Experimental study of hollow, absorbable polyglycolic acid tube as stent for vasovasostomy

Flam, T.; Roth, Robert A.; Silverman, Mark L.; Gagne, Roland G.

doi:10.1016/0090-4295(89)90140-4

Cited by 16 publications

(6 citation statements)

References 14 publications

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“…The use of hollow, polyglycolic acid, self-retaining stents for the inner anastomosis (mucosa) has been investigated in other animal experiments [20,68]. Results have been similar to conventional techniques when the doublelayer technique was used.…”

Section: Other Techniquesmentioning

confidence: 83%

Vasovasostomy

Schroeder‐Printzen

Diemer

Weidner³

2003

Urol Int

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Vasovasostomy after sterilisation vasectomy is the most frequently performed microsurgical intervention in refertilizing surgery. Causes for obstruction other than vasectomy such as juvenile hernia repair and other kinds of surgery affecting the seminal cord appear to be rare. The pre-operative diagnostic approach follows the rules of conventional diagnostics in male infertility. The significance of the intra-operative evaluation of aspirates from the duct and its role in surgical decision-making is controversely debated in the literature. Similar controversies are evident concerning the microsurgical technique that is applied. In particular, the advantages of the two-layered technique (gold standard) of the anastomosis versus the single-layered technique are discussed. Other techniques such as laser applications and fibrin glue are not routinely used in humans. Even difficult microsurgical problems in cases with extended obstructions and cases of re-vasovasostomy can nowadays be managed and have significant success rates. Important prognostic factors appear to be the interval of obstruction, sperm granulomas, and length of the testicular end of the duct. High success rates accompanied by a lower profile in cost make the microsurgical approach (refertilization) superior versus the primary use of ART techniques such as ICSI.

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Section: Other Techniquesmentioning

confidence: 83%

Vasovasostomy

Schroeder‐Printzen

Diemer

Weidner³

2003

Urol Int

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“…Flam et al. [1] used an absorbable hollow polyglycolic acid stent, and described advantages of ease of anastomosis, reduction of perivasal inflammation as a result of minimal extravasation of sperm, maintenance of luminal patency, and satisfactory approximation of the vas deferens ends after placing of the stent. Remarkably, they reported more perivasal inflammation at the anastomotic site of an unstented control group.…”

Section: Discussionmentioning

confidence: 99%

“…The mean operative duration for a bilateral microscopic vasovasostomy procedure is 150 min [1]. It is generally accepted that the microscopic reconstruction leads to better patency and pregnancy rates than the macroscopic procedure [2–4].…”

Section: Introductionmentioning

confidence: 99%

The use of a newly designed nonabsorbable polymeric stent in reconstructing the vas deferens: a feasibility study in New Zealand white rabbits

et al. 2005

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progressive motile sperm density (PMSD), were compared after surgery for both groups. After the final semen analysis, rabbits were killed and patency was assessed histologically at the site of the anastomosis. RESULTSAfter an initial decline the mean total sperm count increased in both groups. The increase was significantly larger ( P = 0.05) in the stented rabbits. The mean motility and PMSD showed no significant differences between both groups ( P = 0.11 and 0.71, respectively). Histological examination of the anastomosed area showed partial obstruction ( > 50% narrowing of the original lumen) in five of the 13 conventionally treated rabbits, with no strictures in the stented group. Despite the narrowing in the conventional group the patency rates were not affected. The mean (range) operating time for the conventional and stented groups was 132 (99-168) and 98 (62-113) min, respectively ( P < 0.001). CONCLUSIONSThe total sperm counts, motility and PMSD showed no or little difference after surgery between the conventional and stented rabbits. The stented reconstruction was easy, had no secondary stricturing and reduced the operating time.

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“…The use of an internal splint dur ing the operation has frequently been discussed. Several studies reported on the use of an absorbable polyglycolic acid tube stent in rats and dogs [5,6]. There seemed to be a superior re-epithelialization and closer return of the vas to normal morphology in polyglycolic stented anasto moses, than in anastomoses created with the conventional two-layer technique.…”

Section: Discussionmentioning

confidence: 99%

Vasovasostomy Results in 66 Patients Related to Obstructive Intervals and Serum Agglutinin Titres

Vrijhof¹,

Delaere²

1994

Urol Int

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In this series we present the results of a retrospective analysis of 66 vasovasostomy procedures performed between 1983 and 1991. Obstructive intervals and serum antisperm antibodies were correlated with pregnancy and patency rates. With obstructive intervals of less than 5 years a patency rate of 100% (31/31) was obtained. Even more than 10 years after reversal, pregnancy occurred in 25% (2/8) of the patients. Preoperative serum antisperm antibodies were correlated with pregnancy rates. Patients with a high agglutinin titre of 1/64 obtained a pregnancy rate of 23% (3/13). Those men who had no circulating antisperm antibodies in their blood had a significantly better chance in obtaining pregnancy (pregnancy rate 80%). In this study we accounted for an overall pregnancy rate of 51.5% (34/66) versus an overall patency rate of 84.8% (56/66). Neither long obstructive intervals nor high antisperm antibody titres should dissuade a surgeon from performing a vasovasostomy procedure.

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Experimental study of hollow, absorbable polyglycolic acid tube as stent for vasovasostomy

Cited by 16 publications

References 14 publications

Vasovasostomy

Vasovasostomy

The use of a newly designed nonabsorbable polymeric stent in reconstructing the vas deferens: a feasibility study in New Zealand white rabbits

Vasovasostomy Results in 66 Patients Related to Obstructive Intervals and Serum Agglutinin Titres

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