Routine Antibiotic Prophylaxis is not Necessary for No Scalpel Vasectomy

No scalpel vasectomy (NSV) is the recommended technique for male contraception. Majority of surgeons use oral antibiotics for 3–5 days following the procedure. The reasons cited for routine use of antibiotics include that most of these operations are performed in camps where asepsis in less than adequate, most patients are unclean and unhygienic surrounding environment. However, there is no database of wound infection following NSV. This study was undertaken to find out the incidence of wound infection following No scalpel vasectomy if no antibiotic prophylaxis is used. Patients undergoing NSV in the minor operation theatre attached to the Surgical Out Patient Department were included in the study. A standard preoperative part preparation protocol was followed in all patients. All procedures were performed under local anesthesia after obtaining informed consent. Post-operatively patients were advised an oral anti-inflammatory drug for 3–5 days and were reviewed after 1 week for development of wound infection. Over a 4-year period, 322 patients underwent NSV and no patient developed wound infection. Hence, it is concluded that routine antibiotic prophylaxis is not necessary for NSV.     

Vasectomy in Male Contraception and its Reversal

Vasectomy is an important option for male contraception. It is highly effective, but many questions about patient selection and information, surgical technique, postoperative follow-up, and complications have to be defined. The use of the no-scalpel technique to access the vasa is associated with the fewest complications. The technique with the lowest failure rate is catheterization of the vasa with fascial interposition. A single postvasectomy semen sample at 3 mo showing rare, azoospermia or nonmotile sperm is acceptable to confirm sterility. No data show that vasectomy is associated with the risk of prostate or testicular cancer.Up to 6% of men who have undergone vasectomy will demand reversal in the form of vasovasostomy or vasoepididymostomy for various reasons. In the age of in vitro fertilization, it becomes even more important to report outcomes after vasectomy reversals.The operative microscope for andrologic procedures has provided enhanced magnification and accuracy for vasectomy reversal. Now robot-assisted microsurgery is used more and more in andrology, but what is its interest in this particular indication?     

No Scalpel, No IV, No Stitch, Microendoscopic Office Laparoscopy Under Local Anesthesia

Background:

The medical literature is replete with articles verifying the usefulness of laparoscopic procedures under local anesthesia. Recent research has examined the efficacy of microendoscopy with local anesthesia. In this series of patients, we focused on new technology to determine if microendoscopy could be utilized in an office setting.

Methods:

Between July 1994 and April 1995, we performed 51 microendoscopic office laparoscopy under local anesthesia (MICRO-OLULA) using the 1.5 mm Pixie laparoscope by Origin, a 1.7 mm laparoscope by Optimed and 5 mm laparoscope by Jarit. All cases were performed in an office operating room at the Women''s Medical Plaza in Montgomery, Alabama. Only one patient was unable to have the procedure completed due to intolerance under local anesthesia.

Results:

Fifty-one micro-olulas were performed on these patients who had an average age of 31 years and an average weight of 157 pounds. Intraoperative abdominal time averaged 3 minutes. One case was done with a 5 mm laparoscope and five cases with the 1.7 mm Optimed laparoscope. The 1.5 mm Pixie laparoscope was used in 45 patients.

Conclusions:

Our patients seemed to like the idea of a small device to view their pelvic cavities. The small laparoscopes provide excellent cosmesis, and laparoscopes deserve further development and clinical trial to determine their most advantageous use in the office setting.     

雌激素与雄性生殖

雌激素与男(雄)性生殖密切相关。人和哺乳动物体内芳香化酶(Ar)参与合成雌激素,雌激素与特异受体(ERα、ERβ)结合,行使其生物学效应。雌激素受体和Ar在雄性生殖器官所有发育阶段几乎都有表达,并通过对生殖细胞、Sertoli细胞、Leyd ig细胞和附睾的多方面调节而发挥作用。     

精囊生理功能的研究进展

精囊的生理功能影响到生育,现综述近年来精囊功能的常用指标、精囊对精液凝固功能及精液粘稠度的影响、以及精囊调节精子的运动和抗氧化功能及免疫效应方面的研究进展。     

精子DNA完整性在男性不育中的作用

精子DNA完整性对自然受精或人工授精 ,胚胎、胎儿和婴儿的发育至关重要。研究表明 ,夫妇中丈夫精子DNA受损率超过 30 %时 ,自然受精率很低。精子DNA完整性被认为是优于传统精液参数的男性不育指标 ,已经有多种方法可用于检测 ,而且监测精子DNA完整性可用于评估欲行辅助生殖技术 ,如卵细胞胞质内单精子注射 (ICSI)治疗的夫妇。最后对精液冷冻和制备技术对精子DNA完整性的影响进行了总结。     

Comparison of the Short-Term Effects of Vasoligation and Open-Ended Vasectomy on the Reproductive Tract of the Male Rat

Comparison was made between the short term effects of vasoligation and open-ended vasectomy in the rat at 2, 4 and 8 weeks after surgery. Epididymal granulomata were observed in 2/5 and 1/5 rats respectively 2 and 4 weeks after vasoligation. No epididymal granulomata were observed following open-ended vasectomy, providing some support for the suggestion that this procedure may be beneficial in reducing early post operative complications in the epididymis. An unexpected observation in the 2 week open-ended vasectomy group was the finding that in 2 of 5 animals the proximal end of the vas had been temporarily obstructed by overgrowth of a fibromuscular cap. Increased distal cauda epididymidis tubule diameter in these animals suggested an increased intratubular pressure. No sustained differences were seen in the incidence of granulomata or in the response of the testis or epididymis to either vasectomy procedure by 8 weeks. The results suggest, because of the high incidence of granulomata formation following vasoligation in the rat, that by 8 weeks after surgery both vasectomy procedures are equally effective in preventing further damage in the epididymis caused by elevated intraluminal pressures.     

Vasectomy in prostatic surgery.

A prospective study was conducted to evaluate the usefulness of vasectomy in prostatic surgery. The results showed that vasectomy does not reduce the incidence of epididymitis. Since vasectomy is not without disadvantages (such as sterility, some prolongation of the operation and the possible occurrence of complications) vasectomy as a routine in prostatic surgery is not indicated.     

Role of Complimentary Therapy for Male LUTS

Phytotherapy, the use of plant based extracts (derived from fruits, seeds, roots, or bark) as medicines or health-promoting agents are often used as first-line treatments for bothersome male lower urinary tract symptoms (LUTS). Their use, either as monotherapy or in conjunction with conventional pharmaceutical treatments is becoming increasingly popular worldwide. There are now over 30 of these phytotherapeutic compounds available, with saw palmetto and pygeum being the most widely used. This paper discusses the mechanism of action, reported efficacies and potential side effects of a number of the most common phytotherapies being used for male LUTS, as well as summarizes outcome data relevant to these agents from the most current peer-reviewed publications.     

肾素-血管紧张素系统在雄性生殖中的意义

除血循环外其他组织也存在一些局部肾素 血管紧张素系统 (RAS)调节机制。雄性生殖系统包括睾丸、附睾和前列腺等都有局部RAS的表达。局部RAS对相应部位功能具有调节作用 ,而其本身也受到性激素、脂肪酸、缺氧和药物的影响。研究发现局部RAS不仅与雄性生殖功能有关 ,与前列腺增生也有关系。除此之外 ,局部RAS的检测可能对雄性生殖系统的肿瘤早期诊断有意义     

Vasectomy in birds: a review

Vasectomy is done to produce infertility by surgically removing a portion of the ductus deferens from both testicles. In birds, vasectomy can be done internally or externally. Internal vasectomy is performed by severing and removing a section of the ductus deferens through bilateral celiotomy or by endoscopic-guided techniques. Vasectomy can be done externally using standard surgical procedures in those species possessing seminal glomera. In this review, the surgical techniques used to perform vasectomy in birds and the implications and applications of each technique are discussed.     

PK刀在腹腔镜阑尾切除术中的应用

目的评估PK刀在腹腔镜阑尾切除(LA)中的应用价值。方法回顾性分析广西桂东人民医院2009年6月至2010年6月期间68例行LA患者的临床资料,其中PK刀组34例,高频电凝钩组34例,比较2组患者的手术时间、术中出血量、术后肠道功能恢复时间及住院时间。结果所有手术均获成功,无中转开腹及术后大出血等并发症发生,PK刀组较高频电凝钩组的手术时间明显缩短(P<0.05)、术中出血量明显减少(P<0.05)及术后肠道功能恢复时间更快(P<0.05);住院时间2组间差异无统计学意义(P>0.05)。结论 PK刀具有凝固均匀、完全、热损伤少、止血效果好、操作简单等优点,可选择性地应用于LA。     

PK等离子刀在腹腔镜脾切除术中的应用

目的探讨PK等离子刀在腹腔镜脾切除术(laparoscopicsplenectomy,LS)中的应用。方法对5例特发性血小板减少性紫癜患者采用PK等离子刀行LS术。结果5例均顺利完成手术,手术时间平均140(70～260)min。术中出血量平均120(50～640)ml。无中转开腹,术后无继发出血。结论PK等离子刀凝血功能强,术中出血少,是较理想的切割止血工具;使用PK等离子刀行LS安全可行,且效果良好。     

Scalpel versus electrocautery in modified radical mastectomy

Forty nine consecutive mastectomy patients were randomized to one of two groups. Twenty four patients had skin flaps created with the cold scalpel and twenty five with the electrocautery. The two groups were similar with respect to age, stage of disease, size of tumor, and weight. Cautery patients had significantly less operative blood loss when compared with scalpel patients, 352 versus 507 milliliters, respectively, P less than 0.05. No cautery patient required transfusion compared with three transfused scalpel patients, P less than .005. Total postoperative hemovac drainage and hospital stay were not significantly different between the two groups. Although the number of fever days and wound complications were slightly higher in the cautery group, the difference was not statistically significant. The electrocautery may be superior to the scalpel for mastectomy.