without prior hospitalisation reported significantly more pain than patients with one or more hospitalisations (OR 1.35, 95% CI 1.11-1.65). CONCLUSIONS: The VR and 2D video glasses did not reduce pain or stress during the vasectomy. In the VR group, the anxiety levels during the procedure were even higher.

Vasectomy and male sexual dysfunction risk: A systematic review and meta-analysis.

BACKGROUND: Unintended pregnancy is popular all over the world, accounting for 40% to 50% of all pregnancies. The condition not only exerts pressure on the relationship of couples and severely impacts the quality of life, but also imposes a heavy burden on the health of women and child. Recently, more than 220 million couples have chosen to be sterilized to obtain contraception, 47.3% of married couples select sterilization, of which vasectomy accounts for 17.1%. Vasectomy is currently the most convenient and effective method of male contraception. We will perform the systematic review and meta-analysis to assess the correlation between vasectomy and male sex dysfunction and provide evidence-based evidence for the couple METHODS:: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org., China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry, and Cochrane Library will be retrieved before November 20, 2021. We will search English literature and Chinese literature with proper Medical Subject Heading or text key words. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION: The aim of this study was to evaluate the effect of vasectomy on the sexual function of patients after operation. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions. REGISTRATION INFORMATION: INPLASY202080014.

Intention to use vasectomy and its associated factors among married men in Debre Tabor Town, North West Ethiopia, 2019.

BACKGROUND: Vasectomy is one of the most effective and permanent male contraceptive methods, and involves cutting and ligating the vas deferens to make the semen free of sperm during ejaculation. Although it is effective, simple, and safe, it is not well known and practiced in the majority of our community. This study assessed the intention to use vasectomy and its associated factors among married men in Debre Tabor Town, North West Ethiopia, 2019. METHODS: A community- based cross-sectional study was conducted among 402 married men from March 05 to April 15, 2019. A simple random sampling technique was employed to select the study participants. Data was collected by face to face interview using a structured and pre-tested questionnaire. Questions concerned socio-demographic and reproductive variables and views on vasectomy. The association between variables was analyzed using a bivariable and multivariable logistic regression model. RESULT: A total of 402 participants were included with a response rate of 98.75%. The mean participant age was 37.12(SD ± 6.553) years with the age range of 20-56 years. The prevalence of intention to use vasectomy was 19.6% with 95%CI (15.6%-23.4%). Multivariable logistic regression showed that age from 30-39 years (AOR = 3.2(95% CI: 1.19-8.86)), having more than three living children (AOR = 2.5(95% CI: 1.41-4.68)), good knowledge (AOR = 3.4(95%CI: 1.88-6.40)) and positive attitude (AOR = 4.8(95% CI: 2.61-8.80)) of married men were significantly associated with intention to use vasectomy. CONCLUSION AND RECOMMENDATION: Intention to use vasectomy was comparable with findings in four regions of Ethiopia (Amhara, Oromia, SNNP, and Tigray). Age, the number of living children, knowledge, and attitude were significantly associated with the intention to use vasectomy. Improving the level of knowledge and attitude towards vasectomy is an essential strategy to scale up the intention of men to use vasectomy.

Intention to use vasectomy and associated factors among married men in Addis Ababa, Ethiopia.

BACKGROUND: Vasectomy is one of the highly effective and non-reversible types of long-term family planning methods for men. Ethiopia has a limited number of studies on the use of vasectomy, and they are focused on men rather than married men. The current study was aimed to identify the intention to use vasectomy as a method of contraception among married men in the study setting. METHODS: A community-based cross-sectional study was conducted from February 1 - April 30, 2018. A sample of 422 married men was recruited using a systematic random sampling method. We conducted face to face interviews with a structured questionnaire (i.e. closed-ended questions). Data were entered into Epi data version 3.1 and SPSS version 23 used for data analysis. The statistical association between the outcome variable (Intention to use vasectomy) and the explanatory variables were first tested with binary logistic regression. Multivariable logistic regression was used to control for confounding effect of each predictor. RESULTS: The study findings showed that the intention to use vasectomy as a method of family planning was reported as high (24%). About 34.8% of the respondents had good knowledge and nearly a quarter (23.2%) of them had a positive attitude toward the acceptance of vasectomy use. In multivariate analysis, age range between 30 and 39 years [AOR = 2.4, 95% CI = (1.16-4.82)], having good knowledge about vasectomy use [AOR = 6.22, 95% CI = (3.17-12.21)], and having a positive attitude toward vasectomy use [AOR = 7.81, 95% CI = (4.25-14.38)] were factors significantly associated to use vasectomy as compared to their counterparts. CONCLUSION: The level of acceptance of vasectomy (24%) was high compared to the level of its use in developing countries (i.e. if acceptability translates to use). The study revealed that age, good knowledge, and a positive attitude towards the use of vasectomy were important predictors of the intention to accept vasectomy. To further promote the use of vasectomy effective communication strategies in family planning programs are needed.

Religious beliefs, social pressure, and stigma: Rural women's perceptions and beliefs about vasectomy in Pwani, Tanzania.

Despite being a reliable and cost effective family planning method, vasectomy remains underutilized in many low resource settings such as East Africa. We explored rural women's perceptions and beliefs regarding barriers to vasectomy use in the low resource setting of Pwani, Tanzania. The qualitative study used in-depth semi-structured interviews to obtain data. Purposive sampling was used to recruit 20 married/cohabiting women with two or more children. Thematic analysis guided the data analysis, with qualitative data reporting informed by COREQ guidelines. Most participants were Muslim and had between two and six children. Most had completed primary-level education and were engaged in small-scale farming. We extracted three main themes with associated sub-themes:1) lack of education, which included men's education levels and inadequate knowledge and misinformation 2) religious beliefs, social pressure and stigma, which included community stigma and the belief that vasectomy was not good for men with multiple wives; and 3) promoting men's involvement in family planning which included educating men and the women's perceived role in promoting vasectomy. Participating women perceived vasectomy uptake to be affected by a lack of low knowledge (among men, women, and the community), misinformation, and various sociocultural barriers. Efforts to promote vasectomy and male involvement in reproductive health services should be directed to addressing deeply-rooted sociocultural barriers. Women may have an essential role in encouraging their partners' vasectomy uptake. In addition, engaging couples in family planning education is critical to enhance knowledge. Ideally, such community based education should be conducted in partnership with communities and healthcare providers.

Childless Men at the Time of Vasectomy are Unlikely to Seek Fertility Restoration.

OBJECTIVE: To examine whether men who were childless at the time of vasectomy sought consultation for fertility restoration. METHODS: Retrospective chart review was performed to determine if patients without children at the time of vasectomy sought consultation for fertility restoration (defined as vasectomy reversal or sperm retrieval). If the patient had not been seen in our healthcare system within the previous 12 months, he was contacted by phone to determine whether he had sought consultation for fertility restoration. RESULTS: Of 1656 men, 68 men (4.1%) were childless at the time of vasectomy. Fifteen patients were excluded as they were not followed in our hospital system and were unreachable by phone. Zero patients sought consultation for fertility restoration. CONCLUSION: Our single institution study demonstrated that no men who were childless at the time of vasectomy sought consultation for fertility restoration. Given that there are no other FDA approved methods for nonbarrier sterilization for males, men with no children at the time of vasectomy should receive the same AUA guideline-recommended counseling that men with children receive.

Assessing the Acceptability of Vasectomy as a Family Planning Option: A Qualitative Study with Men in the Kingdom of Eswatini.

The uptake of vasectomy in many countries in sub-Saharan Africa is low. In Eswatini, a kingdom with strong patriarchal norms, the use of vasectomy is at 0.3%. This is despite great efforts to introduce vasectomy and involve men in reproductive health. This study explored the views of men about the acceptability of vasectomy and their willingness to adopt vasectomy as a family planning option. Focus group discussions were conducted with adult men recruited from health facilities located in rural, semi urban, and urban areas in two of the regions of Eswatini. A thematic approach was used to analyze the data. The acceptability of and intention to use vasectomy as a family planning option was very low. Cultural beliefs, societal norms, lack of knowledge about the procedure for vasectomy, and misconceptions influenced the acceptability of vasectomy greatly. The participants could not grasp the concept of a family planning method that is as permanent as vasectomy. However, the decisions to accept or reject vasectomy were influenced by their misconceptions and fears about vasectomy and were not based on facts. To address the need to involve men in reproductive health and improve the acceptability and adoption of vasectomy, planning should be conducted with them and informed by their understanding of their needs.

Contracepção masculina: a visão de candidatos à vasectomia / Male contraception: the view of vasectomy candidates / Anticoncepción masculina: la visión de candidatos para la vasectomia

Objetivo: analisar a percepção de homens, candidatos à esterilização, sobre a vasectomia e identificar os motivos que os levaram a escolher tal procedimento. Método: pesquisa qualitativa descritiva, realizada com 14 homens em um hospital universitário, do município do Rio Grande/RS, em 2019. Foram realizadas entrevistas semiestruturadas, submetidas à análise de conteúdo. Estudo aprovado pelo Comitê de Ética em Pesquisa. Resultados: a idade média foi de 31,8 anos, e a maioria tinha filhos com a atual e com ex-parceiras. O conhecimento vago sobre vasectomia foi reforçado após encontro com assistente social. A influência de conhecidos foi positiva na tomada de decisão. A proteção da saúde da esposa foi um dos motivos para a realização do procedimento. O histórico de vida cercado por violência na infância também serviu como motivação. Conclusão: é preciso um olhar ampliado, dos profissionais da saúde sobre o tema; considerando o contexto e o projeto de vida do cliente nas situações de planejamento familiar.

Objective: to analyze the perception of men, candidates for sterilization, about vasectomy and to identify the reasons that led them to choose the method. Method: qualitative descriptive research, carried out with 14 men in a university hospital, in the municipality of Rio Grande/RS, in 2019. Semi-structured interviews were carried out, submitted to content analysis. Study approved by the Research Ethics Committee. Results: the average age was 31.8 years, and most had children with the current and former partners. Knowledge about vasectomy was reformed after meeting with a social worker. A known influence was positive in decision making. The protection of the wife's health was one of the reasons for carrying out the procedure. The life history surrounded by childhood violence also serves as an individual motivation. Conclusion: an expanded look is needed by health professionals, taking into account the context and the life project in family planning situations.

Objetivo: analizar la percepción de los hombres, candidatos a la esterilización, sobre la vasectomía e identificar las razones que los llevaron a elegir el método. Método: investigación descriptiva cualitativa, realizada con 14 hombres en un hospital universitario, en el municipio de Rio Grande/RS, en 2019. Se realizaron entrevistas semiestructuradas, sometidas a análisis de contenido. Estudio aprobado por el Comité de Ética en Investigación. Resultados: la edad promedio fue de 31.8 años, y la mayoría tenía hijos con las parejas actuales y anteriores. El conocimiento sobre la vasectomía se reformó después de reunirse con un trabajador social. Una influencia conocida fue positiva en la toma de decisiones. La protección de la salud de la esposa fue una de las razones para llevar a cabo el procedimiento. La historia de la vida rodeada de violencia infantil también sirve como una motivación individual. Conclusión: los profesionales de la salud necesitan una mirada más amplia, teniendo en cuenta el contexto y el proyecto de vida en situaciones de planificación familiar

Barriers for low acceptance of no scalpel vasectomy among slum dwellers of Lucknow City.

BACKGROUND: Uttar Pradesh is the most populated state of the country having population of 199.581 million and total fertility rate of 3.3 (annual health survey [AHS] 2012-2013) with high fertile trajectory. Currently, female sterilization accounts for about 18.4% and male sterilization for 0.3% of all sterilizations in Uttar Pradesh (AHS 2012-2013). A strategy to promote men's involvement in effective birth control is needed to reduce the population growth. Since no scalpel vasectomy (NSV) is an easy method but still not being utilized; hence, the purpose of this research is to ascertain various factors of nonutilization of NSV. OBJECTIVES: The objective of the study is (i) to determine the barriers among married males for adopting NSV as a method of family planning, (ii) to determine the awareness about NSV, (iii) to suggest measures to increase uptake of NSV by the people. METHODS: A cross-sectional study was carried out. A two-staged multistage random sampling technique was used. Lucknow is divided into eight Nagar Nigam zones. In the first stage, two urban slums from each geographical zone were selected randomly. In the second stage, from each selected slum a sample of 24 eligible households was selected at random to achieve the desired sample size. RESULTS: It was observed that among the study participants maximum 89.2% perceived Sociocultural barriers, while 0.6% of the participants perceived service delivery barriers. However, 14% of the participants also perceived procedure-related barriers as the most important cause for not accepting NSV. CONCLUSION: Measures should be taken to remove these barriers, and increase uptake of NSV.

Attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students in a Malaysian private medical college.

INTRODUCTION: This study explored attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students, and determined the association between their demographic characteristics, and attitudes and acceptance. METHODS: A cross-sectional survey was conducted among clinical-year medical students from a Malaysian private medical college using a self-administered questionnaire. RESULTS: There were 330 participants with a female preponderance and a mean age of 22.0 ± 1.1 years. The largest proportion of respondents were from Year 3. The vast majority were ethnically Malay (91.8%) and followed Islam (92.4%). Overall, 60.9% of participants had a positive attitude towards vasectomy and 76.0% showed good acceptance. Gender, academic year, ethnicity and religion variables were not associated with attitudes and acceptance (p > 0.05). A significantly higher proportion of male respondents thought that vasectomy was religiously forbidden and would give a bad impression. A significantly higher proportion of Year 5 students agreed to the statement 'I would recommend vasectomy to relatives, friends and people close to me' compared to Year 3 and 4 students. CONCLUSION: Students' perception of vasectomy as a contraceptive method was encouraging. Our results suggest that their knowledge improved as medical training progressed, and attitudes evolved for the better irrespective of their traditional, cultural and religious beliefs - highlighting the importance of providing students with evidence-based learning about male sterilisation, which is more cost-effective and is associated with lower morbidity than female sterilisation. A qualitative study involving students from different ethnicities and religions would provide a better understanding of this subject.

Long-term safety, health and mental status in men with vasectomy.

Vasectomy is an efficient male contraceptive method, but the long-term effects of this technology in a large population are unclear. To investigate the influence of vasectomy on long-term health effects, we recruited 485 men with a vasectomy and 1940 men without vasectomy in China. After obtaining basic information from the Aging Males' Symptoms (AMS) scale and other questionnaires, peripheral blood was drawn to assess the hormone levels, prostate specific antigen (PSA) and blood biochemistry. Using multiple linear regression analysis, these factors had no relationship with vasectomy except for four factors including the Somatic score (0.31, 0.02 and 0.61) in AMS, SF-36 score (-18.8, -32.00 and -5.60), "Role emotional" (-6.28, -10.34 and -2.22) and "Mental health" (-1.55, -3.08 and -0.02). A stratified analysis showed that with increased age, smoking and drinking, residence in township or a higher level of education, the mental health of men was worse. Vasectomy had no long-term effect on the level of sexual hormones in men, and it did not increase the level of PSA. The impact of the vasectomy on quality of life in men were mainly reflected in psychological effects, which suggests that men with vasectomy groups many benefit from professional psychological counseling.

Percepción de la vasectomía en mujeres militares / Perception of vasectomy in military women

Objetivo: Analizar la percepción de la vasectomía como método de planificación familiar en mujeres militares basadas en la teoría de acción razonada de Nola Pender. Metodología: Se trabajó con un enfoque cualitativo de tipo fenomenológico-descriptivo, con una muestra de catorce mujeres pertenecientes a las fuerza militares. La información se recolectó por medio de entrevistas semiestructuradas, a través de un guión de entrevista; los datos se analizaron en tres fases: codificación abierta, codificación axial y codificación selectiva. Resultados: El procedimiento de la vasectomía es aceptado y considerado altamente eficaz en tanto forma de organizar la sostenibilidad económica y sentimental de núcleo familiar, así mismo, es percibido como un adecuado método de planificación familiar. Conclusión: Las mujeres militares se desenvuelven en un contexto social donde el tema de la vasectomía es la opción inmediata para la planificación familiar

Objective: Analyzing the perception of vasectomy as a method of family planning in military women based on the Nola Pender's theory. Methodology: Phenomenological - Descriptive qualitative approach, one worked with a sample of fourteen women belonging to the military forces, the information is collected through semi - interviews by a script of interviews; data were analyzed in three stages: encoding open, axial coding and selective coding. Results: vasectomy procedure is accepted, they consider it highly effective and a way of organizing economic and emotional stability of the family, likewise an appropriate method of family planning. Conclusion: do military women in a social context where the topic vasectomy is the immediate choice for family planning

Educational status as determinant of men's knowledge about vasectomy in Dangila town administration, Amhara region, Northwest Ethiopia.

BACKGROUND: Although vasectomy is effective and less expensive contraceptive method, only few men are using it in Africa. The main reason for low level use may be low knowledge about vasectomy among men. Only few studies tried to investigate level of knowledge of vasectomy among married men in Ethiopia. But these studies have limitations in measuring knowledge. This study was therefore designed to assess knowledge of vasectomy among married men in Dangila town. METHOD: A community based cross sectional study was conducted in Dangila town. Sample size was calculated using OpenEPI online sample size calculator for population based surveys. Multistage sampling technique was employed to recruit the study participants. Data collectors interviewed selected men using structured Amharic questionnaire from June to July, 2014. Two days training was given to data collectors and supervisors. Data were entered and analyzed using SPSS version 16. Binary logistic regression analysis was done to identify determinants of knowledge about vasectomy. RESULT: A total of 872 men were interviewed. About 75% of men reported that they had ever heard about vasectomy. Men mentioned friends as main source of information for vasectomy. Among those who had ever heard, only 60.8% defined vasectomy correctly. About 20% defined vasectomy as "it is making the man impotent." Similarly about 16% equated vasectomy with castration. In this study, only 44.8% of men were knowledgeable about vasectomy. Married men who completed secondary education were 4.10(95%CI; 2.48 - 6.75) times more likely to be knowledgeable about vasectomy compared to those who did not attend formal education. Those who attended above secondary education were 5.73(95%CI 3.76 - 8.73) times more likely to be knowledgeable about vasectomy compared to those who did not attend formal education. CONCLUSION: Level of knowledge about vasectomy among married men in Dangla town was low and educational status was an important predictor of knowledge about vasectomy. Efforts are needed to improve knowledge of men about vasectomy. In addition, encouraging boys to complete secondary education may help improve knowledge of men about vasectomy.

Perspectives of urban Ghanaian women on vasectomy.

BACKGROUND: Advocacy for male involvement in family planning has been championed over the years after the 1994 International Conference on Population and Development (ICPD). There are a few contraceptive methods for men, and vasectomy uptake has been identified as one of the indicators of male involvement in family planning. Vasectomy also known as male sterilization is a permanent form of contraception. It is a generally safe, quick, easy, effective surgical operation with rare complications to prevent release of sperm. The study explored the vasectomy perspectives of urban Ghanaian women. METHODS: A qualitative approach was used and five focus group discussions were held with women in urban Accra. The study was conducted in the five sub-metropolitan areas of the Accra Metropolitan Health Directorate from September-October 2013. Participants were adult and young adult women who are members of organized groups and unions. Data were analyzed manually after transcribing and coding and themes were sorted using thematic version 0.9. RESULTS: Both adult and young adult participants regarded vasectomy as an easy way for male partners to become promiscuous and cheat on them (women) because the operation renders males incapable of having a child; promiscuity could lead to the women contracting sexually transmitted infections including HIV/AIDS. They were also skeptical about vasectomy and the possibility that it could damage the sexual organs of their partners and affect their sexual relationships. The uptake of vasectomy will not benefit a new wife in case of divorce or death of a previous wife. Some women would allow their partners to undergo the procedure only if both of them will benefit health-wise and also if it would reduce the financial burden on the family. CONCLUSION: The women held mixed perceptions; both negative and positive views were shared on vasectomy uptake. The views were predominantly negative, and they regarded vasectomy as an unacceptable method of contraception. The women virtually had no reasons to encourage their partners to undergo a vasectomy. In order to increase vasectomy uptake in Ghana, innovative efforts to address the misconceptions and superstitions surrounding vasectomy should take centre stage; appropriate and targeted messaging during integrated health services delivery and social/health campaigns would be a good starting point.

Opinions and Attitudes About Vasectomy of Married Couples Living in Turkey.

This study was conducted as a descriptive study, designed to determine the opinions and attitudes of married couples living in Turkey about vasectomy. The sample consisted of 350 women. Researchers used a questionnaire to collect data. Descriptive statistics and chi-square analysis were used. The results showed that 14% of women and 43.0% of men were of the opinion that undergoing a vasectomy procedure was a sin. Chi-square analysis determined statistically significant differences between the male and female groups ( p < .05). More than 88.0% of the men were not willing to have vasectomy and 35.4% thought that vasectomy had a negative effect on marriage and sexual health. In addition, 58.9% thought that vasectomy had a negative effect on men's health. Women were more likely than men to see vasectomy as merely a cultural taboo instead of a sin. Sociocultural factors, such as ideas that contraception is the woman's responsibility, that sterilized men lose status in society, or that sterilized men lose authority in the family, as well as misconceptions about vasectomy such as concerns about sexual functioning, psychological effects, and effects on physical strength, were determined to be the main barriers for vasectomy use in Turkish culture. The study recommends determining strategies for overcoming sociocultural barriers by raising awareness and increasing the utilization of vasectomy. Couple-specific family planning programs can make an important contribution toward improving awareness of the benefits of vasectomy.

Mexican Men's View of Vasectomy.

The present study explored the views of Mexican men concerning vasectomy. One hundred and five men who had not had a vasectomy were asked to complete the following phrase "If you no longer wanted to have more children and a vasectomy was suggested, you would react with . . . or you would think . . . " with at least five different answers. Participants then had to rank each of their answers according to how well they describe the participant's feelings in the hypothetical situation. The results were analyzed using the Natural Semantic Networks Technique. The most common words used by participants with a limited educational background were reject, followed by fear and anger, and they did not use any words that implied acceptance of vasectomy. In contrast, the most common words used by participants with higher education were curiosity, followed by acceptance and interest; however, they also used the words fear and insecurity. The most frequent attitudes reported by men with limited education were negative, whereas participants with a higher education reported more ambivalent attitudes. These findings are discussed in light of sociocultural features and could be helpful in designing reproductive health programs with more effective counseling to diminish negative views about vasectomy.

Infertility, impotence, and emasculation--psychosocial contexts for abandoning reproduction.

From a Darwinian perspective we live to reproduce, but in various situations genetic males elect not to reproduce by choosing medical treatments leading to infertility, impotence, and, in the extreme, emasculation. For many men, infertility can be psychologically distressing. However, for certain genetic males, being infertile may improve their quality of life. Examples include (1) men who seek vasectomy, (2) individuals with Gender Dysphoria (e.g., transwomen, and modern day voluntary eunuchs), (3) most gay men, and (4) men treated for testicular and prostate cancer. Men who desire vasectomy typically have a Darwinian fitness W >1 at the time of their vasectomies; i.e., after they have their desired number of offspring or consider themselves past an age for parenting newborns. In contrast, prostate and testicular cancer patients, along with individuals with extreme Gender Dysphoria, do not necessarily seek to be sterile, but accept it as an unavoidable consequence of the treatment for their condition undertaken for survival (in case of cancer patients) or to achieve a better quality of life (for those with Gender Dysphoria). Most gay men do not father children, but they may play an avuncular role, providing for their siblings' offspring's welfare, thus improving their inclusive fitness through kin selection. In a strictly Darwinian model, the primary motivation for all individuals is to reproduce, but there are many situations for men to remove themselves from the breeding populations because they have achieved a fitness W ≥1, or have stronger medical or psychological needs that preclude remaining fertile.

Sociodemographic And Reproductive Factors Affecting Knowledge Of Married Men Accepting Vasectomy.

BACKGROUND: Men's attitude is very important in the adoption of methods of contraception and limiting the family size. Men represent half the world's population, but account for less than onethird of contraceptive use. Knowledge of men about vasectomy as contraceptive method is also limited. The objectives of the study were to assess the knowledge of males about vasectomy in age group 25-50 years and to identify the factors affecting the knowledge of men regarding vasectomy. METHODS: It was cross-sectional descriptive study. All the clients coming for vasectomy at Lahore General Hospital and Family Health Hospital were included in the study. Data was collected through questionnaire, which was entered in to computer using SPSS-17. Confidentiality of the data was ensured and verbal consent was obtained before data collection. RESULTS: Majority (85.6%) of the men had adequate knowledge about vasectomy. Major source of knowledge, motivation and decision making regarding vasectomy were healthcare providers followed by friends and colleagues. Socio-demographic factors like age of the wife, education of men, income of men, media, friends and relatives showed association with knowledge about vasectomy. CONCLUSIONS: Almost all the respondents had formal education. Majority of the respondents had knowledge about vasectomy. Respondents acquired knowledge from health personnel, television, radio, newspapers, spouses and friends/colleagues. Misconception of the general population regarding vasectomy needs to be cleared and men should be involved actively in family planning programs. Health education program should be held at community level to educate people about the utilization of procedure.

Relationship between Vasectomy and Sexual Frequency.

INTRODUCTION: Men who are considering vasectomy as a means of contraception may have significant anxiety about their future sexual potency. As a result, couples may choose other forms of contraception with lower efficacy. AIM: We sought to determine the relationship between vasectomy and the frequency of sexual intercourse. METHODS: We analyzed data from cycles 6 (2002) to 7 (2006-2008) of the National Survey of Family Growth to compare the frequency of sexual intercourse of men who had undergone vasectomy with men who had not. Analysis was performed using data from male and female responders, and excluded men who had never had sex and those below age 25. We constructed a multivariate logistic regression model to adjust for demographic, socioeconomic, reproductive, and health factors. MAIN OUTCOME MEASURE: The main outcome measure was the sexual frequency in the last 4 weeks. RESULTS: Among male responders, a total of 5838 men met criteria for our study; 353 had undergone vasectomy. For vasectomized men, the average frequency of sexual intercourse was 5.9 times per month compared with 4.9 times for nonvasectomized men. After adjusting for age, marital status, race, education, health, body mass index, children, and income, vasectomized men had an 81% higher odds (95% confidence interval [CI] 6-201%) of having intercourse at least once a week compared with nonvasectomized men. A total number of 5211 female respondents reported 670 of their partners had undergone vasectomy. For partners of vasectomized men, the average frequency of intercourse was 6.3 times per month, compared with 6.0 times for partners of nonvasectomized men. After adjustment, women with vasectomized partners had a 46% higher odds (95% CI 5-103%) of having sexual intercourse at least once a week compared with women with nonvasectomized partners (P = 0.024). CONCLUSION: Vasectomy is not associated with decreased sexual frequency. This finding may be helpful to couples as they consider contraceptive options.