1
|
Samplaski MK, Rodman JCS, Perry JM, Marks MBF, Zollman R, Asanad K, Marks SF. Sperm granulomas: Predictive factors and impacts on patency post vasectomy reversal. Andrologia 2022; 54:e14439. [PMID: 35524153 PMCID: PMC9541413 DOI: 10.1111/and.14439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/06/2022] [Accepted: 03/18/2022] [Indexed: 12/04/2022] Open
Abstract
The objective of this study was to identify factors that predict for sperm granuloma formation and the impact of sperm granuloma presence and quantity on vasectomy reversal (VR) outcomes. A cross sectional retrospective review of prospectively collected data, on the impact of granuloma on VR outcomes from a single academic center was performed. The impact of age, obstructive interval, intraoperative vasal fluid findings, anastomosis type, body mass index, tobacco use and total motile count (TMC) was determined. A total of 1550 men underwent VR between January 2000 and August 2019. Granulomas were present unilaterally in 23.3% (n = 361) and bilaterally in 14.2% (n = 220). On univariate analysis, increasing patient age negatively correlated with a larger number of granulomas (p = .011). Granuloma presence was associated with finding intact and motile sperm from the vasal stump intraoperatively (p = .001), and vasoepididymostomy anastomosis (p < .001). However, granuloma presence (and quantity) did not correlate with obstructive interval or maximum TMC. Tobacco use and body mass index (BMI) were not associated with granuloma presence. On multivariate analysis, granuloma quantity was not associated with TMC. Obstructive interval and vasovasostomy anastomosis were associated with higher TMC, while BMI was negatively associated with TMC. In conclusion, increasing age was negatively correlated with granuloma formation. Granuloma presence was associated with more favourable intraoperative fluid findings and anastomosis type, but not post‐VR TMC, suggesting men with and without granulomas undergoing skilled microsurgery will have similar patency rates. Heavier men should be encouraged for weight loss prior to vasectomy reversal as increasing BMI was associated with lower TMC.
Collapse
Affiliation(s)
- Mary K Samplaski
- Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - John C S Rodman
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, California, USA
| | | | | | - Robert Zollman
- International Center for Vasectomy Reversal, Tucson, Arizona, USA
| | - Kian Asanad
- Institute of Urology, University of Southern California, Los Angeles, California, USA
| | - Sheldon F Marks
- International Center for Vasectomy Reversal, Tucson, Arizona, USA
| |
Collapse
|
2
|
Yang F, Li J, Dong L, Tan K, Huang X, Zhang P, Liu X, Chang D, Yu X. Review of Vasectomy Complications and Safety Concerns. World J Mens Health 2021; 39:406-418. [PMID: 32777870 PMCID: PMC8255399 DOI: 10.5534/wjmh.200073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/10/2020] [Accepted: 06/18/2020] [Indexed: 01/25/2023] Open
Abstract
Vasectomy is a simple, safe, effective, and economical method used worldwide for long-term male contraception. As a surgical operation, it has short-term and long-term complications such as hematoma formation, infection, sterilization failure, sperm granulomas, short-term postoperative pain (nodal pain, scrotal pain, and ejaculation pain), and chronic pain syndrome. Whether it increases the risk of autoimmune disease, cardiovascular disease, testicular cancer, or prostate cancer is still controversial. Changes in plasma concentrations of luteinizing hormone, follicle-stimulating hormone, and testosterone after vasectomy have also been studied, as well as the relation between vasectomy and sexual function. Sperm quality decreases very slowly after vasectomy, and vasovasostomy and intracytoplasmic sperm injection could help a couple achieve a pregnancy if they change their minds at any point. We include a follow-up strategy and suggestions for follow-up care at the end of this review.
Collapse
Affiliation(s)
- Fang Yang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Junjun Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liang Dong
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Kun Tan
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaopeng Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihai Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaozhang Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Degui Chang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xujun Yu
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| |
Collapse
|
3
|
[Vasectomy : Current information]. Urologe A 2021; 60:523-532. [PMID: 33738559 DOI: 10.1007/s00120-021-01494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Abstract
Vasectomy is considered to be the simplest, most effective and cheapest method of fertility control in men, with a significantly lower risk of morbidity and mortality compared to tubal ligation in women. Patient informed consent is particularly important and should include potential irreversibility, surgical options, anesthesia, possible complications as well as postoperative behavior and the need for re-evaluation. There are different access routes available with conventional and no-scalpel vasectomy as well as different techniques for closing the ends of the vas deferens. To confirm sterility the European Association of Urology (EAU) recommends that an ejaculate analysis should be performed 3 months after the procedure and after approximately 20 ejaculations. Complications are relatively rare, although particularly vasectomy failure due to recanalization has to be considered. Approximately 3-6% of vasectomized men strive for a refertilization, which with experienced surgeons is successful in about 90% of cases.
Collapse
|
4
|
Nesro J, Sendo EG, Yesuf NT, Sintayehu Y. Intention to use vasectomy and associated factors among married men in Addis Ababa, Ethiopia. BMC Public Health 2020; 20:1228. [PMID: 32787807 PMCID: PMC7424675 DOI: 10.1186/s12889-020-09316-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background Vasectomy is one of the highly effective and non-reversible types of long-term family planning methods for men. Ethiopia has a limited number of studies on the use of vasectomy, and they are focused on men rather than married men. The current study was aimed to identify the intention to use vasectomy as a method of contraception among married men in the study setting. Methods A community-based cross-sectional study was conducted from February 1 – April 30, 2018. A sample of 422 married men was recruited using a systematic random sampling method. We conducted face to face interviews with a structured questionnaire (i.e. closed-ended questions). Data were entered into Epi data version 3.1 and SPSS version 23 used for data analysis. The statistical association between the outcome variable (Intention to use vasectomy) and the explanatory variables were first tested with binary logistic regression. Multivariable logistic regression was used to control for confounding effect of each predictor. Results The study findings showed that the intention to use vasectomy as a method of family planning was reported as high (24%). About 34.8% of the respondents had good knowledge and nearly a quarter (23.2%) of them had a positive attitude toward the acceptance of vasectomy use. In multivariate analysis, age range between 30 and 39 years [AOR = 2.4, 95% CI = (1.16–4.82)], having good knowledge about vasectomy use [AOR = 6.22, 95% CI = (3.17–12.21)], and having a positive attitude toward vasectomy use [AOR = 7.81, 95% CI = (4.25–14.38)] were factors significantly associated to use vasectomy as compared to their counterparts. Conclusion The level of acceptance of vasectomy (24%) was high compared to the level of its use in developing countries (i.e. if acceptability translates to use). The study revealed that age, good knowledge, and a positive attitude towards the use of vasectomy were important predictors of the intention to accept vasectomy. To further promote the use of vasectomy effective communication strategies in family planning programs are needed.
Collapse
Affiliation(s)
- Jemila Nesro
- Department of Midwifery, Jimma University, Jimma, Ethiopia
| | - Endalew Gemechu Sendo
- Department of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
| | - Nete Tofik Yesuf
- Department of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Yitagesu Sintayehu
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia
| |
Collapse
|
5
|
Histomorphometric Investigation of Changes In Adult Rat Testis After Experimental Vasectomy At Different Periods. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.666778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
6
|
de Oliveira FB, Pereira VX, Oliveira FR, de Abreu LC, Daboin BEG, Norberto AR, de Alcantara Sousa LV, Tavares LFB, Glina S. Effect of ductus deferens lavage on the time to achieve azoospermia in patients undergoing vasectomy. Clinics (Sao Paulo) 2018; 73:e504. [PMID: 30304302 PMCID: PMC6152136 DOI: 10.6061/clinics/2018/e504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/01/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the effect of normal saline lavage of the distal vas deferens ampulla in patients undergoing vasectomy on the time to achieve azoospermia. METHODS A prospective randomized study of 60 men divided into two groups, group lavage (GL, n=30) in which distal vas deferens ampulla lavage was performed with 10 ml of normal saline during the vasectomy, and group without lavage (GWL, n=30) in which control patients received only a vasectomy. The patients provided sperm for semen analysis at the 5th, 10th, 15th, 20th and 25th ejaculations. RESULTS Fifteen participants in GL and 16 in GWL, for a total of 31 patients, were excluded due to not completing the control spermiogram. The tests carried out at the five ejaculations showed immobile spermatozoa in 40 and 85.71%, 66.67 and 78.57%, 93.33 and 85.71%, 86.67 and 71.43%, and 93.33 and 85.71% of participants in GL and GWL, respectively. CONCLUSION Vas deferens duct lavage with 10 ml of normal saline during vasectomy did not decrease the time required to achieve postoperative azoospermia.
Collapse
Affiliation(s)
- Francisco Barros de Oliveira
- Programa de Pos-graduacao, Faculdade de Medicina do ABC (FMABC), Santo Andre, SP, BR
- *Corresponding author. E-mail:
| | - Vadelias Xavier Pereira
- Programa de Pos-graduacao, Faculdade de Medicina do ABC (FMABC), Santo Andre, SP, BR
- Programa de Pos-graduacao, Faculdade de Medicina FMUSP, Sao Paulo, SP, BR
| | | | - Luiz Carlos de Abreu
- Programa de Pos-graduacao, Faculdade de Medicina do ABC (FMABC), Santo Andre, SP, BR
- Programa de Pos-graduacao, Faculdade de Medicina FMUSP, Sao Paulo, SP, BR
| | | | - Alex Rey Norberto
- Programa de Pos-graduacao, Faculdade de Medicina do ABC (FMABC), Santo Andre, SP, BR
| | | | | | - Sidney Glina
- Programa de Pos-graduacao, Faculdade de Medicina do ABC (FMABC), Santo Andre, SP, BR
- Disciplina de Urologia, Faculdade de Medicina do ABC (FMABC), Santo Andre, SP, BR
| |
Collapse
|
7
|
Vasectomy with vessel sealing device: comparison of different diameters. Int J Impot Res 2018; 31:20-24. [PMID: 30154455 DOI: 10.1038/s41443-018-0066-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/25/2018] [Accepted: 08/06/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Vasectomy is a popular and effective male surgical contraceptive method. Different techniques have been proposed to reduce failure rates and complications. In this study, we sought to compare vas deferens occlusion rates using both standard occlusion techniques and LigaSure (LSVS) for vasectomy. MATERIAL AND METHODS A total of nine patients underwent open radical retropubic prostatectomy at our institution. During the procedure, a total of 125 fresh vas deferens samples were obtained and divided into four groups as follows: Group 1: ligation (n = 22), Group 2; ligation and electrocauterization (n = 18), Group 3; 5 mm LSVS (n = 44), Group 4; 10 mm LSVS (n = 41). All specimens were harvested during surgery and subsequent histopathological assessments were performed to assess the luminal status of the vas deferens. RESULTS Histopathological evaluation revealed that the majority of vas lumens with LSVS (79.5% of Group 3 and 89.4% of Group 4) were totally occluded. With standard techniques, however, the majority of vas lumens (86.4 and 77.8% of Groups 1 and 2, respectively) maintained a tiny patency. CONCLUSIONS On histopathological review, the application of LSVS resulted in better occlusion rates, compared to standard ligation methods. These findings suggest a higher occlusive role for LSVS for vasectomy. Further clinical studies are needed to confirm the clinical efficacy and safety of this technique.
Collapse
|
8
|
Ekanayake-Alper DK, Wilson SR, Scholz JA. Retrospective Review of Surgical Outcomes and Pair-housing Success in Vasectomized Rhesus Macaques ( Macaca mulatta). Comp Med 2018; 68:168-176. [PMID: 29663943 PMCID: PMC5897974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/04/2017] [Accepted: 07/01/2017] [Indexed: 06/08/2023]
Abstract
Providing social housing for adult male macaques can be challenging. One successful strategy for long-term social housing of adult male macaques is to pair them with adult females; however, unwanted breeding must be prevented by sterilization of the male or female. Vasectomy is a simple, highly effective, and minimally invasive method of contraception that is used at our institution to facilitate social housing. We performed a retrospective review to analyze the surgical outcomes and rate of postoperative complications after vasectomy of adult rhesus macaques at our research facility. In addition, we evaluated the success rate of pairing vasectomized macaques with female partners. Over 10 y, 16 macaques were vasectomized, of which 5 developed postoperative complications such as orchitis, epididymitis, or surgical site infection. These complications resolved completely and without incident after antibiotic and analgesic therapy; an additional male had postoperative incisional swelling that resolved quickly after NSAID treatment. This complication rate is consistent with that in humans by surgeons who perform open vasectomies relatively infrequently. In addition, 5 of the vasectomized macaques (31%) developed sperm granulomas, which are a common and generally benign complication in humans and have been reported to develop in 40% of macaques after vasectomy. Successful pair housing with a female partner was achieved for 13 of 16 (81%) of the vasectomized macaques. We conclude that surgical vasectomy is a safe and simple procedure that can be used as a highly effective method to facilitate social housing of adult male rhesus macaques in research facilities.
Collapse
Affiliation(s)
- Dilrukshi K Ekanayake-Alper
- Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut, USA; Columbia Center for Transplant Immunology and Institute of Comparative Medicine, Columbia University Medical Center, New York, New York, USA
| | - Steven R Wilson
- Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Jodi A Scholz
- Department of Comparative Medicine, Yale School of Medicine, New Haven, Connecticut, USA; Department of Comparative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,
| |
Collapse
|
9
|
Kısa S, Savaş E, Zeyneloğlu S, Dönmez S. Opinions and Attitudes About Vasectomy of Married Couples Living in Turkey. Am J Mens Health 2017; 11:531-541. [PMID: 26634860 PMCID: PMC5675235 DOI: 10.1177/1557988315620275] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study was conducted as a descriptive study, designed to determine the opinions and attitudes of married couples living in Turkey about vasectomy. The sample consisted of 350 women. Researchers used a questionnaire to collect data. Descriptive statistics and chi-square analysis were used. The results showed that 14% of women and 43.0% of men were of the opinion that undergoing a vasectomy procedure was a sin. Chi-square analysis determined statistically significant differences between the male and female groups ( p < .05). More than 88.0% of the men were not willing to have vasectomy and 35.4% thought that vasectomy had a negative effect on marriage and sexual health. In addition, 58.9% thought that vasectomy had a negative effect on men's health. Women were more likely than men to see vasectomy as merely a cultural taboo instead of a sin. Sociocultural factors, such as ideas that contraception is the woman's responsibility, that sterilized men lose status in society, or that sterilized men lose authority in the family, as well as misconceptions about vasectomy such as concerns about sexual functioning, psychological effects, and effects on physical strength, were determined to be the main barriers for vasectomy use in Turkish culture. The study recommends determining strategies for overcoming sociocultural barriers by raising awareness and increasing the utilization of vasectomy. Couple-specific family planning programs can make an important contribution toward improving awareness of the benefits of vasectomy.
Collapse
Affiliation(s)
- Sezer Kısa
- Oslo and Akershus University College of Applied Sciences, Kjeller, Norway
| | | | | | | |
Collapse
|
10
|
Abstract
Vasectomy is the most effective form of sterilization for men. With approximately 500,000 vasectomies performed each year in the United States, 1-2% of these patients will experience chronic testicular pain for greater than three months after the procedure. Post-vasectomy pain syndrome (PVPS) is diagnosis of exclusion, and may be caused by direct damage to spermatic cord structures, compression of nerves in the spermatic cord via inflammation, back pressure from epididymal congestion, and perineural fibrosis. Treatment should begin with the most noninvasive options and progress towards surgical management if symptoms persist. Noninvasive therapies include acupuncture, pelvic floor therapy and pharmacologic options. Ultimately, management of PVPS requires a multimodal approach. Thorough understanding of the potential etiologies of PVPS along with the therapeutic options currently available is important to improve quality of life.
Collapse
Affiliation(s)
- Varsha Sinha
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
11
|
Lowe G. Optimizing outcomes in vasectomy: how to ensure sterility and prevent complications. Transl Androl Urol 2016; 5:176-80. [PMID: 27141443 PMCID: PMC4837312 DOI: 10.21037/tau.2016.03.04] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Vasectomy provides a long-term effective sterilization for men and is performed on nearly 500,000 men annually in the United States. Improvements in technique have led to a decreased failure rate and fewer complications, although significant variations in technique exist. Use of cautery occlusion with or without fascial interposition appears to have the least failures. A no-scalpel approach lowers risk of hematoma formation, infection and bleeding post-operatively. A patient can be considered sterile when azoospermia is achieved or the semen analysis shows less than 100,000 non-motile sperm per milliliter. Incorporating these principles may allow the physician to optimize outcomes in vasectomy.
Collapse
|
12
|
Altok M, Şahin AF, Divrik RT, Yildirim U, Zorlu F. Prospective comparison of ligation and bipolar cautery technique in non-scalpel vasectomy. Int Braz J Urol 2016; 41:1172-7. [PMID: 26742977 PMCID: PMC4756945 DOI: 10.1590/s1677-5538.ibju.2014.0356] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 01/27/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES There is no trial comparing bipolar cautery and ligation for occlusion of vas in non-scalpel vasectomy. This study aimed to compare the effectiveness of these vasectomy occlusion techniques. MATERIALS AND METHODS Between January 2002-June 2009, patients were allocated in alternate order. We recruited 100 cases in cautery group and 100 cases in ligation group. Non-scalpel approach was performed during vasectomy and fascial interposition was performed in all cases. First semen analysis was done 3 months after vasectomy. Vasectomy success was defined as azoospermia or non-motile sperm lower than 100.000/mL. RESULTS Four patients from the cautery group were switched to the ligation group due to technical problem of cautery device. Thus, data of 96 patients as cautery group and 104 patients as ligation group were evaluated. After vasectomy, semen analyses were obtained from 59 of 96 (61.5%) patients in cautery group and to 66 of 104 (63.5%) patients in ligation group. There was no statistical significant difference between the two groups in terms of the success of vasectomy (p=0.863). CONCLUSION Although bipolar cautery technique is safe, effective and feasible in non-scalpel vasectomy, it has no superiority to ligation. There was no statistically significant difference in terms of the success and complications between the two groups.
Collapse
Affiliation(s)
- Muammer Altok
- Department of Urology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | | | - Rauf Taner Divrik
- Department of Urology, Şifa University, Faculty of Medicine, Izmir, Turkey
| | | | - Ferruh Zorlu
- Department of Urology, M.H. Tepecik Research and Education Hospital, Izmir, Turkey
| |
Collapse
|
13
|
Abnormal Accumulation of Collagen Type I Due to the Loss of Discoidin Domain Receptor 2 (Ddr2) Promotes Testicular Interstitial Dysfunction. PLoS One 2015; 10:e0131947. [PMID: 26158267 PMCID: PMC4497730 DOI: 10.1371/journal.pone.0131947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/08/2015] [Indexed: 02/07/2023] Open
Abstract
Background Loss of functional allele for discoidin domain receptor 2 (Ddr2) results in impaired Leydig cell response to luteinizing hormone (LH), low testosterone production and arrested spermatogenesis in older male Ddr2slie/slie mice. However, the underlying mechanism responsible for this phenotype remains unknown. Herein, we reported for the first time that the deregulated expression of Ddr2 cognate ligand, namely collagen type I (COL1), may account for the disruption of the testicular steroidogenesis in Ddr2slie/slie mutant testes. Methodology/Principal Findings Expression of Ddr2 increased gradually along postnatal development, whereas COL1 expression became negligible from adulthood onwards. In Ddr2slie/slie mutant testis, however, in contrast to the undetectable staining of Ddr2, COL1 expression was constantly detected, with the highest values detected during adulthood. In the experimental vasectomy model, Ddr2slie/slie mutant mice exhibited an early androgen deficiency than wild-type mice, along with the accumulation of fibrotic tissue in the interstitium. Functionally, ablation of endogenous Ddr2 resulted in a significant decrease of testosterone (T) level in TM3 cells in the presence of higher concentration of COL1 treatment. Conversely, overexpression of Ddr2 could help TM3 cells to maintain a normal testicular steroidogenesis even in the presence of high concentration of COL1. Additionally, attenuated expression of Ddr2 correlates to the deregulated level of serum T levels in human pathological testes. Conclusions Abnormal accumulation of interstitial COL1 may be responsible for the steroidogenic dysfunction in Ddr2slie/slie mutant testes.
Collapse
|
14
|
Coe TM, Curington J. An inexpensive yet realistic model for teaching vasectomy. Int Braz J Urol 2015; 41:373-8. [PMID: 26005982 PMCID: PMC4752104 DOI: 10.1590/s1677-5538.ibju.2015.02.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 07/28/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Teaching the no-scalpel vasectomy is important, since vasectomy is a safe, simple, and cost-effective method of contraception. This minimally invasive vasectomy technique involves delivering the vas through the skin with specialized tools. This technique is associated with fewer complications than the traditional incisional vasectomy (1). One of the most challenging steps is the delivery of the vas through a small puncture in the scrotal skin, and there is a need for a realistic and inexpensive scrotal model for beginning learners to practice this step. MATERIALS AND METHODS After careful observation using several scrotal models while teaching residents and senior trainees, we developed a simplified scrotal model that uses only three components-bicycle inner tube, latex tubing, and a Penrose drain. RESULTS This model is remarkably realistic and allows learners to practice a challenging step in the no-scalpel vasectomy. The low cost and simple construction of the model allows wide dissemination of training in this important technique. CONCLUSIONS We propose a simple, inexpensive model that will enable learners to master the hand movements involved in delivering the vas through the skin while mitigating the risks of learning on patients.
Collapse
Affiliation(s)
- Taylor M. Coe
- University of California, San Diego - School of Medicine, San Diego, California, United States
| | - John Curington
- Department of Family Medicine, UCSD School of Medicine, La Jolla, California, United States
| |
Collapse
|