Uterus Transplants Are Here

May 17th, 2014 § 0 comments § permalink

About one in 500 women either have no uterus or problems so severe with it that it can’t carry a child. Until recently, these conditions had no medical treatment.

In Fertility and SterilityMats Brännström and a team of surgeons at the University of Gothenburg in Sweden report uterus transplantation in nine women, eight of whom who were born without a uterus, and one who had it removed for cancer. Two of the women had complications that required surgical removal of the transplanted organs, but seven women made it to six months with their transplants.

The ultimate test of these transplanted uteri remains: whether they can carry babies. If they can, this would be a great advance for the millions of women afflicted worldwide by problems with their uteri so severe that pregnancy is impossible.

I had the pleasure of meeting Dr. Brännström last month at a conference in Brisbane, Australia. These surgeries are not easy, requiring up to six hours to remove the uterus from the donor and up to 13 hours to transplant it into the recipient. It’s a rare kind of surgeon that puts such great effort into coordinating complex care and developing new techniques in a careful and methodical way. Thanks to his efforts, we may be closer to a time when a woman without a womb isn’t hopeless if she wants to carry her child.

World’s First Human Uterus Transplant

February 6th, 2013 § 0 comments § permalink

While this isn’t specifically male health, I do write from time to time about important developments in reproductive medicine. Dr. Munire Akar from Aktinez University In Antalya Turkey reports in Fertility and Sterility the results of the world’s first human uterus transplant from a multiorgan donor. While transplant surgery has been around for a while and is a well accepted form of medical therapy, reproductive organs have come late to transplantation. This is undoubtedly the beginning of a new world for men and women previously unable to conceive for reasons of anatomy. If you’d like to hear Dr. Munire Akar talk about her work, click here. If you’d like to participate in a discussion on her article, click here.

Welcome, Doctor Hotaling!

November 28th, 2012 § 2 comments § permalink

 

Hotaling lighter eyes

We welcome Doctor Jim Hotaling as a contributor to Maledoc. Doctor Hotaling is a male infertility specialist with interests in erectile dysfunction, surgical innovation, epidemiology of infertility, and the statistical genetics of male infertility. He graduated magna cum laude from Dartmouth with majors in chemistry and history, completed medical school at Duke in 2006, and finished a six year urology residency at the University of Washington in 2012.  His goal is to expand the scope of genetic tests available to enable patients and physicians to understand what causes male infertility. He’s also studying how bicycle riding contributes to erectile dysfunction and how to solve that problem with engineering. Welcome, Doctor Hotaling!

Varicose Veins in the Scrotum: Rx

May 25th, 2012 § 16 comments § permalink

Mr. Smith asked me to explain the different methods of treating varicose veins in the scrotum known as a varicocele.  There are a few:

  • A surgeon makes a small incision in the groin, and ties or clips the veins.  The surgeon may use an operating microscope or wear glasses with magnifying lenses to preserve small arteries supplying blood to the testis.
  • A surgeon uses a telescope called a laparoscope to find the veins inside the abdomen and tie or clip them.
  • A radiologist threads a small tube through the veins and injects material to plug them.

Most surgeons who specialize in male fertility prefer to use an operating microscope or wear glasses with magnifying lenses to perform the procedure, but excellent results can be obtained with either laparoscopy or radiology.  A man should ask his doctor about his or her experience, what he or she prefers and why.

This series of pictures shows what the procedure looks like under the operating microscope.  The surgeon uses a small probe to listen to the veins as they sound different than arteries.  In this procedure, titanium clips were used to block the veins, but surgical suture can also be used.

Varicocelectomy

Thanks, Mr. Smith, for asking a great question!

PSA and Prostate Cancer Interview

October 7th, 2011 § 0 comments § permalink

The U.S. Preventative Health Task Force is issuing guidelines today about the blood test PSA and its use in screening for diagnosis.  While I respect those doctors involved in making the guidelines, I don’t entirely agree that PSA shouldn’t ever be used.  ABC Chicago interviewed me this morning, and the segment can be found here.