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Persistent sperm after vasectomy? A relatively common issue that is frustrating to the patient and the urologist alike.
My husband had a vasectomy 8 months ago he has had more then 40 ejaculation since his surgery, or maybe even more. The semen analysis came back with more then 20 hpf. Motile and non motile sperm were seen. Could his vasectomy have failed, or can it take a long time to become sterile? Thank you.
Dr. McHugh’s answer:
There two scenarios here. It is possible that the vasectomy has successfully divided the vas and that the sperm are, for whatever reason, slow to completely clear. If this is the thinking you would re check after another twenty or so ejaculations. On the other hand this may represent a recanalization of the vas tubes, a small channel, that has reconnected the vas tubes. In this case another vasectomy would be performed. A couple of things: You could have a formal semen analysis performed to actually get a count…
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Patients commonly ask if a microscopic vasectomy reversal is similar to having a vasectomy. The former takes two hours or so to perform and the latter fifteen minutes. This explains why a patient might experience more bruising and swelling with a reversal.
Cutting the vas deferens in two (a vasectomy) is easier than putting it back together (a vasectomy reversal) and is indeed a horse of a different color.
- Vasectomies are covered by insurance-vas reversals are not.
- Because the reversal is not covered by insurance the patient sees, feels, and pays the entire expense of the procedure, the surgeon, the supplies (microscopic suture) and the facility.
- The surgeon fees are relatively high because very few urologists do reversals often or often enough to do well.
- Few urologists are comfortable enough to feel they can do the procedure with a high likelihood of patency (presence of sperm after a vasectomy reversal) and this in turn also limits the number of urologists willing to perform the procedure.
- The identification of the vasectomy site and preparing it for the reversal is something that is comfortable to all urologists. Reanastamosing the inner tubule of the vas…
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Saw Palmetto works to reduce the size of the prostate and is effective for some over time. It is in almost every “Men’s Health Vitamin.” Think of it as a weak non prescription form of Proscar or Avodart. As I tell patients who ask me if this an other over the counter meds are worth taking, “It won’t hurt,” I say.
The treatment of incontinence is a multi-factorial pursuit. In addition to the treatments listed estrogen cream and attention to food triggers should be considered. J.M.
Metropolitan Urological Specialists of Saint Louis, Missouri, with offices in Creve Coeur, Kirkwood, Florissant, and Washington, MO is focused on providing innovative solutions for prevalent women’s health conditions. Their purpose is to give practical, easy-to-understand facts so ladies, with their medical professionals, can consider their options and work out educated decisions.
What Is Stress Urinary Incontinence?
Stress Urinary Incontinence, or SUI, is the unexpected, unintended release of urine during normal, day to day activities. SUI is a different sort of condition compared to Overactive Bladder (OAB), a problem characterized by urgency, frequency, getting up at night with or without bladder seepage. Lots of women have both of the types of incontinence. You may have SUI should you lose urine when you:
- Cough, sneeze, or laugh
- Walk, work out, or lift something
- Rise from a sitting or lying position
It’s also possible to visit bathroom frequently each day to protect…
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“A man spends his first fifty years trying to make a living…the second fifty years trying to make water.”
As you watch the video the camera progresses in a fashion similar to the flow of urine: That being from the bladder, over the bladder neck, through the prostatic urethra and then out the urethra. (To grandmother’s house we go!)
You’ll note how the prostate lobes close in on the channel and all you see is lobe touching lobe. This usually begins after the age of fifty in men and is responsible for a slowing of the stream and then the things that accompany this such as frequency, urgency and getting up at night.
Medicines for this condition either relax the prostate to open this blockage (Flomax) or shrink the prostate to enlarge the channel (Proscar). If this is unsuccessful, i.e. the gland is too big for the medicine, then surgical options are done to remove the tissue to open the channel. (GreenLight Page.)
What is the most common question we hear about surgery of the prostate?
“Doc, If you are going to cut out the prostate what happens to the urethra? Do you destroy that too?”
Yes the urethra does line the lobes of the prostate and yes it is destroyed and removed. But much like how your hand heals with a cut, the tissue grows back over it-reepithelialization.
Can be. Post surgical issues of testicular or scrotal procedures are complicated by the fact that the patient can see and feel the area of healing. In other words you can’t see or feel the area of healing of an appendectomy. In addition the testicles move around and this too keeps the fact that something has been done heavy on the mind of the male patient. So many times I’ll see a patient after a vasectomy and they will tell me that one or both of their testicles are swollen. Commonly I examine them and everything is normal. I can only deduce that the post surgical changes brought about by cutting the vas tube and sealing it has set in motion a chain of events that causes discomfort and is perceived by the patient as being “swollen.”