Bilateral Vasectomy Research Articles

The Omission of Genitourinary Physical Exam in Telehealth Pre-Vasectomy Consults Does not Reduce Rates of Office Procedure Completion

ObjectiveTo determine whether the omission of preprocedure genitourinary exam for vasectomy inherent to a virtual consultation reduces the likelihood of successfully completing in-office vasectomy. Currently, the AUA Vasectomy guidelines encourage in-person examination when possible, though COVID-19 has catalyzed the uptake of virtual consultations at many institutions. We hypothesized that rates of completed in-office vasectomy do not significantly differ between patients examined during consultation in the office and those seen virtually with no exam. MethodsVirtual vasectomy consults from April to December 2020 were retrospectively reviewed and compared to a size-matched, randomly-selected control group who underwent in-office vasectomy consultation. The primary outcome was completion of in-office bilateral vasectomy. Baseline demographic characteristics were compared. Fisher's exact test and Student's t-test were performed on categorical and continuous variables, respectively. ResultsOf 211 patients who underwent virtual vasectomy consultation during the study period, 153 presented for in-office vasectomy. They were compared to 153 vasectomies from the in-person consult cohort. No demographic differences were observed between virtual and in-office consult groups. No statistical difference was observed in completion rates of in-office vasectomy, which was 97.4% (149/153) in the virtual consult cohort and 98.7% (151/153) in the in-office consultation cohort (P = .68). ConclusionRates of completed in-office vasectomy did not significantly differ based on consult platform, suggesting that a pre-vasectomy physical exam is not required to predict successful completion of the procedure. Telehealth should be utilized as an additional platform to improve access for male contraceptive procedures in a young and busy population.

New Bipolar Radiofrequency Sealing tool for Transdermal Vasectomy in the Rabbit Model: a Paradigm Shift in Vasectomy Technique?

ABSTRACT Introduction Bipolar Radiofrequency (RF) sealing tools have been shown to be successful in the treatment of many areas in the human body. RF has been utilized in the sealing of larger blood vessels and in nerve pain ablation in humans, showing good results for years. Urology has used RF ablation percutaneously for treating renal tumors for years. Objective We evaluate the utilization of a new bipolar RF sealing tool for transdermal vasectomy in the rabbit model. Methods Two groups of 5 male New Zealand white rabbits were given IV sedation and local anesthetic and subsequent transdermal bilateral vasectomy using a high lateral scrotal approach. We isolated the vas with a novel insulated clamp, fitting the U-shaped electrode of the sealing tool (Figure 1) around the clamp. In Group 1 (n=5), the device was set at 60 watts for 20 seconds. In the second group (n=5), the size of the U-shaped tool jaw was reduced and the device was set at 40 and 60 watts using impedance sensing to automatically shut off energy at a predetermined level. Wound healing, complications, survival, postmortem biopsies, and histology were evaluated. A doe rabbit was used with semen collections & semen analyses preformed on all male rabbits. Results We sacrificed 4 of the 5 (80%) of Group 1 rabbits due to poor wound healing due to excessive thermal damage. All 5/5 (100%) of Group 2 rabbits had good tissue healing and survived the procedure. At about 5 seconds of sealing, the impedance sensing automatically shut off power to the device in all Group 2 procedures. All rabbits had a negative semen analysis and on histology had occluded vas deferens. In bench top testing, we found that a 5 second interval is optimal for vas ligation. (Figure 1) Bench top testing revealed that thin short jaws created lower nearby tissue temperature (50 degree Celsius) than wide long jaws (77 degree Celsius). Conclusions Transdermal bipolar radiofrequency sealing successfully occludes the vas deferens in rabbit vasectomy. The jaw size and sealing time using an impedance alarm system appear to be important for wound healing. This novel technique may decrease vasectomy time and morbidity. Further studies are needed before its application in humans. Disclosure Yes, this is sponsored by industry/sponsor: Signati Clarification: Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Signati

757 An Audit of Post-Vasectomy Semen Analysis Adherence

Abstract Aim Following vasectomy, patients undergo post-vasectomy semen analysis (PVSA) to determine whether they can be “cleared” to safely discontinue contraception. The adherence rates to PVSA are notoriously poor in the literature. The aim of this project is to assess our patient’s adherence to PVSA and identify areas for improvement. Method All vasectomies undertaken at a large urology centre between 01/01/2019 and 31/12/2019 were included. PVSAs were scrutinised one year later to determine clearance or special clearance according to the 2016 Laboratory Guidelines for Post-vasectomy Semen Analysis endorsed by the British Andrology Society. Results 256 patients underwent bilateral vasectomy, with 132 (51.6%) undergoing PVSA, at a median of 16.4 weeks (range 7.3 – 71.6). At time of review, 71 (54.5%) of these have been cleared; 45 (63.4%) after a single PVSA and 19 (26.8%) after the second. Seven patients (9.9%) received special clearance, two patients (1.5%) were not cleared despite meeting the special clearance criteria and one patient suffered early failure (0.8%). Clearance letters were issued at a median of 2.7 weeks (range 0.1 – 28.8) following satisfactory PVSA results. Moreover, 33 patients (25%) had at least one PVSA sample rejected by the lab, mainly due to timing issues or incomplete information on the request form. Conclusions The adherence rate to PVSA in our cohort is in keeping with the literature, and the majority of patients who are cleared achieve this with just one PVSA. Interventions aimed at counselling patients about the importance of PVSA, reducing unnecessary repeats and reducing rejected samples are necessary.

PD25-12 ONLINE VASECTOMY CONSULTS: IS A PRE-VASECTOMY PHYSICAL EXAM REALLY NECESSARY? A CASE-CONTROL STUDY

You have accessJournal of UrologyHealth Services Research: Value of Care: Cost and Outcomes Measures II (PD25)1 Sep 2021PD25-12 ONLINE VASECTOMY CONSULTS: IS A PRE-VASECTOMY PHYSICAL EXAM REALLY NECESSARY? A CASE-CONTROL STUDY Johnathan Doolittle, Bradley Gill, and Sarah Vij Johnathan DoolittleJohnathan Doolittle More articles by this author , Bradley GillBradley Gill More articles by this author , and Sarah VijSarah Vij More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002018.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In light of the pandemic and necessary shift to virtual care, this study aimed to determine whether vasectomy, the most commonly performed procedure by urologists, requires an in-person consultation prior to the procedure, as advised by the 2015 American Urological Association guidelines. It tested the hypothesis that aborted in-office vasectomy rates do not differ between patients seen virtually or in-person for consultation. METHODS: A retrospective review was conducted of all cases of virtual vasectomy consults from April to December 2020 with controls comprised of a randomly selected cohort of men who underwent in-office vasectomy consultation during the same time period. Men with a previous scrotal exam by a urologist or advanced practice provider prior to the virtual consult were excluded. The primary outcome was completion or abortion of in-office bilateral vasectomy. Baseline demographic characteristics were compared. Fisher’s exact test and t-tests were performed on categorical and continuous variables, respectively. RESULTS: Of 189 men who underwent virtual vasectomy consultation during this time period, 153 ultimately presented for in-office vasectomy. During this same period, 568 men presented for in-office consultation, of which 153 were randomly selected for chart review. No differences were observed between virtual and in-office consult cohorts with respect to age (36.6 vs 37.2 years), race, or BMI (27.2 vs 27.3). Most (149/153, 97.4%) virtual consult patients completed in-office vasectomy. One patient experienced a vasovagal episode after the first side was completed and 3 procedures were aborted due to difficultly palpating one or both vasa. Most (151/153, 98.7%) men with in-office consultation completed vasectomy-no statistical difference was observed between completion rates between the two groups (p=0.68). CONCLUSIONS: Rates of completed in-office vasectomy were equivalent regardless of pre-procedure consult platform or a pre-vasectomy physical exam. Virtual platforms appear to be an ideal means for completing vasectomy consultation and may be a more desirable and efficient way to care for this typically young and busy patient population. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e436-e436 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Johnathan Doolittle More articles by this author Bradley Gill More articles by this author Sarah Vij More articles by this author Expand All Advertisement Loading ...

Vasectomy reversal: Unilateral versus bilateral vasovasostomy.

The aim of this study was to evaluate and compare the efficiencies of unilateral and bilateral vasovasostomies as the vasectomy reversal procedures. A total of 95 patients with a history of bilateral vasectomy were evaluated. 42 of them had undergone unilateral surgery, and bilateral surgery had been done for the other 53 patients. Their information including the age, the time interval between the initial vasectomy to the reversal surgery and other underlying illnesses or medications was gathered. Patency rates in the unilateral and bilateral groups were 88.1% (38 patients) and 88.7% (48 patients), respectively, the difference of which was not statistically significant (p=.907). Successful pregnancies occurred in 22 (52.4%) and 29 (54.7%) patients, respectively, which did not show any statistically significant difference too (p=.713). Based on the multivariate logistic regression model, only the time interval between vasectomy and the reversal (duration of obstruction) was predictive of patency (OR=1.112, p=.037). The outcomes of the unilateral and bilateral vasovasostomies in terms of patency and pregnancy rates were not significantly different. We suggest that performing unilateral, instead of bilateral, vasovasostomy can reduce the time of anaesthesia and surgery and save costs and consumables without having a significant negative impact on the surgical outcomes.

Pre-scrotal bilateral vasectomy in a dog

A one year old mongrel male dog was presented in VCC Bikaner, for surgical sterilization. Owner wants sterilization of his dog without affecting its sexual behaviour. As per owner’s request a successful surgical sterilization through ligation and removal of a segment of ductus deferens, was performed through inguinal region of presented animal. Dog was recovered completely on 10th day of surgery without any complication of wound dehiscence.

Fournier’s Gangrene after Bilateral Vasectomy-A Case Report

Fournier’s gangrene is an acute, rapidly progressing, potentially fatal necrotizing fasciitis affectingthe external genitalia, perineal or perianal regions and is caused by a mixed infection with aerobic/anaerobic bacteria, which commonly affects the men, but can also occur in women and children. The most common foci of infection are from gastrointestinal tract, genitourinary tract or less commonly from the cutaneous injuries. The common risk factors includediabetes mellitus,alcohol abuse, extremes of age, male gender, chronic steroid use, malnutrition and immunosuppression. Uncommonly, Fournier’s gangrene has been documented after vasectomy operation-a permanent technique for male partner sterilization. Here we present a case of Fournier’s gangrene in an adult male who had undergone bilateral standard vasectomy for permanent contraception and presenting after 7 days with gangrene in the scrotum requiring urgent debridement and broad-spectrum antibiotics.

Application of a laparoscopic technique for vasectomy in standing horses

This report describes a technique for standing laparoscopic vasectomy in stallions through a prospective descriptive study. A preliminary study was carried out with two experimental intact male horses and subsequently...

Hematogenous dissemination of Chlamydia muridarum from the urethra in macrophages causes testicular infection and sperm DNA damage†

The incidence of Chlamydia infection, in both females and males, is increasing worldwide. Male infections have been associated clinically with urethritis, epididymitis, and orchitis, believed to be caused by ascending infection, although the impact of infection on male fertility remains controversial. Using a mouse model of male chlamydial infection, we show that all the major testicular cell populations, germ cells, Sertoli cells, Leydig cells, and testicular macrophages can be productively infected. Furthermore, sperm isolated from vas deferens of infected mice also had increased levels of DNA damage as early as 4 weeks post-infection. Bilateral vasectomy, prior to infection, did not affect the chlamydial load recovered from testes at 2, 4, and 8 weeks post-infection, and Chlamydia-infected macrophages were detectable in blood and the testes as soon as 3 days post-infection. Partial depletion of macrophages with clodronate liposomes significantly reduced the testicular chlamydial burden, consistent with a hematogenous route of infection, with Chlamydia transported to the testes in infected macrophages. These data suggest that macrophages serve as Trojan horses, transporting Chlamydia from the penile urethra to the testes within 3 days of infection, bypassing the entire male reproductive tract. In the testes, infected macrophages likely transfer infection to Leydig, Sertoli, and germ cells, causing sperm DNA damage and impaired spermatogenesis.

Factors predicting success after microsurgical vasovasostomy.

To identify factors predicting success and analyze critically the status of microsurgical double-layer vasovasostomy using predictive models. A cohort of 263 patients treated at our institution for vasectomy reversal between 1986 and 2010 was included in our study, and the literature was reviewed. Inclusion criteria were previous bilateral vasectomy and presence of at least two postoperative semen analyses; patients reporting pregnancy without a postoperative semen analysis were excluded. A double-layer, microscope-assisted, tension-free anastomosis vasovasostomy was performed approximating mucosa to mucosa and muscle to muscle with a 10-0 non-absorbable suture. A multivariate logistic regression backward stepwise model was used to predict combined success, and a predictive model was calculated with remaining variables. Mean age was of 41.6years (SD 7.1); mean duration of obstruction 7.2years (SD 6.7). On multivariate analysis, uni- or bilateral granuloma and Silber grade of I-III were variable identified predicting higher probability to success (OR 3.105; 95% CI 1.108-8.702; p=0.031 and OR 4.795; 95% CI 2.117-10.860; p<0.001, respectively). Based on our results, some factors predicting success after vasovasostomy surgery are known but others remain unknown; our predictive model may easily predict patency and success after this surgery and offers a concrete assistance in counseling patients.

MP89-17 MICROSCOPIC EVALUATION OF THE VASAL FLUID FOR SPERM AT THE TIME OF VASECTOMY REVERSAL – DO WE REALLY NEED TO CHECK?

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2017MP89-17 MICROSCOPIC EVALUATION OF THE VASAL FLUID FOR SPERM AT THE TIME OF VASECTOMY REVERSAL – DO WE REALLY NEED TO CHECK? Ethan Grober and Sammi Tobe Ethan GroberEthan Grober More articles by this author and Sammi TobeSammi Tobe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2815AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES During vasectomy reversal (VR), intra-operative microscopic evaluation of the vasal fluid for sperm presence and quality can inform of the possibility of epididymal obstruction and need for a vasoepididymostomy (VE). Despite its potential utility, the practice of intra-operative microscopic vas fluid evaluation is not universal. Some centers may not have bench microscopy available. Some surgeons may only perform vasovasostomy (VV) and therefore are not influenced by vasal fluid characteristics or alternatively feel that the vasal fluid quality alone can predict the need for a VE. Objective: In an effort to validate the utility of microscopic vasal fluid evaluation, the current initiative correlates vasal fluid characteristics with sperm presence and quality in a large series of VRs. METHODS 1108 bilateral vasectomy reversals performed by a single surgeon (EG) yielded a total of 2216 vasal units (right & left sides) for analysis. During VR, vasal fluid was expressed and sampled from the transected testicular end vas and the fluid was characterized (thick-paste/opaque/translucent/clear). The volume of vasal fluid was documented (copious/minimal). Each aspirated sample underwent microscopic evaluation for sperm quality and categorized as: motile sperm/intact non-motile sperm/sperm parts/no sperm. The predictive utility of the gross vasal fluid characteristics with respect to sperm presence and quality was analyzed. RESULTS Table 1 summarizes the relationship between the gross vasal fluid characteristics and the microscopic presence and quality of sperm within the fluid among 2216 vasal units. When thick-pasty fluid was observed, no sperm were seen in the samples in 50% of cases and if present, only non-motile sperm were observed. Importantly, even in the setting of more favorable vasal fluid characteristics (clear, translucent & opaque fluid), no sperm were seen in 7-11% of cases, suggesting the possibility of epididymal obstruction and the need for a VE. CONCLUSIONS Intra-operative microscopic evaluation of the vasal fluid for sperm is a necessary practice during vasectomy reversal to optimize surgical outcomes. The gross characteristics of the vasal fluid alone does not universally predict sperm presence and quality. Reliance on vasal fluid characteristics in isolation, without microscopic sperm analysis, may lead to unrecognized epididymal obstruction and the possible need for a VE in approximately 10% of cases of VR. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1208 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Ethan Grober More articles by this author Sammi Tobe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Effects of bilateral vasectomy on the interleukin 1 system in mouse epididymis

Regional difference in the inflammatory response in vasectomized (VAX) epididymis remains unraveled. Epididymal expression of interleukin 1α (IL1α), IL1β, IL1 receptor antagonist (IL1ra), IL1 receptor 1 (IL1R1), IL6, IL10, tumor necrosis factor α (TNF-α), and transforming growth factor-β1 (TGF-β1) was examined in bilateral VAX mice by real-time RT-PCR and immunohistochemistry. IL1α, IL1β, IL1ra, and IL1R1 were expressed in the epididymal epithelia of normal mice. Following VAX, IL1R1 mRNA was not changed, but TNF-α, IL10, IL1α, IL1β, and IL1ra mRNA were significantly upregulated in whole epididymis, whereas IL6 and TGF-β1 mRNA were significantly increased in corpus and cauda but not in caput epididymis. Consistently, IL1α, IL1β, and IL1ra immunoreactivities were visibly increased in epididymis following VAX. Following VAX, IL1α, IL1β, IL1ra, IL10, and TNF-α may mediate immune reaction in whole epididymis, whereas IL6 and TGF-β1 may mediate regionally different immune response primarily in the lower part of epididymis.

Expression and function of HSP110 family in mouse testis after vasectomy.

HSP110 functions to protect cells, tissues, and organs from noxious conditions. Vasectomy induces apoptosis in the testis; however, little is known about the reason leading to this outcome. The aim of the present study was to evaluate the expression and function of HSP110 in mouse testis after vasectomy. Following bilateral vasectomy, we used fluorescent Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) to detect apoptosis, Western blotting and immunohistochemistry to examine HSP110 expression and localization. Serum antisperm antibody (AsAb) and testosterone were measured by Enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay, respectively. Expression of endoplasmic reticulum stress (ERS) sensors and downstream signaling components was measured by Reverse Transcription-Polymerase Chain Reaction (RT-PCR), and the phosphorylation of eIF2α and JNK was detected by Western blotting. Vasectomy induced morphologic changes, increased apoptosis in the testis, increased serum AsAb, and decreased testosterone levels. After vasectomy, ORP150 mRNA level was increased first and then decreased, Bcl-2 was decreased, and the expression of HSPA4l, GRP78, GADD153, PERK, ATF6, IRE-1, XBP-1s, Bax, Bak, and caspases and the phosphorylation of eIF2α and JNK were increased. We present that an ER stress-mediated pathway is activated and involved in apoptosis in the testis after vasectomy. HSPA4l and ORP150 may play important roles in maintaining the normal structure and function of testis.

Vasectomy in Spotted Paca (Cuniculus paca)

Background: Cuniculus paca is the second largest neotropical rodent. It is not endangered, but your habitat has been destroyed and the specie has been hunted, because of its prized meat. In this context captive breeding is an alternative to reduce the hunt. Then, adult male vasectomy is an interesting alternative for Cuniculus paca since the animal does not lose libido and maintain cyclicity of females into the enclosure. This technique is a method of sterilization which the vas deferens is surgically clamped, cut, or otherwise sealed and thus prevents the release of sperm when a male ejaculates. The aim of this study was to describe the vasectomy technique on a male spotted paca kept in captive. Case: A captive adult male of Cuniculus paca, lived in Brazilian wild fauna breeding for scientifc research. It was maintained on precinct with no other animal, ate fruits, vegetables, tubers and rodent chow and water offered ad libitum. It was submitted to bilateral vasectomy to maintain reproductive behavior on bevy, but not impregnate females. The anaesthesia was performed using ketamine hydrochloride (25 mg/kg IM) and midazolam (0.5 mg/kg IM) as premedication, and isoflurane in open system by facemask diluted in 100% O2 for induction and maintenance. Immediately after induction, was performed epidural anesthesia using 4 mg/kg of lidocaine hydrochloride without vasoconstrictor associated in the same syringe with 0.2 mg/kg of methadone hydrochloride to promote analgesia. As the testes in this species are inside the abdomen, the surgical approach was made by paraprepucial skin incision and ventral midline abdominal incision. After access the cavity, the testes were located and the vaginal tunics were incised to access the vas deferens. After exposed, both were doubly ligated, sectioned and removed a segment of approximately 1 cm of each duct. Finally, the occlusion of subcutaneous and muscle layers were made using 2-0 absorbable and skin with 2-0 non-absorbable sutures. Postoperatively, benzathine penicillin (30,000 IU/kg IM once), tramadol (4 mg/kg IM once) and meloxicam (0.3 mg/kg SC SID for 3 days) were administered. Ten days post-surgery, the animal was fully recovered and after twenty days, it was transferred to enclosure of females. None were fertilized after vasectomy, and there was no change in reproductive behavior among individuals. Discussion: Zoos and breeding have a problem when animal population increases too much, thus vasectomy is an important alternative to avoid this, because it does not lose sexual behavior, but cannot impregnate. The spotted paca presented intracavitary testicles without elevation Skin evidence to scrotum formation, however may also present inguinal regions testes beside penis or scrotum, most evident in reproductive season, similarly occurs in rats and agoutis. In the present case was performed bilaterally vasectomy to have satisfactory results for spermatogenesis reduction, confrming was indicated by some studies in rats and rabbits. Some studies in monkeys and rodents showed that after some time the spermatic cells decrease. In the present study sexual behavior and quality of patient ejaculate, were not completely monitor, to not interfere on management, but there was no female fertilized in a period of 1 year. This procedure showed to be feasible and an easy implementation for maintenance of the estrous cycle of females. Keywords: Cuniculidae, reproduction, rodent, surgery, vas deferens.

Apoptosis in testicular tissue of rats after vasectomy: evaluation of eNOS, iNOS immunoreactivities and the effects of ozone therapy.

We aimed to investigate the changes in endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) expression and apoptotic index in rat testicular tissue, as well as serum and seminal plasma sex hormone levels after vasectomy, and the effect of ozone therapy (OT). Adult male Wistar rats were used (n=6 per group). Control (G1), sham for 4 weeks (G2) or 6 weeks (G3), orchiectomy at the 4(th) (G4) or 6(th) (G5) week after left vasectomy, orchiectomy at the 4(th) (G6) or 6(th) (G7) week after bilateral vasectomy, orchiectomy after 6 weeks OT following left (G8) or bilateral (G9) vasectomy, orchiectomy after 6 weeks OT (G10). In the left testes, while there were increases in eNOS and iNOS immunoreactivity and apoptotic indexes in G4 and G5, no changes were observed in contralateral testis. These values increased in G6 and G7, while OT inhibited these parameters in the left testis of G8 and both testes of G9. Sex hormone levels did not show any changes after vasectomy and ozone therapy. While OT was found to be protective against some parameters mentioned above under stress conditions, it seemed to cause some harmful effects when used in healthy conditions.

Laparoscopic Vasectomy in African Elephants (Loxodonta africana)

To describe a surgical technique for, and outcome after, laparoscopic vasectomy of free-ranging elephants. Case series. African elephants (Loxodonta africana; n = 14). Male elephants (12-35 years old) were anesthetized with etorphine and supported in a sling in a modified standing position, and positive pressure ventilated with oxygen. Anesthesia was maintained with IV etorphine. Vasectomy was performed under field conditions by bilateral, open-approach, flank laparoscopy with the abdomen insufflated with filtered ambient air. A 4-cm segment of each ductus deferens was excised. Behavior and incision healing were recorded for 8 months postoperatively. Successful bilateral vasectomy (surgical time, 57-125 minutes) was confirmed by histologic examination of excised tissue. Recovery was uneventful without signs of abnormal behavior. Large intestine lacerations (3 elephants; 1 full and 2 partial thickness) were sutured extracorporeally. One elephant found dead at 6 weeks, had no prior abnormal signs. Skin incisions healed without complication. Laparoscopic vasectomy can be performed in African elephants in their natural environment.

Laparoscopic Vasectomy vs Laparoscopic Sterilization in Dogs: A Comparison of Two Techniques

Twelve clinically healthy, adult male dogs randomly equally divided into two groups (I and II). Animals of both the groups received xylazine-ketamine anesthesia. Laparoscopic bilateral vasectomy was performed in group I, whereas in animals of group II in additition to vasectomy, spermatic artery-vein plexus were clipped with titanium clips at a distance of 1 to 2 cm. Insufflation of abdominal cavity was achieved by CO2 (2 liter/minute) at 10 mm Hg pressure gradient. Clinical observations revealed no significant changes. Differential leukocyte count (DLC) revealed significant neutrophilia and comparative lymphopenia on 3rd postoperative in both groups. Significant increase (p 0.05) up to 7th postoperative day in animals of group II. On the basis of the parameters studied, it can be concluded that capnoperitoneum at 10 mm Hg pressure gradient and CO2 at the flow rate of 2 liter/minute provides optimum visualization of intra-abdominal organs and found suitable for laparoscopic sterilization in male dogs. The laparoscopic vasectomy alone in male dogs was found comparatively quick, less time consuming and can be successfully applied for mass sterilization program. Oxidative stress in laparoscopic vasectomy (group I) was less as compared to other group.

Long-term effect of vasectomy on spermatogenesis in men: a morphometric study

Spermatogenic damage may occur after vasectomy, and the damage is pressure mediated, occurring when the occluded reproductive tract is unable to accommodate additional sperm produced by the testis. This study aimed to determine the long-term effect of vasectomy on spermatogenesis in humans and clarify how the balance between sperm production in the testis and sperm storage in or removal from the tract might be maintained. During inguinal hernia repair, an open biopsy was performed to obtain testicular tissue blocks from 51 Chinese men (aged ≥50 years), of whom 25 (control group) had not undergone vasectomy and 26 (vasectomized group) had undergone bilateral vasectomy 22-42 years before. Methacrylate resin-embedded testicular sections were made, and morphometric studies were performed using light microscopy. In addition, sizes of the testis and epididymis were estimated with ultrasonography. The testicular tissue blocks obtained from one control and seven vasectomized men consisted almost completely of connective tissue. In the other 43 men, significant differences were not found between the two groups in the testicular or epididymal size, qualitative histology or quantitative parameters including the mean diameter or volume fraction of the seminiferous tubules. In conclusion, sperm production and sperm storage/removal reached a static equilibrium after vasectomy, likely due to spermatogenic degeneration or less sperm production as a result of aging or due to vasectomy-induced testicular (interstitial) fibrosis. Thus, complications that might occur in association with overproduction of sperm and distension of the tract would disappear or be relieved with time.

The Effects of Vasectomy on Testicular Tissue of Mice: Histological Changes and DNA Fragmentation Study

Introduction: We aim to investigate the effect of vasectomy on the histology of the testis as well as to evaluate DNA fragmentation in testicular tissue of male mice. Methods: Bilateral vasectomy was performed on 20 mature male mice; 10 control mice underwent sham-operation. After 6 weeks, the testes were evaluated for histological changes and DNA fragmentation by single cell gel electrophoresis (comet assay). Results: Marked alterations were observed in the testes of vasectomized mice, including degeneration of spermatids, thickened basement membrane, dilatation of the seminiferous tubules, exfoliation of germ cells, reduction in the seminiferous cell population, vacuolated appearance of the epithelium in the tubules and marked interstitial fibrosis. Single cell gel electrophoresis showed a highly significant (P&lt;0.0001) increase in DNA damage among vasectomized mice (46.02%) compared with control group (%27.17) after six weeks of operation. Conclusion: Vasectomy induced deterioration in the seminiferous tubules associated with increased testicular cell’s DNA fragmentation.

Kontralaterale inguinale Metastase eines seminomatösen Hodentumors

We report the case of a 42-year-old patient with contralateral inguinal seminoma metastasis. He had a history of prior bilateral open inguinal hernia repair and scrotal vasectomy. Staging CT revealed no further lymphoma or organ metastases. After discussion of adjuvant treatment options and contacting a referral centre for testicular cancer, adjuvant treatment was performed with 3 cycles of cisplatin, etoposide and ifosfamide. The development of the contralateral inguinal metastasis is most likely caused by the prior inguinal and scrotal surgery, whereas a primary atypical retrograde metastatic route can't be ruled out. Physical examination of the inguinal lymph nodes should be performed in all patients with testicular cancer and prior inguinal and scrotal surgery.