Monday, April 14, 2008

Contraceptive for men a shot in the arm

New Australian-developed contraceptive jab for men, taken four times a year, has been proven to be just as effective as birth-control pills for women. Sydney researchers found the hormonal injection is a quick and reliable method of contraception for up to 95 per cent of males. Until now, the only effective non-barrier contraceptive for men was a vasectomy, meaning that women tended to take on theresponsibility. Now there is an alternative - but pharmaceutical companies have shown little interest in making it available to the public.

The new jab works by suppressing sperm output but does not have a permanent effect. Made up of a combination of the hormones androgen and progestin - mostly testosterone - it needs to be administered every two to three months. Researchers from the ANZAC Research Institute, University of Sydney and Concord Hospital studied 1756 men aged 18 to 51 and found the combined jab was quicker and more effective than an androgen-only version.

Associate Professor Peter Liu, co-author of the integrated analysis study, said he was disappointed pharmaceutical companies had pulled out of the project to develop a commercially available male contraceptive jab. "I think there's a real need for it because I see a lot of couples where a female doesn't want to use or is intolerant to a female contraceptive pill or males who want to delay vasectomy" Professor Liu said. "There are also couples who say it's not fair, why should (birth control) be up to the female? I hear that from both partners."

Research has been hindered by a shortage of government interest and funding. "My perception is that people want it but it seems to be that somehow that isn't being heard at a government level," Professor Liu said. "No one has really pushed this issue and I don't know why that is. Sometimes, the Government doesn't know what the community wants so the community has to tell them."

The jab is as effective as a vasectomy without the need for surgery or stopping sperm completely, according to the study which has been published in the Journal of Clinical Endocrinology and Metabolism, and Medical Observer magazine. "We conclude that androgen-progestin administration can suppress sperm output in a timely fashion to concentrations that are compatible with reliable contraception in most, but not all, men," the study authors wrote. "The rate of suppression is comparable to that achieved after vasectomy."

The World Health Organisation is understood to be planning an international study to test a three-monthly androgen-progestin combination injection for men. Countries such as China, where population growth is exploding, are expected to be among the biggest markets for the new jab.


Look, no scars: organs removed via the mouth

The minister charged with overhauling the NHS is testing a new form of scar-free surgery in which diseased organs are pulled out through the patient’s throat. Professor Lord Darzi, chair of surgery at Imperial College London, has conducted preliminary experiments with the technique in which robotically controlled instruments are lowered into the patient’s stomach. A hole is made in the lining of the stomach, then the organ - usually an appendix or gall bladder - is cut out and pulled up through the throat before the hole is stitched, leaving the patient with no external scars and a reduced risk of infection because the wounds are not exposed to the air. [But it is exposed to acid!]

The technique, called natural orifice translumenal endoscopic surgery, has been successfully used on patients in America, France and India. Darzi, who became a health minister last year, is one of the first surgeons in Britain to use the technique in experiments on pigs, before the first human tests. While admitting it was still “early days”, Darzi believes the probe could eventually be used to remove cancers.

The main after-effects include a sore throat and an unpleasant taste in the mouth from having a diseased organ pulled through it. Other orifices could be used but Darzi said he believed the mouth was the most promising. He said some aspects of the procedure needed perfecting. “If we are going to enter through the stomach we need to develop the appropriate tools to make sure we can close the hole properly,” he said.

Darzi’s team are developing a new surgical robot called the iSnake, which they hope will assist in the new procedure and in keyhole surgery. Other research projects on the new procedure are under way at hospitals around Britain. The first operations on patients in Britain are expected in three to four years.


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