No abstract available.
Humans ; Male* ; Sterilization ; Sterilization, Reproductive*

Vasectomy as a male sterilization has been performed popularly in the world including Korea from 1962. In recent demand for reversal of reproduction increases more than past times due to sudden loss of offspring or change of mind. In this presentation, we report 13 cases of vasovasostomy operated from December in l983 to June in 1985 and observe the results after operation & technics used at our department of urology. The results after operation is described anatomically & functionally with ratio.
Korea ; Reproduction ; Sterilization, Reproductive ; Urology ; Vasectomy ; Vasovasostomy*

No abstract available.
Abortion, Therapeutic* ; Female* ; Humans ; Pregnancy ; Sterilization, Reproductive*

Vasectomy as a male sterilization has become increasingly popular as one of methods of planned parenthood in many countries including Korea. In this presentation the subject of an overview of male sterilization consists of mainly technical aspects of the ordinary vasectomy and vasovasostomy. the principle of vasectomy is same but some many different technics have been reported and utilized. specific differences are found in technics for immobilizing the vas for making the scrotal incision. for treating the cut ends of vasa, and for removing segments of vas Therefore the author discusses some important factors so as to provide complete protection against the passage of sperm without any failure and to improve the chances of later reversibility according to his experiences of over 7000 vasectomies and 200 vasovasostomis. In the part of ordinary vasectomy procedure, various items such as ideal operative level local anesthesia immobilization of the vas skin incision isolation for the vas treatments of the cut ends of vas prevention of hematoma formation disappearance rate of residual sperm immediate sterility technic complication psychological effects and antibodies following vasectomy are reviewed. In the part of vasovasostomy numerous factors such as operative technics splint various factors for the successful operation overall success rates and low pregnancy rates are discussed and compared with the author's series.
Anesthesia, Local ; Antibodies ; Hematoma ; Humans ; Immobilization ; Infertility ; Korea ; Male* ; Pregnancy Rate ; Skin ; Spermatozoa ; Splints ; Sterilization ; Sterilization, Reproductive* ; Vasectomy ; Vasovasostomy

PURPOSE: Because of the volume of elective sterilizations performed in the world during the past decade, the vasectomy was a popular method for male sterilization in Korea and this, in turn, had been followed by an increase in the number of patient requiring vasectomy reversal with the high rate of subsequent divorce and remarriage. Recently, many authors have reported high success rates of vasovasostomy using microsurgical techniques and we performed modified two layer vasovasostomy with intravasal silicone tube to increase postoperative patency and pregnacy rate. METHODS: Microscopic vasovasostomy was performed in 9 patients at our department using modified two layer vasovasostomy with silicone tube insertion. Their ages ranged from 28 to 44 with an average of 35.78+/-1.36 years. Standard Guibor silicone tube, consisting of two 17.7cm, 0.064cm diameter, malleable, stainless steel probes connected by 29cm of silicone tubing wedged onto disposable probes, were used in all cases. RESULTS: Success rates were 88.8% for patency and pregnancy 44.4% for pregnancy in modified two layer vasovasostomy with silicone tube insertion. The patency rates were higher in cases of long postoperative day and in cases of short duration of vasectomy and vasovasostomy. CONCLUSION: We used a modified method to correspond the patency and pregnancy rate in microscopical modified two layer vasovasostomy using the intravasal silicone tube permanently. This method brings normal patency in microsurgical vasovasostomy because the silicone tube prevent obstruction of anastomosed site of the vas permanently.
Divorce ; Humans ; Korea ; Marriage ; Microsurgery ; Pregnancy ; Pregnancy Rate ; Silicones ; Stainless Steel ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy

Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patients requesting vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy persist between the patency and pregnancy rate despite improvements in surgical techniques. A total of 200 patients undergoing vasovasostomy from May 1983 to April 1990 were reviewed. Of these 200 patients, only 130 patients (98 patients by two-layer, 32 patients by modified two-layer technique) could be followed up and analyzed as to pregnancy rate related to age, vasal obstructive interval, gross appearance and sperm quality of the vas fluid, operative method, and presence or absence of sperm granuloma. Success rates were 90.3% for patency and 65.4% for pregnancy. With regard to factors influencing to operation, it seemed that the results were better when there was a shorter vasal obstructive interval, watery vas fluid, presence of normal morphologic sperm quality, presence of sperm granuloma, and when the operation was done using the two-layer technique. However, no statistically significant difference was found, except between the bilateral presence and absence of sperm granuloma at the vasectomy site. Thus it is suggested that the most important single factor influencing the success rate of vasovasostomy is a meticulous and skillful operative technique itself, althought other factors may affect the outcome. More effort and research are needed to find the factors affecting the success rate of vasovasostomy.
Granuloma ; Humans ; Infertility* ; Korea ; Pregnancy Rate ; Pregnancy* ; Spermatozoa ; Sterilization, Reproductive ; Vasectomy ; Vasovasostomy*

PURPOSE: Vasectomy has become a popular method for male sterilization in Korea and this, in turn, has been followed by an increase in the number of patient requiring vasectomy reversal. Recently, many authors have reported high success rates of vasovasostomy using microsurgical techniques. The purpose of this study was to compare patency and pregnancy rates and operation time of a new method for vasovasostomy developed at the Department of Urology, Dong-A University Hospital with those of other methods, and to find out other factors influencing patency and pregnancy rates. MATERIALS AND METHODS: Microscopic vasovasostomy was performed in 149 patients from June 1990 to September 1997 at our department. Among 89 patients who could be followed up post-operatively, standard two layer vasovasostomy was performed in 22 patients, modified one layer vasovasostomy with 4 full thickness sutures in 32 patients and modified one layer vasovasostomy with 5 full thickness sutures developed at our department in 35 patients. We compared mean operation times and patency and pregnancy rates between the techniques and examined patency and pregnancy rates according to age, vasal obstruction interval, presence of sperm in vas fluid and sperm granuloma. RESULTS: Success rates were 95.5% for patency and 68.2% for pregnancy in standard two layer vasovasostomy, 87.5% for patency and 59.42% for pregnancy in modified one layer vasovasostomy with 4 full thickness sutures and 97.1% for patency and 65.7% for pregnancy in modified one layer vasovasostomy with 5 full thickness sutures and there was statistical significance in the patency rates between each method (p<0.05). Mean operation times were 136.6+/-19.2 minutes in standard two layer vasovasostomy, 86.6+/-16.8 minutes in modified one layer vasovasostomy with 4 full thickness sutures and 96.7+/-18.4 minutes in modified one layer vasovasostomy with 5 full thickness sutures (p<0.001). With regard to factors influencing operation, the pregnancy rates were slightly higher in cases of younger patients, presence of sperm in vas fluid and presence of sperm granuloma (p>0.05) and significantly lower in case of longer vasal obstruction interval (p<0.0005). CONCLUSIONS: We found little difference in success rates between standard double layer vasovasostomy and modified one layer vasovasostomy with 5 full thikness sutures and the latter was easier and more time saving technique.
Granuloma ; Humans ; Korea ; Pregnancy ; Pregnancy Rate ; Spermatozoa ; Sterilization, Reproductive ; Sutures ; Urology ; Vasectomy ; Vasovasostomy*

AIMTo study the histologic changes of the vas deferens following Nd: YAG laser irradiation.

METHODSIntravasal laser irradiation was given to (i) 52 segments of rabbit (laser dosage: 2 seconds at 40 W approximately 50 W) and 16 segments of human (3 seconds at 45 W approximately 55 W) vas deferens in vitro, (ii) 25 rabbit vasa (2 seconds approximately 2.5 seconds at 40 W approximately 45 W) in vivo and (iii) 2 human vasa (3 seconds at 55 W) in vivo. Segments of vasa were removed from the in vivo irradiated vasa deferentia 15 days approximately 180 days (rabbit) or 15 days (man) after the exposure. All vas segments were embedded in methacrylate resin. Serial sections (thickness 25 microm approximately 30 microm) were obtained and observed under a light microscope.

RESULTS(i) Laser-induced damage reached the muscularis layer in 27% and 94% of the rabbit and human vas segments in vitro, respectively. (ii) Fourteen of the 25 in vivo rabbit vasa were completely occluded by fibrous tissue and the longer the time interval after treatment, the more likely was the vas occluded. Those unoccluded vasa had either a normal histology or a mucosal damage. (iii) One in vivo human vas was almost completely occluded by the fibrous tissue but the other had a relatively large lumen packed with sperm granulomatous tissue and partial destruction of the smooth muscle layer.

CONCLUSIONLaser irradiation can induce long-term vas occlusion; for rapid occlusion, laser doses just completely destroying the mucosal layer will be advisable.

Animals ; Humans ; Laser Coagulation ; Male ; Rabbits ; Sterilization, Reproductive ; methods ; Vas Deferens ; anatomy & histology ; Vasectomy

The article gives a detailed introduction of the process of marking flat tube needle for vas deferens puncture and a brief explanation of its application. This kind of tube needle can be easily made of readily available material, convenient to be cleaned and sterilized, with high success rate of puncturing and good effect. Other tube needles can be made by imitating it.
Equipment Design ; Humans ; Male ; Needles ; Punctures ; instrumentation ; Sterilization, Reproductive ; instrumentation ; Vas Deferens

OBJECTIVETo study the effect of Ar(+) laser on human vas deferens and to compare the effects of using different radiation levels with varying thickness of tissue and varying levels of injury.

METHODSAfter initial tests on animals, four human scrotums were opened and treated directly with Ar(+) laser radiation. Then 58 human individual scrotums were treated with radiation by the method of trans-skin puncture. The rate of sperm reduction and elimination was tested.

RESULTSIn 60 cases, the sperms were found to be eliminated completely after six months of radiation treatment. In 2 cases the sperms were found not to be eliminated completely due to the insufficient radiation.

CONCLUSIONAr(+) laser is one of the best forms of radiation for coagulation of vas deferens. It can be used to coagulate vas deferens without any complications or sequelae.

Adult ; Follow-Up Studies ; Humans ; Laser Coagulation ; Male ; Sterilization, Reproductive ; methods ; Vas Deferens ; surgery