France D+1 post vas
b40_
before coming to vasectomy. We have used condoms for almost 4 years
(last birth) and this wasn't very fun, it was time to quit pill and
IUD wasn't suitable for medical reasons. Tubar occlusion is a tough
procedure more risky and less effective than vasectomy.
I'm living in France where vasectomy is not very popular and even was
illegal untill 2001. I didn't knew any man (relative, friend,
collegue) who had vasectomy and find a good help to make an opinion by
the internet.
Read a lot of bad stories, but men without anyproblem don't post,
especially for long time follow up, vasectomy becomes something
forgotten. On the other hand,some men make a lot of things as far as
it concern their testicles or penis, and I believe the way to live
with your problem is directly dependant on your mind.
I know the risk and accept them, and I'm ready to cope with if
anyproblem occurs.
I wasn't ready to go to London for NSV and prefer an uro I knew and
trust for a conventional procedure under local anesthesic.
D-0 I was not feeling anxious at all.
Procedure was absolutely fine, painless. Hardly felt the needle (less
than for blood test or vaccination) and afterwards nothing except a
little tinglering coming up to the groin when grasping the vas.
Little pain after 2 hours drive and the end of anesthesy but very
little
Night and D-1 Brusing quite important ( and may worry some man) but no
pain at all with paracetamol and ibuprofen only disconfort. Good
suporter brief needed, with an other one over and refrigerant gel pack
between them. A great help ... have only to wear a jogging for coming
out of my place and long pullover, the volume could be quite
indecent... But I rest at my place reading and watching DVD.
Glad I have some holiday untill the end of the week.
Will let you know how it goes.
rvfsl
"b40_" <b4...@msn.com> a écrit dans le message de
news:4c544a9c.0402...@posting.google.com...
Happy to read a french story , I sent you a mail to talk with you in French
about the procedure.
As you , more I search , more I think PVP is very low risk , if you find a
qualified surgeon , if it's a urologist , not a general doctor .
In USA , there are about 500 000 vasectomies a year . suppose you could have
PVP in 1 per cent of all . That seems that 5000 men per an have PVP . in ten
years, you will have 50 000 men who have PVP . We can estimate that about
an half have now Internet . And I am surprised this forum has only about
twenty bad stories ( I'm sure that an half have'nt be update ) . If PVP
was found in 1 % of all vasectomies , I think you should have many hundred
or thousand of bad stories on vasectomy.information web site . I think PVP
in very rare , maybe one for 10 000 and it's probably due to heath problems
before the surgery and bad pratices of the surgeon .
David
French
> about the procedure.
If either of you would like to send in your story I'd be happy to put them
on the website. I'd really like to have the stories in French and English if
possible.
> As you , more I search , more I think PVP is very low risk , if you find a
> qualified surgeon , if it's a urologist , not a general doctor .
> In USA , there are about 500 000 vasectomies a year . suppose you could
have
> PVP in 1 per cent of all . That seems that 5000 men per an have PVP . in
ten
> years, you will have 50 000 men who have PVP . We can estimate that about
> an half have now Internet . And I am surprised this forum has only about
> twenty bad stories ( I'm sure that an half have'nt be update ) . If PVP
> was found in 1 % of all vasectomies , I think you should have many hundred
> or thousand of bad stories on vasectomy.information web site . I think
PVP
> in very rare , maybe one for 10 000 and it's probably due to heath
problems
> before the surgery and bad pratices of the surgeon .
Exactly my way of thinking, and it is true that many of the pvp stories
haven't been updated. Most of them are now dead email links, as I have tried
on occasions to get updates.
David
www.vasectomy-information.com
recentlyfixed
I would agree from what I've seen here, including referenced research
publications, and my own conversations with 2 different urologists
that it probably is indeed a very low risk. However, I believe
something in the 1% range is indeed a very reasonable and likely
number. My new urologist deals with the pvp issue and stated that
about 1% of vasectomy patients will have pvp problems. I didn't ask
if he had docummented numbers, or what his basis was for this
statement. Will try to remember on next visit.
Just think though, using the numbers above for the USA, assume the
5000 men are spread across the country in the 200 largest cities.
That's only 25 per city, per year. Factor in that there are lots
smaller towns/cities where some of these cases may be, and it's very
easy (IMHO) to see that there are likely very few pvp sufferers in any
one area. Therefore, you're not going to see a large group of these
folks together in any one place, complaining, protesting,
demonstrating, etc. Also, in cities where there may be larger
concentrations of the pvp cases, probably many of them may end up
seeing specialists who have dealt with this problem. Thus you have
some doctors who will say they have never had patients with this
problem, and will find the few urologists who quite often see patients
with this issue.
Where are these people now, and where are the 50,000 after 10 years?
Well, I would think that those with the most extreme cases, such as
Steve, eventually have their pvp resolved with treatment, either
reversal or other things discussed as treatment options. Many others,
such as myself, will eventually get some sort of satisfactory
treatment to at least help deal with the problems, if not correct
them. Finally, I suspect that some of those with pvp do not have
excruciating pain or extremely severe problems, and just learn to deal
with it, live with it, and get on with things.
Lastly, whether having a severe case or a fairly mild case of pvp,
most people probably seek some treatment and help for awhile until
getting some sort of resolution or giving up. Either way, we all have
to get on with our lives, and you won't hear anything out of them
anymore. Most of them also probably never find this web-site and
newsgroup, don't know how to search the web, or aren't interested in
keeping up with this subject. It's not surprising to me that most
don't ever update their stories, and many of the e-mail addresses are
dead after awhile. Once the deed is done, we're all mostly on to
other things. Most of us currently posting won't be here a year from
now, with the exception of the few regular and interested people like
David, Trifold, Steve, etc. So for me, YES, 1% is quite likely, maybe
even up to 2 or 3 %. However, if one suggests a number of 5% or more,
I vote no way.
David
interpretation of the numbers you talk about 1 years statistics in the main.
Multiply the numbers you use by 10, and then you do wonder "why" in a big
city, 250 men with severe problems haven't managed to team up even two of
them! I'm sure that we can think of may reasons why we don't hear more from
men with PVP, however it seems to me that if we assume the 1% and 500,000 to
be accurate, then over the ten year period 50,000 men with severe problems
are being deathly quiet, even allowing for reasons why we wouldn't hear from
most of them.
There is another problem - the numbers *really* don't add up! We talk about
500,000 and 1%, but neither of those numbers is any more than a guess, and
we *never* talk about men outside the US. OK, the majority of posters here
are from the US, and 500,000 is a number we don't need to use a calculator
on but how accurate are these numbers, and what of the world outside the US?
The 500,000 isn't a count - it's a "Guestimate". It was done a few years ago
by surveying medical practitioners and anyone the researchers could talk to,
and comes from an extremely complex formula. The same applies to tubal
ligations in the US - nobody really knows the true figure, but the
guestimates are generally accepted as the best possible people are likely to
get.
My personal opinion is that the figure is likely to be higher. Take the UK
and NZ - both have higher percentages of men with vasectomy. Why is this? Is
there a cultural or acceptance difference between these societies who are so
very similar in many ways? In the UK and NZ, logistically it's easier to
perform counts, and culturally it's something we do. The figures for these
countries are actual counts as opposed to educated guesses. *If* a count of
men in the US with vasectomy were to be done, I'd suggest that the trends
would be broadly similar, giving a higher number of men than the
conservative 500,000.
OK - 1%. Again, it's a guess. I'd be interested to know what your doctor
bases this on. Take a look at some of the surveys into PVP incidence, and
you get a very wild spread of numbers, ways of calculating it, and what it
actually is! Example the Scottish one that we always talk about. Small
sample of men, 30% pvp. However it also comes up with over half of the men
with it say it's "Not troublesome" - HUH?????????? and very few men with it
regret vasectomy - double HUH??????
Basically I don't know what the true figures are - nobody does, but
logically if there *were* the number of men we talk about having it they
would make a lot more noise than they do. Don't forget their brothers in the
rest of the world, they can shout too - but also don't.
David
www.vasectomy-information.com
Steve and Lisa
large-scale study. (I have a background in market research, having
managed a group of phd's and mba's doing market research and planning
in my past....so I think my opinion is at least an informed one.)
Given my mistrust of the numbers, my approach to trying to understand
the 'scale' of pvp has been to personalize it.
One 'number' I have seen is that about 15% of men in the US have been
vasectomized - so theoretically about 1 in 6 men I know have been
vasectomized. Over the last 4 years I've brought up the subject of
vasectomy to many of my acquaintances - 50 seems about the right
number. 1 in 6 seems to be low given these conversations - it could
be related to the fact that I live in a middle class area, with more
'upscale' demograhics composed of men who are more educated and
therefore more willing to consider vasectomy. I would say that about
15 of these 50 have had a vasectomy. In these conversations, I've
found that 5 of my friends / acquaintances who have had vasectomies
have had some type of chronic testicular pain. One had a vasectomy
about 15 years ago. About twice a year, he develops painful
granulomas that aren't bacterial in nature (antibiotics don't help).
Until I brought it up, he hadn't even considered that it could be
related to his vasectomy. Another had an awful vasectomy. Uro
couldn't find the vas - he ended up with 65 stitches. Took over a
year to heal from that - only to find that he has chronic pain.
Probably related to the butcher job the uro did... Another has
ongoing pain similar to what I experienced, another has bouts of
epidydymal pain....also had never considered that it could be related
to the vasectomy he had 5 or 6 years ago.
So, of the about 50 guys that I have discussed the issue with over the
last 4 years, about 15 have been vasectomized. Of the 15, 5 have had
some type of chronic testicular pain - one-third of my acquaintances
who have had a vasectomy have also experienced some form of PVP.
Certainly not a scientific obversation. Also interesting to note that
about half had not considered that their pain could be related to
their vasectomy - their uros had certainly never suggested it.....
How 'big' is PVP as an issue. I don't know. I only know what I have
encountered in my own group of friends / acquaintances (the women in
my neighborhood now hate me - their husbands are now a little
skeptical of the topic). I am also skeptical that we will find out in
the near future - I don't believe the vasectomy industry, at least in
the US, really wants to know because of economic considerations.
Just my 2 cents worth.....
dez
> Basically I don't know what the true figures are - nobody does, but
> logically if there *were* the number of men we talk about having it they
> would make a lot more noise than they do. Don't forget their brothers in the
> rest of the world, they can shout too - but also don't.
Well, I agree that it is hard to know the exact number, but I don't
think that we can refute the 5% number because if "there were that
large number of men, they would talk about it."
First of all, as I myself found out, when I went to two
highly-respected urologists over horrible pain after my vasectomy,
they summarily dismissed any notion of PVP, prescribed antibiotics,
and implied there was a slight psychosomatic side to my complaints
(and thus asked that I stop reading this newsgroup and vasectomy
information web sites). This latter technique probably did the trick,
because the bulk of my pains are going away :-).
The point is, as "Steve and Lisa" suggested, that the vasectomy
industry has a stake in propagating the myth that vasectomy is a
simple and safe procedure that can be used en masse for birth control.
While I do think vasectomy is *relatively simple and safe*, I still
believe that it is still ultimately a crap shoot. Pray that you don't
get behind the eight ball on this one....
--Dez.
David
that in order to asses the real numbers, a very large study would be needed.
The point I was making is that the numbers are very much open to debate, and
I go with our French freinds assesment.
> Well, I agree that it is hard to know the exact number, but I don't
> think that we can refute the 5% number because if "there were that
> large number of men, they would talk about it."
I think we can refute *all* numbers. The only thing that can be quoted
statistically is the enormous variance that all of the studies come up with.
The Christiansen & Sandlow article that discusses and anlyses pvp research
published in 2003 that many here regard as excellent doesn't even attempt to
come up with a figure for this reason. The current UK guidelines that looks
at some 250+ studies makes the point that you can get figures between 0 to
50% quoted. It makes the point that the studies are pretty well all small
questionaire studies, and thus more likely to attract responses from those
who have problems. It also states that whatever the incidence rates from the
studies, the same study data also quotes that those men that seek medical
attention for the condition are typically less than 1%.
Another point the document makes is that very few studies asses the
incidence of chronic testicular pain amongs the non-vasectomised control
groups. The one study that did found that the non-vasectomised men had CTP
half as often as vasectomised men. Most studies imply that the controls
didn't have CTP, and this may well have not been true.
More food for thought.
>
> First of all, as I myself found out, when I went to two
> highly-respected urologists over horrible pain after my vasectomy,
> they summarily dismissed any notion of PVP, prescribed antibiotics,
> and implied there was a slight psychosomatic side to my complaints
> (and thus asked that I stop reading this newsgroup and vasectomy
> information web sites). This latter technique probably did the trick,
> because the bulk of my pains are going away :-).
But you are still here reading us and getting better!!!!!
>
> The point is, as "Steve and Lisa" suggested, that the vasectomy
> industry has a stake in propagating the myth that vasectomy is a
> simple and safe procedure that can be used en masse for birth control.
> While I do think vasectomy is *relatively simple and safe*, I still
> believe that it is still ultimately a crap shoot. Pray that you don't
> get behind the eight ball on this one....
I believe I mentioned the fact there is a big world that exists outside the
US???? I have never been to your country so can only go by what posters from
there say. Not everybody agrees that there *is* a vasectomy industry in the
US. There certainly isn't a vasectomy industy in Europe or Australia/NZ. The
UK and NZ leads the world in vasectomy take-up despite not having an
industry, or the product promoted. *IF* the vasectomy industry does exist in
the US (and I have my doubts) then it isn't very successful at promoting the
product, as the take-up is considerably lower (according to the famed
500,000 figure) than in countries that certainly don't promote it, yet have
higer take-up rates.
Doesn't add up IMHO.
Steve also makes the point that you can ignore the studies as they are so
inconclusive, but you can't ignore what you know from discussing it amongst
people you know.
I don't usually tell people I've had a vasectomy. I certainly don't tell
people of my involvement here. However, if people bring up the subject
first, I'll indicate I've had a vasectomy to see the reaction. The
conversation usually starts by us talking about kids, and then if asked I
usually indicate that I'm "Deffinitely not" having any more. Others
invariably interpret this correctly. Many rely "Same here", so I know that
over 50% of the men I work with have had a vasectomy and all have indicated
that it was a positive thing. I'd also say that the same is true for freinds
I know well, and my brother also has the snip. In fact, he's the only one I
know that had a problem - a granuloma that dissapeared after a few weeks.
Last night a group of us were sat round a table. One of them was going on
about his wife having an early misscariage this week. He also said that they
had been trying for 18 months, and mentioned his sperm motility figures. I
quipped back that I had "Zero motility", and of the 7 of us on the table
there were two more that that said "same here" with a grin. The subject went
back to this guy's problems at that point.
I know that one datapoint doesn't make a survey, but in my circle of
aquaintances the uptake is high, and as they all seem to be positive it was
a good thing I'm guessing that none of them have had any problems.
Just my £0.02 worth.
David
www.vasectomy-information.com
dez
> >
> > First of all, as I myself found out, when I went to two
> > highly-respected urologists over horrible pain after my vasectomy,
> > they summarily dismissed any notion of PVP, prescribed antibiotics,
> > and implied there was a slight psychosomatic side to my complaints
> > (and thus asked that I stop reading this newsgroup and vasectomy
> > information web sites). This latter technique probably did the trick,
> > because the bulk of my pains are going away :-).
>
> But you are still here reading us and getting better!!!!!
Well, per doctors' orders, I imposed a 1imit on reading vasectomy
issues on the Internet during the past two weeks, and besides: as my
big pains went away, I grew less interested in the topic.
On the other hand, although the bulk of the pain is gone, there is
still a definite low-grade pain in my left testis which to me seems
chronic, since I am almost through with the antibiotics. It is
ignorable most of the day, so I don't worry about it anymore. I have
too many things to do, and I want to get on with my life. I also want
to get the "all-clear" so I can at least have some unplanned fun.
That doesn't mean I will have to make some "reversal" decisions later
(say, in four months) if the pain doesn't go away.
But as you no doubt guessed, the point of my post was to highlight the
fact brought up by previous people: that all vasectomized guys have
to move on, that pain may exist in some of us for a long time, and we
have to learn to ignore it and live with it, or get some clinical
help. If we choose not to ignore it, then our urologist more often
than not says it is in our imagination. That may be why the figures
are so low. Like you, I don't know. I'm just guessing.
Capricious
> believe that it is still ultimately a crap shoot. Pray that you don't
> get behind the eight ball on this one....
>
> --Dez.
I agree.
Capricious
rvfsl
I would like to remember that the vasectomy is a surgical procedure and I
think like any surgical operation, we can have failures. I think that it
is undoubtedly the main origin of the cases of PVP.
"Capricious" <m...@mail.com> a écrit dans le message de
news:Xns9499CFB...@207.217.125.205...
Steve and Lisa
> I would like to remember that the vasectomy is a surgical procedure and I
> think like any surgical operation, we can have failures. I think that it
> is undoubtedly the main origin of the cases of PVP.
>
sorry - I think that's a cop out. with the proper research, the
causes of pvp could be better understood, with a corresponding
increase in the chance of predicting what type of patients would be
more prone to pvp. the research is not being done. the vasectomists
dont want to know...
David
I would point out that the Christiansen & Sandlow article "Testicular Pain
Following Vasectomy: A Review of Postvasectomy Pain Syndrome" that we have
been discussing recently was published in 2003 (written in 2002). It
references studies published within 2 years of it's writing date - IE
2000/2001 as well as some of the older studies.
I'd also point out that there isn't a huge amount of research into vasectomy
as a whole at the moment - it's an old procedure with a lot of research
already behind it. I'd like to see more research personally, but the reality
is that getting funding to do research on a very old (by comparitison)
procedure is probably quite difficult.
By saying that doctors don't want to know, then I assume that you are saying
that despite taking the hippocratic oath at some point in their learning
they would all happily ignore this for a few dollars? I know that money
talks - I'd be rather naive to believe otherwise, but the assertion that ALL
doctors are purely in it for the cash and don't give a s**t about the
patients is something many would find a little hard to accept. To assert
that all doctors performing the procedure *do* know that they are causing
harm deliberately is a very strong point of view.
Yes, there are doctors that don't counsel properly. Yes there are quacks out
there. I have always felt that one of our purposes here is to help men
considering it to spot doctors who are not up to date, or not that
interested in their patients etc, and I feel we do this. But to tar
absolutely all of them as some sort of criminal is unjustified.
David
www.vasectomy-information.com
dez
> > the research is not being done. the vasectomists dont want to know...
>
> as a whole at the moment - it's an old procedure with a lot of research
> already behind it. I'd like to see more research personally, but the reality
> is that getting funding to do research on a very old (by comparitison)
> procedure is probably quite difficult.
>
> By saying that doctors don't want to know, then I assume that you are saying
> that despite taking the hippocratic oath at some point in their learning
> they would all happily ignore this for a few dollars?
Hi David:
I think the problem is not in an INDIVIDUAL physician but in the
system as a whole, especially in the United States.
From time to time, I get involved in medical physics work, and
therefore know the "medical research" industry here in the USA pretty
well. A lot of the medical research money goes from the US Treasury
to the National Institutes of Health, who then distribute the money
based on perceived need, which more often than not is based on
political, not medical, considerations.
For example, there is plenty of money now in breast and prostate
cancer research (disclaimer: I consult for a breast and prostate
cancer imaging company), and very little money in topics like bladder
cancer, or deafness. Why? It is simple political considerations. In
addition, a huge amount of money goes into drug discovery and genomics
work, which has a large presence in the US budget due to lobbyists for
the pharmaceutical industry.
As a result, any advancement in vasectomy research will NOT come from
the USA (the NSV procedure came from China), and any advancement in
mitigating hearing loss will also not come from the USA (the cochlear
implant was first done in Australia), and recent advances in bladder
cancer came from Israel, not the USA.
This does not mean that American doctors are "criminal", it simply
means that a lot of medical research is profit-driven (like Viagria
and Cialis) or politically-driven (like sickle cell, which though
small in the total population, typically attacks African-Americans).
Simply put, there is not enough financial incentive to research
problems in pvp or deafness, whose relative numbers in the population
are just not there.
Here's an experiment: look at the research money being made available
this year at NIH, http://www.nih.gov, and try to find any research
money being made available to research in post-vasectomy pain
syndrome, or better ways of counseling men who want a vasectomy, or
better ways of performing vasectomies. Unless there is a significant
amount of money being made available, it is highly doubtful anyone in
this country will do the research for free.
Cheers,
--Dez.
Steve and Lisa
> > the research is not being done. the vasectomists dont want to know...
>
> I would point out that the Christiansen & Sandlow article "Testicular Pain
> Following Vasectomy: A Review of Postvasectomy Pain Syndrome" that we have
> been discussing recently was published in 2003 (written in 2002). It
> references studies published within 2 years of it's writing date - IE
> 2000/2001 as well as some of the older studies.
>
I haven't paid to read the article - you obviously know more about the
subject than I. But my position hasn't changed - no large scale study
has been done which would validate the incendence of pvp, much less
studies which confirm the cause and report on the predictors for those
who might be more prone to pvp.
> I'd also point out that there isn't a huge amount of research into vasectomy
> as a whole at the moment - it's an old procedure with a lot of research
> already behind it. I'd like to see more research personally, but the reality
> is that getting funding to do research on a very old (by comparitison)
> procedure is probably quite difficult.
>
No argument here.
> By saying that doctors don't want to know, then I assume that you are saying
> that despite taking the hippocratic oath at some point in their learning
> they would all happily ignore this for a few dollars? I know that money
> talks - I'd be rather naive to believe otherwise, but the assertion that ALL
> doctors are purely in it for the cash and don't give a s**t about the
> patients is something many would find a little hard to accept. To assert
> that all doctors performing the procedure *do* know that they are causing
> harm deliberately is a very strong point of view.
I didn't say that 'doctors' don't want to know. I said that
"vasectomists" don't want to know. It's become kind of a code word
for me, I guess. Those 'cut and snip' doctors whose entire career and
income is wrapped up in doing as many 'cuts and snips' as they can
every day. These doctors probably do the vast majority of vasectomies
- especially in the large suburban areas like Atlanta. Most of them
don't beleive they are doing harm - they certainly won't admit it if
they do. Every pvp patient i've had personal contact with has been
told by their original vasectomist something like "I've never had a
patient like you." All 3 of the vasectomists I saw told me
essentially the same thing. One did say that they see a pvp patient
"every now and then" who had been vasectomized at another practice.
It's much easier for them to believe that they are not doing harm -
and also allows them to continue with huge incomes and the
corresponding lifestyle.
>
> Yes, there are doctors that don't counsel properly. Yes there are quacks out
> there. I have always felt that one of our purposes here is to help men
> considering it to spot doctors who are not up to date, or not that
> interested in their patients etc, and I feel we do this. But to tar
> absolutely all of them as some sort of criminal is unjustified.
>
> David
> www.vasectomy-information.com
I did not tar "them" as being criminal. My position is that the
vasectomy "industry" - those performing the majority of vasectomies,
primarily large urology groups in large suburban areas - have a vested
self-interest in continuing the status quo. They receive a
significant amount of revenue generated by the procedure, and are
certainly not funding any studies which would change the status quo.
I realize that the US is different from the rest of the world - but
the free market in the US is funding a significant amount of, if not
the majority of, health-related research that is going on in the
world, and is the basis for most of the ground-breaking medical
research because of the vast amount of currency available to fund
research. I expect to see no ground-breaking research on this issue
in the US because of the financial incentives related to keeping the
status quo, and the lack of a financial return on such research.
David
Pain
> > Following Vasectomy: A Review of Postvasectomy Pain Syndrome" that we
have
> > been discussing recently was published in 2003 (written in 2002). It
> > references studies published within 2 years of it's writing date - IE
> > 2000/2001 as well as some of the older studies.
> >
>
> I haven't paid to read the article - you obviously know more about the
> subject than I. But my position hasn't changed - no large scale study
> has been done which would validate the incendence of pvp, much less
> studies which confirm the cause and report on the predictors for those
> who might be more prone to pvp.
To an extent the article above discusses the causes, possible predictors and
treatments. What it doesnt do is attempt to put a figure on incidence as
it's a review study. It does make the point that the studies do vary widely.
I agree that larger studies need to be done to assess true incidence, and I
think some of the points you make I am discussing in my relpy to Dez that
I'm working on.
> I realize that the US is different from the rest of the world - but
> the free market in the US is funding a significant amount of, if not
> the majority of, health-related research that is going on in the
> world, and is the basis for most of the ground-breaking medical
> research because of the vast amount of currency available to fund
> research.
I'd say this was overstating it. Whilst US corporations do pay for some
research outside the US, I don't think it's the "majority". Much of the
research done in the EU is funded by national governments and the EU budget
as a whole. Obviously pharaceutical companies do pay for some research, but
not all are US companies.
> I expect to see no ground-breaking research on this issue
> in the US because of the financial incentives related to keeping the
> status quo, and the lack of a financial return on such research.
I agree that there is not much likelihood of any major research being done,
but there usually is some new article on Medline each mointh. The reason for
this IMHO isn't to keep the status quo, but that it isn't as
sexy/political/newsworthy as other research is. It's an old procedure and no
longer considered a high priority for research. I'm not saying that is
right, but that is the way it is.
David
www.vasectomy-information.com
Giraud
> I did not tar "them" as being criminal. My position is that the
> vasectomy "industry" - those performing the majority of vasectomies,
> primarily large urology groups in large suburban areas - have a vested
> self-interest in continuing the status quo.
But I would think that those doctors would not want to invite law suits.
Certainly it would be better to take a slightly smaller revenue (by
scaring away some prospects) than to risk litigation, which could cut
their profits much more severely or even ruin their careers...?
Giraud
David
I'm not too sure why a thread about a vasectomy in France has turned out
this way.............
> I think the problem is not in an INDIVIDUAL physician but in the
> system as a whole, especially in the United States.
I sort of get the feeling that we are blurring the status of medical funding
debate in general with the behaviour of doctors, and they are two separate
issues.
The posts we have seen tend to paint the picture of the average vasectomy
doctor as someone who knows that 30% of his patients *will* have a serious
problem but has no intention of warning them. Also, of someone who is going
to deliberately counsel prospective candidates falsely (despite taking the
hippocratic oath) in order to make sure nobody cancels as they are greedy
wage slaves only interested in buying a bigger house/car etc.
I'd like to point out that the above isn't really in response to current
discussions - more the impression that has been given here historically.
The problem with this behaviour is that it *always* comes back to bite the
perpetrators in the bum! EG Norplant that was heavily promoted for a while
backfired with the company concerned having to pay doctors to take the
implants out again, and HRT seems to be going down the pan too. I'm sure
there are many more examples that could be used. I am aware what happens
when business becomes involved and morals fly out the window. In the case of
vasectomy, it's been around for absolutely YEARS and quite honestly if there
really was a skeleton in the closet I think it would have been outed by
now - especially when you look at the uptake figures.
The official UK government stats for 2002 (2003 won't be published until
September) state that:- "Between ages 40-49 men were more likely than women
to have had an operation to become sterile (30% of men compared with 19% of
women aged 40-44, and 32% of men compared with 21% of women aged 45-49). In
all other age groups the proportions of men and women who had had an
operation to become sterile were very similar." The overall statistics for
2002 state that "18% of men between 16 and 69 had had a vasectomy and 1% had
become sterile as a result of another operation"
Now for something that has an uptake of "18% of men between 16 - 69", and if
we believe that the true figure of problems is 30%, and vasectomy doctors
have been hiding virtually all of it for many years I'd say that quite
frankly it is a completely implausible notion.
I know there are differences in our healthcare systems, but many people will
find the image of the doctor portrayed above to simply not fit. I still find
the suggestion that all doctors will routinely lie to patients in order to
obtain a nicer car quicker difficult to accept, and the suggestion that they
*have* been doing this wholescale as an industry for the last xxx years AND
getting away with it even harder. Especially bearing in mind the sheer
numbers involved, the time the procedure has been routinely practiced and
the litiginous nature of the populace.
The issue of improved counselling involving risks I'm on record here for
supporting this wholeheartedly - I've said it on many occasions.
> A lot of the medical research money goes from the US Treasury
> to the National Institutes of Health, who then distribute the money
> based on perceived need, which more often than not is based on
> political, not medical, considerations.
I think the same applies here to be honest.
>
> For example, there is plenty of money now in breast and prostate
> cancer research (disclaimer: I consult for a breast and prostate
> cancer imaging company), and very little money in topics like bladder
> cancer, or deafness. Why? It is simple political considerations. In
> addition, a huge amount of money goes into drug discovery and genomics
> work, which has a large presence in the US budget due to lobbyists for
> the pharmaceutical industry.
We don't have the pharmaceuticals lobbying for money in the same way. The US
boitech companies trying to get the EU to accept GM foods have found out
that lobbying does not work the same way here as there. In fact, the
pharmaeutical companies role in the EU seems to be more towards sponsoring
research. Not sure this is altogether a good thing. The situation whereby
the company that is going to benefit from sales of the product paying for
the research isn't healthy, but unfortunately what happens sometimes.
>
> As a result, any advancement in vasectomy research will NOT come from
> the USA (the NSV procedure came from China), and any advancement in
> mitigating hearing loss will also not come from the USA (the cochlear
> implant was first done in Australia), and recent advances in bladder
> cancer came from Israel, not the USA.
It could be said that "Vasclip" is an American invention (FDA approval early
2003). I'm not too sure that the FDA approving it on the basis of a small
sample trial over a short time AND paid for by Vasclip was a good idea
though. I would hope that some independant and objective research will be
done at some point.
>
> This does not mean that American doctors are "criminal", it simply
> means that a lot of medical research is profit-driven (like Viagria
> and Cialis) or politically-driven (like sickle cell, which though
> small in the total population, typically attacks African-Americans).
> Simply put, there is not enough financial incentive to research
> problems in pvp or deafness, whose relative numbers in the population
> are just not there.
>
> Here's an experiment: look at the research money being made available
> this year at NIH, http://www.nih.gov, and try to find any research
> money being made available to research in post-vasectomy pain
> syndrome, or better ways of counseling men who want a vasectomy, or
> better ways of performing vasectomies. Unless there is a significant
> amount of money being made available, it is highly doubtful anyone in
> this country will do the research for free.
I can only agree with you here, and state that to an extent it's the same in
the EU. Whilst some research is done using public money, vasectomy would
have to be prioritised alongside all the other people vying for the cash. As
I said earler, bearing in mind that it's a very old (comparitively)
procedure many might feel that it's had it's chance longe since. As I said
to Steve, I'm not saying this is right - just the way it is.
David
www.vasectomy-information.com