FIBRIN-GLUE ASSISTED VASOEPIDIDYMOSTOMY - A COMPARISON TO STANDARD END-TO-SIDE MICROSURGICAL VASOEPIDIDYMOSTOMY IN THE RAT MODEL

Purpose. The use of fibrin glue for vasovasostomy has produced high pa tency rates in animal models. Vasoepididymostomy is a microsurgical te chnique that might be made easier if fibrin glue could substitute for microsutures. We evaluated the efficacy of a new vasoepididymostomy te chnique using fibrin glue. Materials and Methods. Bilateral vasoepidid ymostomies were performed in 24 male Sprague-Dawley rats using a conve ntional microsurgical technique on one side and a fibrin-glue assisted technique on the other. The rats were sacrificed 30 days after surger y and anastomotic patency was assessed by examining the vasal fluid fo r sperm, injecting methylene blue dye into the vas deferens and observ ing backflow into the epididymis by gross inspection and histological studies. Additionally, the incidence of granuloma formation was compar ed between the two techniques. Results. Fibrin-glue anastomoses showed a patency rate of 79% (n = 19), compared with 63% (n = 15) for the co nventional suture anastomoses (p = 0.29). Among the patent anastomoses , the incidence of sperm granuloma formation between the sutured (12, 50%) and the fibrin glue anastomoses (16, 67%) did not differ signific antly (p = 0.36). Morphological tissue changes were similar for the tw o techniques. The time required for enastomosis using fibrin glue was significantly shorter than the conventional suture technique (p <0.001 ). Conclusions. Conventional suturing techniques for vasoepididymostom y require advanced microsurgical skills. The use of fibrin glue simpli fies this procedure and provides patency rates comparable to microsutu red, end-to-side anastomoses.