Male Sterilization-Vasectomy

MALE STERILIZATION-VASECTOMY

Q. 1

After vasectomy aspermia will become evident in:

 A

2 to 3 weeks

 B

4 to 6 weeks

 C

8 to 10 weeks

 D

10 to 12 weeks

Q. 1

After vasectomy aspermia will become evident in:

 A

2 to 3 weeks

 B

4 to 6 weeks

 C

8 to 10 weeks

 D

10 to 12 weeks

Ans. D

Explanation:

10 to 12 weeks


Q. 2

A case of vasectomy is said to have failed as the vasectomised person’s wife gives birth to a child ten months after the operation. Which one of the following is the most probable cause :

 A

Failure of the husband to use a condom after vasectomy

 B

Surgical failure

 C

Recanalisation

 D

Wife had extra — marital contact

Q. 2

A case of vasectomy is said to have failed as the vasectomised person’s wife gives birth to a child ten months after the operation. Which one of the following is the most probable cause :

 A

Failure of the husband to use a condom after vasectomy

 B

Surgical failure

 C

Recanalisation

 D

Wife had extra — marital contact

Ans. A

Explanation:

Failure of the husband to use a condom after vasectomy


Q. 3

Following vasectomy for family planning, a patient should be advised to use some other method of contraception, till :

 A

Removal of all sutures

 B

Pain completely subsides

 C

Two weeks

 D

None

Q. 3

Following vasectomy for family planning, a patient should be advised to use some other method of contraception, till :

 A

Removal of all sutures

 B

Pain completely subsides

 C

Two weeks

 D

None

Ans. D

Explanation:

None


Q. 4

With references to vasectomy, consider the fol­lowing statements :

  1. Non-scalpel vasectomy and conventional vasec­tomy have complication rates of 0.4% and 3% re­spectively
  2. When sperms are absent from two consecutive samples of semen, the vasectomy is considered complete for contraception
 A

1 Only

 B

2 only

 C

Both 1 and 2

 D

Neither 1 nor 2

Q. 4

With references to vasectomy, consider the fol­lowing statements :

  1. Non-scalpel vasectomy and conventional vasec­tomy have complication rates of 0.4% and 3% re­spectively
  2. When sperms are absent from two consecutive samples of semen, the vasectomy is considered complete for contraception
 A

1 Only

 B

2 only

 C

Both 1 and 2

 D

Neither 1 nor 2

Ans. B

Explanation:

2 only


Q. 5

Which of the following statements are false regarding vasectomy?

 A

1 in 2000 men can become fertile again

 B

Sperm granuloma is a common complication

 C

Sperm production will be stopped following the procedure

 D

Done under local anaesthesia

Q. 5

Which of the following statements are false regarding vasectomy?

 A

1 in 2000 men can become fertile again

 B

Sperm granuloma is a common complication

 C

Sperm production will be stopped following the procedure

 D

Done under local anaesthesia

Ans. C

Explanation:

A risk of about 1 in 2000 of pregnancy resulting from late recanalisation after previous clearance.

1 in 2000 men can become fertile again due to rejoining of the two ends of the vas, so vasectomy is not 100% effective.

Common complications are Scrotal bruising, haematoma, Chronic testis pain affecting quality of life (1-2%) and sperm granuloma. 
 
Sperm will still be produced by the testis but will get dissolved in the body. Sperm can still be present for a few months and so a semen analysis is done three months after vasectomy.
A second contraception is needed during this period. 
 
It is done under local anaesthesia. The sex hormones will still be produced by the testes so libido and erectile function are unaffected.
 
Ref: Vasectomy ; BMJ 2013;346:f1674; AUG Guidelines: http://www.auanet.org/content/media/vasectomy.pdf.

Q. 6

All of the following are true about vasectomy, EXCEPT:

 A

Take about 3 months before the sperm stores are used up

 B

Sperm granulomas are less common if electrocautery is used

 C

Reversal is most successful within 10 years of initial surgery

 D

There is a risk of chronic testicular pain

Q. 6

All of the following are true about vasectomy, EXCEPT:

 A

Take about 3 months before the sperm stores are used up

 B

Sperm granulomas are less common if electrocautery is used

 C

Reversal is most successful within 10 years of initial surgery

 D

There is a risk of chronic testicular pain

Ans. B

Explanation:

Sperm granulomas are less common if thermal cautery is used rather than electrocautery.

 
Some complications of vasectomy:
 
a) Hematoma and infection
b) Sperm Granulomas
c) Chronic testicular pain
d) Spontaneous recanalisation
e) Antisperm antibody formation
 
Ref: Oxford Handbook of Clinical Specialities, 8th Edition, Page 305; Shaw’s Textbook of Gynaecology, 12th Edition, Page 182

 


Q. 7

After agreeing to have no more children, a man and his wife decided he should have a vasectomy. What structure would then be surgically ligated?

 A

Ductus deferens

 B

Ejaculatory duct

 C

Epididymis

 D

Fossa navicularis

Q. 7

After agreeing to have no more children, a man and his wife decided he should have a vasectomy. What structure would then be surgically ligated?

 A

Ductus deferens

 B

Ejaculatory duct

 C

Epididymis

 D

Fossa navicularis

Ans. A

Explanation:

In a vasectomy, the ductus deferens is ligated or excised.
This means that the fluid that is then ejaculated from the seminal vesicles, prostate, and bulbourethral glands has no sperm.
The sperm simply degenerate in the epididymis and the proximal ductus deferens.
It would not be a good idea to ligate the ejaculatory duct or the seminal vesicle because that might compromise the patient’s ability to ejaculate. Just remember, another name for the ductus deferens is the vas deferens, so it make sense that the procedure to ligate this structure is called a vasectomy.
 
Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 33. Sterilization. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e. 

Q. 8

Which of the following structure in spermatic cord doesn’t come during surgery for vasectomy?

 A

Testicular artery

 B

Ilioinguinal nerve

 C

Autonomic nerves

 D

Testicular vein

Q. 8

Which of the following structure in spermatic cord doesn’t come during surgery for vasectomy?

 A

Testicular artery

 B

Ilioinguinal nerve

 C

Autonomic nerves

 D

Testicular vein

Ans. B

Explanation:

The ilioinguinal nerve (L1) passes through part of the inguinal canal but not a part of spermatic cord.

The spermatic cord contains the following structures:
  • Ductus deferens
  • Testicular (gonadal) artery
  • Testicular (gonadal) vein
  • Autonomic neurons

Q. 9

Antibodies against sperms may develop after:

 A

Trauma

 B

Infection

 C

Vasectomy

 D

Orchidectomy

Q. 9

Antibodies against sperms may develop after:

 A

Trauma

 B

Infection

 C

Vasectomy

 D

Orchidectomy

Ans. C

Explanation:

C i.e. Vasectomy

50% of men who have been vasectomized develop antibodies against spermatozoaQ. This holds significance, as because of these antibodies reversal of vasectomy may not restore fertility, even when the reversal is successful.


Q. 10

Method of contraception shown in the photograph below is ? 

 A

Scalpel vasectomy.

 B

No scalpel vasectomy.

 C

Laser vasectomy.

 D

None of the above.

Q. 10

Method of contraception shown in the photograph below is ? 

 A

Scalpel vasectomy.

 B

No scalpel vasectomy.

 C

Laser vasectomy.

 D

None of the above.

Ans. B

Explanation:

Method of contraception shown in the photograph above represents No scalpel vasectomy.

Noscalpel vasectomy (also called keyhole vasectomy) is a vasectomy procedure in which a sharp hemostat is used to puncture the scrotum.


Q. 11

A case done by the method as shown in the picture below is said to have failed as the person’s wife gives birth to a child ten months after the operation. Which one of the following is the most probable cause? 

 A

Failure of the husband to use condom after vasectomy.

 B

Surgical failure.

 C

Recannalisation.

 D

Wife had extramarital contact.

Q. 11

A case done by the method as shown in the picture below is said to have failed as the person’s wife gives birth to a child ten months after the operation. Which one of the following is the most probable cause? 

 A

Failure of the husband to use condom after vasectomy.

 B

Surgical failure.

 C

Recannalisation.

 D

Wife had extramarital contact.

Ans. B

Explanation:

The method shown in the picture above represents Vasectomy.

It is the case of surgical failure as pregnancy occured immediately after surgery (delivery occured 10 months after surgery).

Recanalization occurs after sometime of successful surgery. Women become pregnant 16 months to 3 years after surgery that means delivery will occur 9 months later to this period.



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