Fournier's gangrene of the scrotum following day case vasectomy

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Complications of vasovasostomy

Microsurgical vasovasostomy has become a common urologic procedure. A successful anastomosis is related to good mucosal alignment and a water-tight anastomosis rather than to a specific technique. The presence of vasal or epididymal sperm granulomas as well as antisperm antibodies will also influence postoperative pregnancy rates.

Vasectomy

Vasectomy has become a popular method of family planning in recent years in Australia. The relatively simple procedure is effective, has few complications and usually does not require hospitalisation.

Estrogens and surgery in women with von Willebrand's disease

While receiving estrogen therapy, three women with classic type I von Willebrand's disease showed significantly less bleeding and improved hemostasis. One took estrogens to prevent menopausal symptoms, and two used oral contraceptives. These women underwent major surgery without excessive bleeding and without requiring cryoprecipitate or other blood components. Prior to estrogen therapy, each woman had received cryoprecipitate or fresh frozen plasma to stop bleeding from dental extractions or other surgical procedures. Furthermore, two other women with type I von Willebrand's disease also exhibited improved hemostasis while taking oral contraceptives. These experiences suggest a short course of estrogen therapy may effectively prepare some women with von Willebrand's disease for elective surgery.

[Experience with the tupla-clip for tubal sterilization by laparoscopy (author's transl)]

For the last 18 months a plastic clip made of polyoxymethylene was used for tubal sterilization by laparoscopy. The clip was used in 140 cases. This report reviews 106 cases. One pregnancy occurred early in this series. There were no other complications. The advantages of the method are the short operating time and the elimination of intra-abdominal damage by heat. Reversibility of the method has not yet been assessed.

Hematoma of liver: a lesion-mimicking hepatic neoplasm

A plethora of case reports of women on birth control agents who present with hepatic masses and who are ultimately found to have liver neoplasms have overshadowed the clinicians' awareness of other possible diagnoses in patients who present in a similar fashion. Hematomas of the liver, secondary to vascular lesions induced by these agents, must be considered and preoperative attempts to make the diagnosis must be ensured by obtaining appropriate studies.

Vasectomy for voluntary male sterilisation

Vasectomy was performed in 90 men in Department of Surgery II of the University Central Hospital of Helsinki during the period January 1st, 1972 to December 31st, 1973. Operation was performed on an ambulatory basis under local anesthesia. After resection and ligation of vas deferens the cut ends were placed in different fascial planes in order to avoid recanalisation. The patients were mainly in the age group 31-40 years. Seven patients had postoperative complications, scrotal hematoma being the most common. Recanalisation was found in one patient, in whom a new operation was performed. The author stresses the importance of a correct vasectomy method, histological verification of the divided vasa and most of all the postoperative sperm analysis. Two negative sperm analyses with an interval of at least 1 month must be recorded before sterility can be confirmed.