Studies of polyglycolic acid hollow self-retaining vasal stent in vasovasostomy

Berger, Richard E.; Jessen, John; Patton, Dorothy L.; Bardin, E. D.; Burns, Mark W.; Chapman, William E.

doi:10.1016/s0015-0282(16)60562-9

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…This sperm leakage and inflammatory reaction could increase the risk of late scarring. Hollow, bi‐flanged, hydrolysable, self‐retaining stents of polyglycolic acid were used by Berger et al [19] in a randomized prospective comparative study between a stented and a modified two‐layer vasovasostomy group in rats and dogs. The outcome suggested better patency rates in the stented group (80% vs 20%).…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…As early as 1987, Flam and Berger reported use of biodegradable intraluminal vasal stents for augmented anastomotic VV to obviate the need for a two-layer anastomosis (69,70). However, a subsequent randomized clinical trial revealed lower patency with the use of the stent compared with the traditional two-layer technique (81.0% vs. 89.6%; P¼ .2) and the technique was largely abandoned (71).…”

Section: Glues Stents and Morementioning

confidence: 99%

Fertility-enhancing male reproductive surgery: glimpses into the past and thoughts for the future

Halpern

Brannigan

2019

Fertility and Sterility

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Over the past few decades, there have been numerous paradigm shifts in male reproductive surgery, resulting from a combination of technologic advancements in both the operating room and the laboratory. The operating microscope transformed the field of male reproductive surgery, enabling novel techniques and higher precision for the treatment of male-factor subfertility. The subsequent widespread adoption of microsurgical approaches was largely responsible for the emergence of a cadre of highly specialized male infertility microsurgeons. The advent and evolution of in vitro fertilization/intracytoplasmic sperm injection was a concurrent story that further revolutionized the field. The ability to achieve fertilization and pregnancy with just a single sperm changed the ways in which male reproductive surgeons could approach a wide range of pathologies from obstructive to nonobstructive causes, culminating in the microdissection testicular sperm extraction procedure for the treatment of nonobstructive azoospermia. Here we review the recent advancements in fertility-enhancing male reproductive surgery for the treatment of four disease processes: varicocele, obstruction of the excurrent ductal system, ejaculatory duct obstruction, and nonobstructive azoospermia. While examining the great strides of the past, we look forward to exciting developments on the horizon. (Fertil Steril Ò 2019;112:426-37. Ó2019 by American Society for Reproductive Medicine.

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“…However, a patency rate of 88% and a pregnancy rate of 59% could be observed even in cases where no aspirates could be retrieved [20]. Aspirates are evaluated directly by the operating surgeon due to different macroscopic and microscopic criteria.…”

Section: Intra-operative Evaluation Of Aspiratesmentioning

confidence: 99%

“…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: 99%

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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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Studies of polyglycolic acid hollow self-retaining vasal stent in vasovasostomy

Cited by 9 publications

References 13 publications

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

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

Fertility-enhancing male reproductive surgery: glimpses into the past and thoughts for the future

Vasovasostomy

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