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Vasal reanastomosis using fibrin glue combined with sutures: which combination of sutures in a delayed protocol?
O Vankemmel1, A de la Taille, J M Rigot
1Clinique Urologique, Centre Hospitalier Universitaire, Lille, France.
Objectives:
The actual number of transmural sutures needed to ensure a successful fibrin-glued vasovasostomy is a key study parameter of the few experimental works already published. The present work was done to evaluate fibrin-glued vasovasostomy in rats in combination with only 2 transmural sutures. We compared the results to our previous study in which we demonstrated the efficiency of a combination of the use of fibrin glue with 3 sutures in comparison with a conventional microsurgical technique.
Materials And Methods:
Twenty Sprague-Dawley rats underwent bilateral vasectomy followed 2 weeks later by bilateral vasovasostomy using fibrin glue combined with 2 transmural sutures. Each animal was sacrificed 7 weeks postoperatively after a 3-week mating period with a Sprague-Dawley female rat, the vasal specimens were evaluated for sperm granuloma formation. Mean operative time and fertility rates were recorded.
Results:
The combination of fibrin glue with 2 transmural sutures gave evidence of less successful performances than the combination with 3 transmural sutures and the conventional microsurgical technique for all parameters evaluated but the mean operative time.
Conclusion:
Our study underlines the need for a third transmural suture placed 120 degrees apart from the others when performing a fibrin glue delayed vasovasostomy. This allows a better vas lumen opening at the anastomotic site and therefore a more efficient vasal anastomosis in a delayed protocol.