Ensuring Vasectomy Success: What Is the Standard?

Makhlouf, Antoine A.; Niederberger, Craig S.

doi:10.2164/jandrol.106.000612

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…17 In addition to our anecdotal experience with academic centers in the United States, reports from France, Finland, England, and New Zealand have described surgeons and institutions routinely sending vasectomy specimens for analysis (the rationale varies from legal support to historical practice to early identification of failure to transect the vas). 18,19 The most recent American Urologic Association vasectomy guideline recommends isolating the VD from perivasal tissue and only transecting a "bare vas." 2 At times, more perivasal tissue may intentionally be taken to speed up the procedure or because the assistant happens to take a larger cut.…”

Section: Discussionmentioning

confidence: 99%

Rethinking the Value of Sending Vasectomy Specimens for Histologic Examination

Patel

Lowe

Zynger

2014

American Journal of Clinical Pathology

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Section: Discussionmentioning

confidence: 99%

Rethinking the Value of Sending Vasectomy Specimens for Histologic Examination

Patel

Lowe

Zynger

2014

American Journal of Clinical Pathology

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“…9 For these reasons, although it is not required to submit the excised length of VD for histologic confirmation of its structure following vasectomy, it is common practice for some urologists. [1][2][3] Pathologists confirm the presence of successfully transected VD by light microscopic findings, via the presence of a ductal structure lined by folded epithelium composed of apical columnar and cuboidal basal cells, surrounded by 3 muscular coats. However, these structures are sometimes destroyed or incomplete due to the surgical procedure or histologic processing of the specimen.…”

Section: Discussionmentioning

confidence: 99%

“…1 Many urology practitioners routinely send the resected portions of the VD for histologic confirmation. [2][3][4] Although the success of vasectomy is eventually confirmed by azoospermia in a semen specimen, histologic examination is beneficial for detecting certain surgical mishaps, such as mistaking another structure for the VD. 4 For pathologists, it is important to ensure that the VD has been transected by identifying a complete cross-section of the VD, which is composed of pseudostratified apical columnar epithelium with stereocilia and cuboidal basal cells overlying loose connective tissue stroma and a well-developed, thick, 3-layered muscular coat.…”

mentioning

confidence: 99%

Use of Immunohistochemical Markers to Confirm the Presence of Vas Deferens in Vasectomy Specimens

et al. 2009

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CD10 has recently been described as a marker that can distinguish wolffian duct derivatives from müllerian remnants but has yet to be tested in vasectomy specimens. We sought to determine if CD10 and pankeratin could corroborate the presence of vas deferens (VD). For the study, 103 consecutive vasectomy specimens were immunohistochemically analyzed for CD10, pankeratin, and CD31 expression in luminal and basal layer cells. In all cases with optimal epithelial histologic features (92/103), CD10 demonstrated intense apical membranous expression in all VD and weak basal cytoplasmic staining in about 98% of cases. Pankeratin demonstrated cytoplasmic and membranous expression in apical and basal layers in 99% of VD. In cases with suboptimal epithelial histologic features (11/103), the detection of epithelia was 100% for CD10 and pankeratin. Our data show that CD10 and pankeratin can be used to confirm the presence of VD in vasectomy specimens in which the epithelial histologic features are suboptimal.

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“…There are various reasons for this, such as the application of several techniques for identifying DNA fragmentation and being of individuals with different sperm characteristics [68][69][70].…”

Section: Varicocele and Dna Damagementioning

confidence: 99%

The Effects of Varicocele on DNA Morphology

2014

J Androl Gynaecol

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Varicocele is one of the major causes of infertility in men. Although there are different theories related to the pathophysiology of the varicocele, the exact pathophysiologic mechanism remains unknown. Sperm DNA damage may be the cause of undiagnosed infertility problems. The standard semen examination may not be sufficient to determine the etiology of infertility. For this reason, extra tests are needed to identify sperm DNA damage. Despite conflicting reports, many studies have shown that varicocele repair improves the quality of sperm DNA.Another mechanism related to the association between varicoceles and male infertility is increased oxidative stress (OS) [21,22]. Varicoceles may increase reactive oxygen species (ROS) production and decrease antioxidant capacity. Thus, varicoceles can cause OS [23][24][25]. A number of studies have demonstrated an increase of OS in serum, semen, and testicular tissues of patients with a clinical diagnosis of varicocele. This suggests that the impairment of sperm parameters found in men with varicocele may be related to oxidative stress [26][27][28][29][30][31]. Furthermore, OS may cause mtDNA deletions in human spermatozoa and mtDNA mutations can cause impairment of sperm functions [32]. In addition, an abnormal amount of ROS and antioxidants is connected to sperm motility defects and sperm quality [33,34].Other pathologies that could affect the spermatogenesis in patients with varicocele are Y chromosome micro deletions, acrosome reaction disorders, protamine deficiency, and endocrinological changes. Whereas Y chromosome micro deletions are found in 0.3-7% of infertile men, the rate goes up to approximately 18% in varicocele cases with poor semen parameters and testicular hypotrophy [35,36]. Previous studies have suggested that the varicocele may disrupt the acrosome reaction occurring between sperm and the zona pellucida Varicocele and InfertilityInfertility is defined as a failure to achieve pregnancy in spite of regular unprotected sex. The male infertility by 50% contributes to this important health problem affecting about 15-20% of couples in society [1,2]. A study carried out by the World Health Organization (WHO) in1992, which included 9,034 infertile couples, indicated varicocele in 25.4% of men with disordered sperm parameters and in 11.7% of men with normal sperm parameters [3]. Varicocele is the dilatation of the pampiniform plexus veins within the spermatic cord [4]. Varicocele occurs in roughly 15% of the adult male population. The rate of occurrence increases to 21-41% in men with primary infertility and to approximately 80% in those with secondary infertility [5,6]. Varicocele is found on the left side of the scrotum in 75-95% of cases. While its bilateral likelihood is 10%, the likelihood of varicocele occurring on the right side of the scrotum is 2% [7,8]. Etiology and PathophysiologyAlthough there are different theories related to the disease pathophysiology, the effects of varicocele on testicular dysfunction and infertility are not completely ...

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Ensuring Vasectomy Success: What Is the Standard?

Cited by 10 publications

References 24 publications

Rethinking the Value of Sending Vasectomy Specimens for Histologic Examination

Rethinking the Value of Sending Vasectomy Specimens for Histologic Examination

Use of Immunohistochemical Markers to Confirm the Presence of Vas Deferens in Vasectomy Specimens

The Effects of Varicocele on DNA Morphology

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