Fibrin glue vasal anastomosis compared to conventional sutured vasovasostomy in the rat. 1991

J I Silverstein, and B C Mellinger
Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York 11042.

Vasectomy reversal has become a frequently performed surgical procedure with best results obtained with the use of the operating microscope and microsurgical technique. The present study was undertaken to evaluate the use of fibrin glue ("Tisseel", Immuno U.S., Inc.) for vasovasostomy and to compare this technique to conventional sutured vasovasostomy. Utilizing 60 male Sprague Dawley rats, a conventional two layered sutured anastomosis of vasovasostomy (30 rats) was compared to a fibrin glue technique of vasal anastomosis (30 rats). The fibrin glue technique was performed with two transmural sutures, was unstented, and utilized the biological glue to seal the anastomosis. The contralateral vas of each animal underwent vasectomy and reapproximation of unligated ends so that the rate of spontaneous recanalization could be accessed. Rats were sacrificed at 24 hours, one week, four weeks, and three months postvasovasostomy. The vasal specimens were evaluated for gross patency, presence and size of sperm granuloma, mean flow rates at varying infusion pressures, tensile strength measurements and histologic studies. Combining the one and three month groups, a similar patency rate was obtained by either technique; 83% (n = 18) for the sutured group, and 90% (n = 21) for the fibrin glue group. The rate of spontaneous recanalization of the contralateral vasa in the one and three month animals was 8% (n = 38). The mean flow rates obtained at high and low infusion pressures were not statistically different for the two techniques. The tensile strength of the glue anastomosis averaged 78% of the tensile strength achieved by the conventional sutured technique. The incidence of sperm granuloma after vasovasostomy was 28% for the fibrin glue group and 61% for the sutured group. Additionally, 67% of granulomas were small (less than 3 mm.) in the glue group, compared to only 36% in the sutured group. Histology revealed similar morphological changes in the area of anastomosis with either technique. Operative time for sutured vasovasostomy averaged 24 minutes, compared to an average of 11 minutes for the glue assisted vasovasostomy. The use of fibrin glue allowed the performance of a sperm tight patent anastomosis that had the advantages of reduced incidence of sperm granuloma formation, reduced operative time, and less microsurgical skill required to perform the anastomosis.

UI MeSH Term Description Entries
D008297 Male Males
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D011919 Rats, Inbred Strains Genetically identical individuals developed from brother and sister matings which have been carried out for twenty or more generations or by parent x offspring matings carried out with certain restrictions. This also includes animals with a long history of closed colony breeding. August Rats,Inbred Rat Strains,Inbred Strain of Rat,Inbred Strain of Rats,Inbred Strains of Rats,Rat, Inbred Strain,August Rat,Inbred Rat Strain,Inbred Strain Rat,Inbred Strain Rats,Inbred Strains Rat,Inbred Strains Rats,Rat Inbred Strain,Rat Inbred Strains,Rat Strain, Inbred,Rat Strains, Inbred,Rat, August,Rat, Inbred Strains,Rats Inbred Strain,Rats Inbred Strains,Rats, August,Rats, Inbred Strain,Strain Rat, Inbred,Strain Rats, Inbred,Strain, Inbred Rat,Strains, Inbred Rat
D006099 Granuloma A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. Granulomas
D000714 Anastomosis, Surgical Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side. Surgical Anastomosis,Anastomoses, Surgical,Surgical Anastomoses
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D013718 Tensile Strength The maximum stress a material subjected to a stretching load can withstand without tearing. (McGraw-Hill Dictionary of Scientific and Technical Terms, 5th ed, p2001) Strength, Tensile,Strengths, Tensile,Tensile Strengths
D014654 Vascular Patency The degree to which BLOOD VESSELS are not blocked or obstructed. Patency, Vascular,Patencies, Vascular,Vascular Patencies

Related Publications

J I Silverstein, and B C Mellinger
November 1995, The Journal of surgical research,
J I Silverstein, and B C Mellinger
January 1994, Investigative urology (Berlin, Germany),
J I Silverstein, and B C Mellinger
October 2005, The Journal of urology,
J I Silverstein, and B C Mellinger
January 1997, European urology,
J I Silverstein, and B C Mellinger
August 1988, Diseases of the colon and rectum,
J I Silverstein, and B C Mellinger
April 1992, Fertility and sterility,
J I Silverstein, and B C Mellinger
January 1984, Archives of oto-rhino-laryngology,
J I Silverstein, and B C Mellinger
April 2015, Journal of plastic surgery and hand surgery,
Copied contents to your clipboard!