The Experts below are selected from a list of 99 Experts worldwide ranked by ideXlab platform

Marc Goldstein - One of the best experts on this subject based on the ideXlab platform.

  • the impact of obstructive interval and Sperm Granuloma on outcome of vasectomy reversal
    The Journal of Urology, 2004
    Co-Authors: Stephen A Boorjian, Michael E Lipkin, Marc Goldstein
    Abstract:

    ABSTRACTPurpose: We studied the impact of the interval from vasectomy to reversal and presence of Sperm Granuloma on outcomes of reversal.Materials and Methods: A total of 213 microsurgical vasectomy reversals performed by a single surgeon were stratified according to obstructive intervals of less than 5 years, 5 to 10 years, 10 to 15 years and greater than 15 years. The effects of obstructive interval on patency and pregnancy rates were assessed using multivariate logistical regression. The impact of Sperm Granuloma on patency and pregnancy was assessed using the chi-square test.Results: Patency did not change with increasing obstructive intervals as can be seen with 91% patency at less than 5 years, 88% at 5 to 10 years, 91% at 10 to 15 and 89% at greater than 15 years. There was no difference in pregnancy rates (89%, 82% or 86%) at obstructive intervals of 0 to 5, 5 to 10 or 10 to 15 years, respectively. Pregnancy rates were significantly lower (44%, p <0.05) with obstructive intervals greater than 15 ...

  • comparison of absorbable and nonabsorbable sutures for microsurgical vasovasostomy in rats
    Urology, 1999
    Co-Authors: Yefim Sheynkin, Margret S Magid, Diane Carlson, Edward C S Chen, Marc Goldstein
    Abstract:

    Abstract Objectives. At least 12% of initially patent vasovasostomies (VVs) shut down. Currently, only nonabsorbable sutures are used for VV. A synthetic, slowly absorbing, monofilament polyglactin suture has been developed that retains tensile strength for up to 6 months. We performed a prospective controlled randomized study comparing absorbable and nonabsorbable sutures for rat VVs. Methods. Bilateral microsurgical VV was performed in three groups of 36 Wistar male rats, with 10-0 nylon, 10-0 polypropylene, and 10-0 polyglactin sutures. Twelve control rats underwent sham operations. Three rats in each group were killed at 2, 6, 12, and 24 weeks. The abdominal end of the vas deferens was transected and the intraluminal fluid examined microscopically for presence of Sperm. The segment of the vas deferens containing the anastomosis was excised. Fluid from the testicular end was examined for Sperm to confirm Spermatogenesis. Patency was confirmed by an antegrade indigo carmine vasogram of the anastomotic segment. Segments were randomly sent for histologic or tensile strength evaluation. Results. The mean tensile strength of the anastomoses performed with nylon was slightly higher than in polypropylene and polyglactin sutures, although the difference was not statistically significant. Polyglactin consistently maintained tensile strength throughout 6 months without significant fluctuations. The mean patency rate in the polyglactin group was 96%, in nylon 81%, and in polypropylene 61%. Although polyglactin had a consistently higher patency rate compared with nonabsorbable sutures, the difference was not statistically significant ( P = 0.11) but indicated a strong trend. The occurrence of microscopic Sperm Granuloma, muscle layer injuries, intimal fibrosis, and adventitial fibrosis of the vas deferens was not significantly different between suture types. Conclusions. The three suture materials appear equivalent with respect to overall tensile strength of anastomosis; with histologic evaluation, the trend was toward better patency with polyglactin. Polyglactin 10-0 microsurgical suture is a viable alternative to nonabsorbable sutures in microsurgical VVs, although further studies are indicated to assess long-term results.

Stefan Hinz - One of the best experts on this subject based on the ideXlab platform.

  • impact of obstructive interval and Sperm Granuloma on patency and pregnancy after vasectomy reversal
    International Journal of Andrology, 2010
    Co-Authors: Ahmed Magheli, Soroush Raisbahrami, Carsten Kempkensteffen, Wolf H Weiske, Kurt Miller, Stefan Hinz
    Abstract:

    The objective of this study was to determine the effect of the obstructive interval and the presence of a Sperm Granuloma on vas patency and pregnancy rate following vasectomy reversal. We identified 334 patients with complete follow-up who met the inclusion criteria. There were significant associations between the obstructive interval and procedure performed as well as with patient age. Patients with longer obstructive intervals were more often older (p < 0.001) and more likely to have a vaseoepididymostomy performed (p < 0.001). There was no association between the presence of a Sperm Granuloma or the length of the obstructive interval with post-operative vas patency and pregnancy rates. The only independent predictor of post-operative fertility was age of the female partner (p = 0.015). Our data clearly demonstrates that when state of the art surgical techniques are used, neither the presence of a Sperm Granuloma nor the obstructive interval serve as prognosticators of post-operative vas patency and pregnancy rates. However, when counselling patients and their female partners, it is of utmost importance to stress that the age of the female partner is an independent predictor of successful vasectomy reversal.

Pablo Gomez Ochoa - One of the best experts on this subject based on the ideXlab platform.

  • ultrasonographic diagnosis of unilateral scrotal hernia varicocele and Sperm Granuloma in a ram
    Acta Veterinaria Brno, 2009
    Co-Authors: D Lacasta, L M Ferrer, J J Ramos, Pablo Gomez Ochoa
    Abstract:

    A four-year-old ram was presented with a conspicuous hemilateral scrotal enlargement that was noticed four weeks before. Based on the history, clinical signs, palpation, trans-scrotal ultrasonography and semen collection, a left scrotal hernia was diagnosed. Ultrasonographic examination showed a presumably omental fat scrotal hernia with an atrophic left testis and varicocele, and the presence of two Sperm cysts could be observed in the right epididymal tail. The testis appeared as a homogeneous and moderately echogenic structure and it was possible to distinguish atrophy of the left testis that was covered by a hyperechoic area, presumably omental fat, within the hernial sac. In addition, on ultrasound examination non-echogenic tortuous areas were present and diagnosed as varicocele. Post mortem examination confirmed gross lesions identified ultrasonographically. The libido of the ram was normal but the semen showed total azooSpermia. Ultrasound imaging can be used as a diagnostic technique to confirm the diagnosis of scrotal hernia, varicocele, Sperm cyst and testis mineralization.

  • ultrasonographic diagnosis of a unilateral scrotal hernia varicocele and Sperm Granuloma in a four year old ram
    2009
    Co-Authors: D Lacasta, L M Ferrer, J J Ramos, Pablo Gomez Ochoa
    Abstract:

    A four-year-old ram was presented with an important hemilateral scrotal enlargement that was noticed four weeks before. Based on the history, clinical signs, palpation, trans-scrotal ultrasonography and semen collection, a left scrotal hernia was diagnosed. Ultrasonographic examination showed a presumably omental fat scrotal hernia with an atrophic left testis and varicocele, and the presence of two Sperm cysts could be observed in the right epididymal tail. The testis appeared as a homogeneous and moderately echogenic structure and it was possible to distinguish atrophy of the left testis that was covered by a hyperechoic area, presumably omental fat, within the hernial sac. In addition, on ultrasound examination non-echogenic tortuous areas were present and diagnosed as varicocele. Post mortem examination confirmed gross lesions identified ultrasonographically. The libido of the ram was normal but the semen showed total azooSpermia. Ultrasound imaging can be used as a diagnostic technique to confirm the diagnosis of scrotal hernia, varicocele, Sperm cyst and testis mineralization.

Stuart W Mcdonald - One of the best experts on this subject based on the ideXlab platform.

  • macrophages of the Sperm Granuloma 3 months after vasectomy in the albino swiss rat
    Clinical Anatomy, 2000
    Co-Authors: C M Tait, J S Mcginn, E W Milne, N K Bennett, Stuart W Mcdonald
    Abstract:

    This study documents the appearance and arrangement of the macrophages of the Sperm Granuloma 3 months after vasectomy in the Albino Swiss rat. We found, as have others, that the macrophages form a distinct layer in the Granuloma wall, external to the central mass of extravasated Spermatozoa. Those closest to the Spermatozoa showed much phagocytosis. Many had two, three, or more nuclei. The largest macrophages, giant cells of the foreign body and Langhans types, were generally farther from the Sperm mass, but retained evidence of phagocytic activity in the form of Sperm fragments. Macrophages, either mono- or multinucleate, frequently showed numerous surface microridges that interdigitated with those of neighboring cells. The microridges varied in length, but were of uniform thickness and cytoplasmic content and were rarely branched. Monocytes were frequently observed, indicating continuing significant recruitment of cells of the macrophage series to the Granuloma. We also noted mononucleate cells in the connective tissue external to the macrophage layer. Their cytology suggested they were macrophages, but they showed much less phagocytic activity than those of the main macrophage layer and had distinctive aggregations of moderately electron-dense droplets.

  • vasectomy review sequelae in the human epididymis and ductus deferens
    Clinical Anatomy, 1996
    Co-Authors: Stuart W Mcdonald
    Abstract:

    Following vasectomy, Spermatogenesis continues, the human epididymis and ductus deferens may distend and leak, and the extravasated Spermatozoa stimulate formation of a Sperm Granuloma. Granulomas may occur at 60% of vasectomy sites and are usually asymptomatic and relieve intraluminal pressure. About 3-5% of patients experience pain. Intraluminal phagocytosis may explain why some reproductive tracts become depleted of Spermatozoa. Distension of the epididymis is common after vasectomy and may lead to Granuloma formation there. Up to 6% of patients have symptoms, but many with epididymal changes have no discomfort. Most episodes of painful epididymitis and Granulomas resolve with conservative treatment, but < 1% require vasectomy reversal or, if this is ineffective, excision of the epididymis and obstructed ductus deferens.

  • cell recruitment to the Sperm Granuloma which follows vasectomy in the rat
    Clinical Anatomy, 1996
    Co-Authors: J C Caldwell, N K Bennett, J Mcgadey, R Kerr, Stuart W Mcdonald
    Abstract:

    Sperm Granulomas are chronic inflammatory lesions at sites of extravasation of Spermatozoa from the reproductive tract. Using light and transmission electron microscopy, monocytes were identified in the wall of the early Granuloma of the vasectomized rat. Some young macrophages contained Sperm fragments and scanning electron microscopy showed them to wrap around, and partially engulf, Spermatozoa. T-lymphocytes predominated over B-lymphocytes in the Granuloma wall, helper cells being more numerous than suppressor/cytotoxic cells. The percentage of lymphocytes of all classes among the cells of the Granuloma wall was higher at 3 months than at 3 weeks and 6 months after vasectomy, reflecting the high immunological activity known to occur at this interval after vasectomy in the rat.

Yefim Sheynkin - One of the best experts on this subject based on the ideXlab platform.

  • comparison of absorbable and nonabsorbable sutures for microsurgical vasovasostomy in rats
    Urology, 1999
    Co-Authors: Yefim Sheynkin, Margret S Magid, Diane Carlson, Edward C S Chen, Marc Goldstein
    Abstract:

    Abstract Objectives. At least 12% of initially patent vasovasostomies (VVs) shut down. Currently, only nonabsorbable sutures are used for VV. A synthetic, slowly absorbing, monofilament polyglactin suture has been developed that retains tensile strength for up to 6 months. We performed a prospective controlled randomized study comparing absorbable and nonabsorbable sutures for rat VVs. Methods. Bilateral microsurgical VV was performed in three groups of 36 Wistar male rats, with 10-0 nylon, 10-0 polypropylene, and 10-0 polyglactin sutures. Twelve control rats underwent sham operations. Three rats in each group were killed at 2, 6, 12, and 24 weeks. The abdominal end of the vas deferens was transected and the intraluminal fluid examined microscopically for presence of Sperm. The segment of the vas deferens containing the anastomosis was excised. Fluid from the testicular end was examined for Sperm to confirm Spermatogenesis. Patency was confirmed by an antegrade indigo carmine vasogram of the anastomotic segment. Segments were randomly sent for histologic or tensile strength evaluation. Results. The mean tensile strength of the anastomoses performed with nylon was slightly higher than in polypropylene and polyglactin sutures, although the difference was not statistically significant. Polyglactin consistently maintained tensile strength throughout 6 months without significant fluctuations. The mean patency rate in the polyglactin group was 96%, in nylon 81%, and in polypropylene 61%. Although polyglactin had a consistently higher patency rate compared with nonabsorbable sutures, the difference was not statistically significant ( P = 0.11) but indicated a strong trend. The occurrence of microscopic Sperm Granuloma, muscle layer injuries, intimal fibrosis, and adventitial fibrosis of the vas deferens was not significantly different between suture types. Conclusions. The three suture materials appear equivalent with respect to overall tensile strength of anastomosis; with histologic evaluation, the trend was toward better patency with polyglactin. Polyglactin 10-0 microsurgical suture is a viable alternative to nonabsorbable sutures in microsurgical VVs, although further studies are indicated to assess long-term results.