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To evaluate the association of body mass index (BMI) and spermatic vein diameters (SVDs) in men treated for varicocele.One hundred fourteen men who underwent scrotal color duplex ultrasounds prior to microsurgical varicocelectomy were classified as normal (BMI = 18.5-24.9), overweight (25-29.9), or obese (≥30). SVDs were measured with and without Valsalva, standing and supine. SVD, pre- and postoperative...
A 47-year-old male and his 34-year-old wife presented with two years of infertility. He had poor semen quality and a low serum testosterone. Physical examination revealed a grade 3 left and a grade 2 right varicocele. He underwent bilateral subinguinal microsurgical varicocelectomy. The “sign of the fox” is the typical appearance of the wounds just prior to closure after bilateral repair.
When men present for vasectomy, incidental varicoceles may be discovered. After varicocelectomy, the deferential veins become the only avenue for testicular venous return and could be compromised during nonmicroscopic vasectomy. We discuss the indications and technique required to safely perform simultaneous vasectomy and varicocelectomy.From 1992 to 2005, 18 (4.8%) of 379 men presenting for vasectomy...
Vasoepididymostomy outcomes are heavily dependent on the surgeon’s microsurgical experience and skill. To avoid back-walling the tubular lumen, the needles are generally placed inside-out through the vasal lumen using double-armed microsutures. These double-armed sutures for infertility microsurgery are very expensive and may be difficult to obtain. We describe a randomized trial that used a novel...
Objectives. At least 12% of initially patent vasovasostomies (VVs) shut down. Currently, only nonabsorbable sutures are used for VV. A synthetic, slowly absorbing, monofilament polyglactin suture has been developed that retains tensile strength for up to 6 months. We performed a prospective controlled randomized study comparing absorbable and nonabsorbable sutures for rat VVs.Methods. Bilateral microsurgical...
Objectives. To evaluate the effect of commonly used intraoperative vasography and tissue staining agents, indigo carmine, methylene blue, and Renografin, on sperm motility.Methods. Semen from 20 healthy men was obtained after 2 to 4 days of abstinence. Sperm motility was initially evaluated in each specimen. Standard solutions of indigo carmine, methylene blue, and Renografin-60 were diluted 2x and...
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