Bm. Shekarriz et al., FIBRIN-GLUE ASSISTED VASOEPIDIDYMOSTOMY - A COMPARISON TO STANDARD END-TO-SIDE MICROSURGICAL VASOEPIDIDYMOSTOMY IN THE RAT MODEL, The Journal of urology, 158(4), 1997, pp. 1602-1605
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.