Microsurgery of the male reproductive system

McClure, R. Dale

doi:10.1007/bf00326403

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…During evaluation of aspirate appearance, aspirates are classified into 4 groups: clear, opalesque, creamy, and pasty. Clear aspirates are considered fortunate in terms of a good prognosis [21,22]. Belker et al [19] found patency rates of 91 and 93% and pregnancy rates of 49 and 59%, respectively, when aspirates were clear or opalesque during microsurgery.…”

Section: Intra-operative Evaluation Of Aspiratesmentioning

confidence: 99%

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: Intra-operative Evaluation Of Aspiratesmentioning

confidence: 99%

Vasovasostomy

Schroeder‐Printzen

Diemer

Weidner³

2003

Urol Int

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“…The vas was exposed and transected, microsurgi cal end-to-end anastomoses were performed in a modified one-layer fashion [6] using 10-0 full thickness sutures at the 10, 2 and 6 o'clock positions and 8-0 nylon sutures at 12, 4 and 8 o'clock which were placed through the muscularis only. The other side was used for the treatment group, distribution was random.…”

Section: Methodsmentioning

confidence: 99%

Laser-Assisted Vasovasostomy in the Rat

Burger¹,

Gerharz²,

Jansen³

et al. 1988

Urol Int

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A comparative study was undertaken to investigate the Nd:YAG and CO₂ laser systems for laser-assisted vasovasostomies (LAVs). In 32 rats 64 vasovasostomies were performed, either conventionally sutured (CSV) or laser-welded (LAV-CO₂ and LAV-Nd:YAG). Postoperative investigations included patency tests, gross examination, light and electron microscopy. The highest rate of sperm granulomas (50%) and the lowest patency rate (50%) was seen in the LAV-Nd:YAG group. LAV-CO₂ showed the lowest rate of sperm granulomas (12.5%) and had a patency rate (82%) which was comparable to that of CSV (88%). Laser-assisted vas anastomosis is time saving and technically easy to perform. Contrary to microvascular anastomoses, where both laser types offer the same results, vas anastomosis is better done using a CO₂ laser system.

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“…In der Weltliteratur publizierten das gleiche Vorgehen Fogedstam [12] und Mc Clure [13] 1986, Thomas [14] 1987, Weiske [15], Niederberger [16] 1993 sowie Schwarzer [ 17,18] Auch im Zeitalter der rasanten Entwicklung und der bereits erfolgreichen klinischen Anwendung neuer Techniken der assistierten Reproduktion (MESA, TESE, ICSI) darf nicht vergessen werden, daß bei einer Azoospermie, die durch eine Obstruktion im NH-Bereich bedingt ist, nur eine mikrochirurgische Refertilisation die Wiedererlangung der männlichen Fertilität auf natürlichem Wege ermöglicht [19].…”

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