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Int Urol Nephrol. 1971;3(3):265-70.

On the surgery of the vas deferens.



The most frequent indication for blocking the vas arises in prostatic surgery. By dividing the vas, the urethro-vasal reflux, an etiological factor in postoperative epididymitis, is eliminated. If infection is already present, blocking may be ineffective. Also it may be ineffective if performed at the termination of a prostatic operation because during such surgery infectious material may be pressed into the genital tract. In family planning recanalization of a divided vas has been observed. However surgical recanalization has but limited chances of success. A method of temporary reversible blockade would probably popularize this procedure. A method is described in which the stumps of the divided vas are exteriorized instead of being buried in the scrotum. Recanalization, funiculitis, and spermatic granuloma are thus avoided. Clamping of the vas was found to be unsatisfactory. Obturation of the vas with silver wire or nylon thread in the lumen was then used. The obturated vas was then exteriorized by wrapping it around with scrotal skin thus producing a "coffee handle" effect. This avoided complications following burying the occluded vas in the scrotum. Vasography with contrast fluid showed that it was necessary to adjust the calibre of the obstructing agent to the vasal lumen. Microscopic examination after 1-2 weeks showed only slight inflammatory reaction from the silver wire. After removal of the wire normal patency was restored. However the nylon thread caused destructive changes ending in complete obstruction of the lumen. Severence of the "coffee handle" permitted retraction of the stumps of the vas so that attempts at surgical reunion would be made more difficult. Ligation of the exteriorized vas in the "coffee handle" by black silk thread proved best. The blockade is thus assured and secondary recanalization facilitated if desired.

[Indexed for MEDLINE]

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