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Histological study of vas deferens following intravasallaser irradiation

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Asian Journal of Andrology 2003年第4期5卷 287-294页

作者： Xiao-HongWen Xin-MinXiao PengHuang Xian-YongXie Zheng-WeiYang MorphometricResearchLaboratory DepartmentofUrology ChinesePLA452ndHospitalChengdu610021China DepartmentofPathology NorthSichuanMedicalCollegeNanchong637007China

Aim: To study the histologic changes of the vas deferens following Nd: YAG laser irradiation. Methods: Intravasal laser irradiation was given to (i) 52 segments of rabbit (laser dosage: 2 seconds at 40 W-50 W) and 16 segments of human (3 seconds at 45 W-55 W) vas deferens in vitro, (ii) 25 rabbit vasa (2 seconds-2.5 seconds at 40 W-45 W) in vivo and (iii) 2 human vasa (3 seconds at 55W) in vivo. Segments of vasa were removed from the in vivo irradiated vasa deferentia 15 days-180 days (rabbit) or 15 days (man) after the exposure. All vas segments were embedded in methacrylate resin. Serial sections (thickness 25μm-30μm) 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. Conclusion: Laser irradiation can induce long-term vas occlusion; for rapid occlusion, laser doses just completely destroying the mucosal layer will be advisable.

关键词： histology laser male contraception photocoagulation vas deferens vas occlusion

Early microrecanalization of vas deferens following biodegradable graft implantation in bilaterally vasectomized rats

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Asian Journal of Andrology 2009年第3期11卷 373-378页

作者： Christopher M. Simons Barry R. De Young Thomas S. Griffith Timothy L. Ratliff Erin Jones Surya K. Mallapragada Moshe Wald Department of Urology University of Iowa Iowa City IA 52242-1089 USA Department of Pathology University of Iowa Iowa City IA 52242-1089 USA Department of Chemical and Biological Engineering Iowa State University Ames IA USA

We evaluated a biodegradable graft for reconstruction of rat vasa deferentia with long obstructed or missing segments. A total of 47 Sprague-Dawley rats underwent bilateral vasectomy and were divided into groups according to length of the vas deferens affected （0.5, 1, 1.5 cm）. After 8 weeks, poly-（D,L-lactide）（PDLA） grafts were used to reconnect the vas deferens, Grafts and adjoining vasa deferentia were excised 8 and 12 weeks later and evaluated microscopically. At 8 weeks, microscopic changes included a robust inflammatory response around the grafts. All grafts were still intact but in the early stages of degradation. No microtubules, indicative of vas deferens recanalization, were identified. One specimen showed evidence of healing and neovascularization at the interface zone between the vas deferens and the graft. At 12 weeks, grafts were further degraded but still present. Microscopic evaluation showed decreased inflammation. Seven specimens showed neovascularization at the interface zone; two of these showed distinct epithelialized vas deferens microcanals at the graft edges. One specimen showed a microcanal spanning the entire 0.5-cm graft. A time period of 8 weeks is not ample enough for vas deferens regeneration in the setting of a biodegradable PDLA graft; however, early evidence of re-growth was seen at 12 weeks. A longer healing time should permit further biodegradation of the graft, as well as re-growth and possible eventual reconnection of the vas deferens, allowing passage of sperm. These findings suggest a potential role for biodegradable grafts in the reconstruction ofvas deferens with long obstructed segments.

关键词： graft infertility male vas deferens

Micro-recanalization in a biodegradable graft for reconstruction of the vas deferens is enhanced by sildenafil citrate

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Asian Journal of Andrology 2010年第6期12卷 814-818页

作者： Peter A. Holoch Surya K. Mallapragada Carlos A. Ariza Thomas S. Griffith Barry R. DeYoung Moshe Wald DePartment of Urology University of lowa lowa City 1A 52242 USA Department of Chemical Engineering Iowa State University Ames IA 50011 USA Department of Pathology University of Iowa Iowa City IA 52242 USA

This study investigated the effect of sildenafil citrate on micro-recanalization and neovascularization, which were previously demonstrated in a rat model using biodegradable grafts （BGs） for vas deferens reconstruction. A total of 24 male rats underwent bilateral vasectomy with removal of a 0.5-cm vasal segment and were randomly assigned to four groups. Groups 1 and 2 underwent immediate vasovasostomy. Groups 3 and 4 underwent interposition of a 0.5-cm BG in the vasal gap. Groups 1 and 3 were given 5 mg kg-1 day-1 oral sildenafil. Other groups were given placebo. Rats were housed with females 12 weeks postoperatively. Reconstructed vasal segments were harvested 16 weeks postoperatively and analyzed histologically. Fluid from the distal vasal stump was analyzed for motile sperm. Urine samples obtained 16 weeks postoperatively were analyzed for cGMP levels. cGMP levels in rats treated with sildenafil were signifcantly higher than in control rats. No pregnancies were sired by grafted groups. In all, 5/6 rats in group 1 and 3/6 rats in group 2 sired litters. No motile sperm were noted in the vasal fluid of the grafted groups. Motile sperm were noted in all rats in group 1 and in 5/6 rats in group 2. In addition, 29 and 4 microcanals were detected in the sildenafil and placebo groups, respectively （P = 0.023）. No microcanal exceeded 3 mm in length. An average of 12 and 28 blood vessels per graft were noted in the placebo and sildenafil groups, respectively （P 〈 0.0001）. In conclusion, sildenafil enhances micro-recanalization and neovascularization in BG used for vas deferens reconstruction, but does not increase the microcanal length after 16 weeks.

关键词： graft infertility male sildenafil citrate vas deferens vasectomy

Morphological changes of spermatozoa in proximal vas deferens after vasectomy

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Asian Journal of Andrology 1999年第1期1卷 61-65页

作者： Ren-QianWEN Shi-QinLI Chun-XiangWANG Qing-HuiWANG Mei-YiLIU FantityPlanningResearchInstituteofGuangdong Guangzhou510600China FamilyPlanningResearchInstituteofShenzhen Shenzhen518006China

Aim: To investigate the morphological changes of spermatozoa in the proximal vas deferens after vasectomy.Methods: Proximal vas deferens fluids were collected from 79 fertile men (group A) and 64 vasectomized men (groupB) during the operations of vasectomy or vasovasostomy. Sperm morphology in the proximal vas deferens wasanalyzed after staining with the modified Papanicolaou method. Results: The percentage of spermatozoa with anormal oval head from group B (50.7 % ± 21.7 % ) was significantly lower than that of group A (75.2 % ±11.1%). The data in group A was similar to those of normal semen and therefore represents the physiologicalcondition of the proximal vas deferens sperm of fertile men. There were no significant differences in the percentages ofnormal oval heads in group B with the time since vasectomy. Conclusion: After vasectomy, the spermatozoa in theproximal vas deferens and epididymis were continuously degenerating and being replenished by spermatozoa comingfrom testis. The obvious morphological degeneration occurred in the sperm tail and spermatozoa with a small oval headand amorphous heads were increased.

关键词： spermatozoa vas deferens epididymis vasectomy vasovasostomy

Non-invasive reversal of intraluminal vas deferens polymer injection-induced azoospermia——technology

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Asian Journal of Andrology 1999年第3期1卷 131-134页

作者： Sujoy K.Guha Centre for Biomedical Engineering Indian Institute of Technology and All India Institute of Medical Sciences New Delhi-110016 India

Aim: The rationale and technique underlying a novel concept of non-invasive removal of an intravasal vas deferens poly-meric contraceptive drug to reverse drag injection-induced azoospermia are explained. Thus the conventional methods ofsurgical exploration to remove vas deferens plugs and intravasal injection of solvents to flush out contraceptive drugs are tobe replaced by steps which will be readily accepted by subjects. Methods: The approach is based upon the non-invasiveapplication of specific forces to various segments of the vas deferens so that non-sclerosing and non-tissue-adherent com-pounds, in particular styrene maleic anhydride (SMA) can be expelled. Forces are generated by palpation; percuta-neous electrical stimulation; vibration application; and percussion. The forces help to propel the intravasal polymer to-wards the ejaculatory duct for expulsion during ejaculation. All aspects of the total technique are clinically acceptable,simple, atraumatic, unlikely to cause pain and discomfort even without tranquilizers, local or general anaesthetics. Theprocedure may be repeated several times in different sittings spaced apart by about one week to achieve adequate plug ex-pulsion. Results: Model experiments demonstrated the feasibility of the concept. The polymer was nonadherent andcould be moved within the vas deferens by the application of specific forces. Sufficient removal was possible to enablespermatic fluid to be transported along a region previously occupied by the polymer. A corroborating subhuman primatestudy by an independent investigator has shown that the semen profile becomes normal following the reversal. Conclu-sion: Adoption of the new technique may provide a means of non surgical restoration of normal semen profile after a pe-riod of fertility control obtained by intravasal drag injection. (Asian J Androl 1999 Sep ; 1: 131 - 134)

关键词： vas deferens male contraceptive agents maleic anhydrides sterilization reversal palpation electric stimulation

Biophysical mechanism-mediated time-dependent effect on sperm of human and monkey vas implanted polyelectrolyte contraceptive

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Asian Journal of Andrology 2007年第2期9卷 221-227页

作者： Sujoy K. Guha School of Medical Science and Technology Indian Institute of Technology and National Institute of Medical Science and Technology Kharagpur 721302 India

Aim： To determine the short and long-term morphological effects on sperm as induced by intra-vas alteration of pH and electrical charge. Methods： Desired biophysical influences were obtained by injection of reversible inhibition of sperm under guidance （RISUG） into the lumen of the vas deferens of human subjects and the monkey. RISUG is a polyelectrolyte hydrogel complex of styrene maleic anhydride （SMA） and dimethyl sulfoxide （DMSO） which generates an electrostatic charge and also lowers in a near space of pH domain. The morphology of sperm was examined by light microscopy, scanning and transmission electron microscopy. Human study enabled semen collection by masturbation as early as 3 h after injection and studies extended up to 6 months, in the monkey, on vas excision after RISUG implantation, sperm characteristics were examined in serial sections. Results： Semenology in clinical studies and histological data of the monkey showed a time-sequenced sperm plasma membrane, tail mitochondria and nuclear decondensation alterations in sperm structural components, which beared marked similarity to changes in the sperm head and tail during capacitation and entry into the ovum. Conclusion： The findings provide a means of causing such changes in the sperm that inhibit the fertilizing ability before the nucleus is affected. Therefore achieving non-obstructive vas-based contraception, without genotoxic or teratogenic effects caused by infertile sperm passing into the semen, is feasible.

关键词： reversible inhibition of sperm under guidance vas deferens electrical charge sperm electron microscopy acrosome mitochondria chromatin decondensation

vasectomy reversal： a clinical update

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Asian Journal of Andrology 2016年第3期18卷 365-371,I0007页

作者： Abhishek P Patel Ryan P Smith Department of Urology University of Virginia Charlottesville VA 22908-0422 USA.

vasectomy is a safe and effective method of contraception used by 42-60 million men worldwide. Approximately 3%-6% of men opt for a vasectomy reversal due to the death of a child or divorce and remarriage, change in financial situation, desire for more children within the same marriage, or to alleviate the dreaded postvasectomy pain syndrome. Unlike vasectomy, vasectomy reversal is a much more technically challenging procedure that is performed only by a minority of urologists and places a larger financial strain on the patient since it is usually not covered by insurance. Interest in this procedure has increased since the operating microscope became available in the 1970s, which consequently led to improved patency and pregnancy rates following the procedure. In this clinical update, we discuss patient evaluation, variables that may influence reversal success rates, factors to consider in choosing to perform vasovasostomy versus vasoepididymostomy, and the usefulness of vasectomy reversal to alleviate postvasectomy pain syndrome. We also review the use of robotics for vasectomy reversal and other novel techniques and instrumentation that have emerged in recent years to aid in the success of this surgery.

关键词： epididymovasostomy microsurgery postvasectomy orchialgia postvasectomy pain syndrome vas deferens vasectomy vasectomy reversal vasoepididymostomy vasovasostomy

A 30-year retrospective study of rare ectopic seminal tract opening cases

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Asian Journal of Andrology 2020年第3期22卷 287-291页

作者： Hong-Fei Wu Jia-Geng Zhu Jian-Zhong Lin Guang-Dong Shi Jia-Qi Yu Wei-Zhang Xu Hong-Bo Yu Department of Urology Nanjing BenQ Hospital Affiliated to Nanjing Medical UniversityNanjing 210019China Department of Urology Nanjing First HospitalNanjing Medical UniversityNanjing 210006China Department of Urology Gaogang Hospital of Traditional Chinese MedicineTaizhou 225321China Fourth Clinical Institute Nanjing Medical UniversityNanjing 211166China Department of Urology Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and Nanjing Medical University Affiliated Cancer HospitalNanjing 210019China

Ectopic seminal tract openi ng is a rare con genital malformation.Until rece ntly,there has been a lack of comprehensive reporting on the condition.The purpose of this retrospective study is to summarize the experience of diagnosis and treatment of this condition based on 28 clinical practice cases throughout the past 30 years.We conducted auxiliary examinations on such patients including routine tests,imaging examinations,and endoscopy.Among these 28 cases,there were ectopic opening of vas deferens into enlarged prostatic utricles(6 cases);ejaculatory ducts into enlarged prostatic utricles,Mullerian ducts cysts,and urethras(18 cases,2 cases,and 1 case,respectively);and ectopic opening of the unilateral vas deferens and the contralateral ejaculatory duct into enlarged prostatic utricle(1 case).The size of the enlarged prostatic utricle,the type of ectopic seminal tract opening,and the opening's location effectively assisted in the selection of clinical treatment methods,including transurethral fenestration of the utricle,transurethral cold-knife incision,open operation,laparoscopic operation,and conservative treatment.Satisfactory effect was achieved during follow-up.In conclusion,a definite diagnosis and personalized treatment are especially important for patients with ectopic seminal tract opening.

关键词： congenital malformation ectopic opening ejaculatory duct enlarged prostatic utricle vas deferens

L-NAME诱发的高血压大鼠输精管的胆碱能收缩：西地那非的作用

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Asian Journal of Andrology 2010年第3期12卷 415-421,I0012页

作者： Serap Gur Suresh C. Sikka Gillian E. Knight Geoffrey Bumstock Wayne J.G. Hellstrom Department of Urology Tulane University Health Sciences Center New Orleans LA 70112 USA Autonomic Neuroscience Centre Royal Free and University College Medical School Rowland Hill Street London NW32PF UK

Hypertension （HTN） is a risk factor for erectile dysfunction, but its effect on vas deferens （VD） contractility and the ejaculatory response has not been delineated. NG-nitro-L-arginine methyl ester （L-NAME）, a nitric oxide synthase inhibitor, was used for induction of nitric oxide （NO）-deficient HTN. Our aim was to evaluate the effects of L-NAME-induced HTN on rat VD contractility and to determine whether sildenafil affects VD contractility. A total of 36 male rats were divided into （1） control, （2）L-NAME-HTN, （3） sildenafil treated L-NAME-HTN groups. Group 2 was treated with L-NAME （40 mg kgI per day） in drinking water for 4 weeks. Group 3 received sildenafil （1.5 mg kg^-1 per day, by oral gavage） concomitantly with L-NAME. The prostatic portion of the VD was subjected to electrical field stimulation （EFS, 1-20 Hz）, and the P2X1 agonist α,β-methylene ATP （α,β meATP, 100 μmol L^-1-1 μmol L-1） and the al-adrenoceptor agonist phenylephrine （Phe, 100 μmol L^-1-1 mmol L^-1） were used to construct concentration-response curves. These experiments were repeated in the presence of P2X receptor antagonist, pyridoxalphosphate-6-azophenyl-2＇,4＇-disulfonic acid （PPADS, 30 μmol L-1）. VD contractions in response to EFS, a,β-meATP and Phe were significantly enhanced by L-NAME. Sildenafil treatment in the L-NAME group improved the contractile response of VD to EFS （20 Hz）. In the presence of PPADS, the enhanced contractile response of VD to EFS and a,β-meATP in hypertensive rats was reversed. In the rat model of chronic NO depletion, the purinergic and adrenergic components and EFS affect VD contractility. The VD contractile response may be mediated more by the purinergic system than the adrenergic system, and sildenafil may alter the ejaculatory response in men with PE.

关键词： hypertensive rat NG-nitro-L-arginine methyl ester purinergic receptors P2X sildenafil vas deferens