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Urologic microsurgery

Ryan M Dickey, Alexander W Pastuszak, Tariq S Hakky, Aravind Chandrashekar, Ranjith Ramasamy, Larry I Lipshultz
In the USA, about 500,000 vasectomies are performed each year, with up to 6% of men requesting reversal. The technique of vasectomy reversal has evolved from macrosurgical to the implementation of both microscopic and robotic technologies. The very earliest attempts at vasectomy reversal, the vasoepididymostomy and vasovasostomy, have remained central in the treatment of male infertility and will continue to be so for years to come. As seen throughout its history, urological microsurgery has consistently implemented advanced techniques and state-of-the art technology in its craft, and its continued refinement will allow for even more favorable outcomes in the lives of patients seeking restoration of fertility following vasectomy...
June 2015: Current Urology Reports
Alexander W Pastuszak, Evan P Wenker, Larry I Lipshultz
No abstract text is available yet for this article.
May 2015: Urology
Fu-Jun Zhao, Jing Peng, Philip S Li, Richard Lee, Marc Goldstein
Male infertility microsurgery represents the fastest growing sub-specialty in urology and clinical andrology over the past two decades. The importance of microsurgery for male infertility has risen as a part of the urologist's armamentarium in the medical and surgical management of male infertility. Despite the advances in male infertility microsurgery in China, the lack of standardized and well-organized training programs for male infertility microsurgery remains a serious problem affecting its development...
July 2014: Zhonghua Nan Ke Xue, National Journal of Andrology
Jing Peng, Zheng Li, Xiang-An Tu, Long Tian, Yan Zhang, Kai Hong, Xiang Wang, Yi-Ming Yuan, Lian-Ming Zhao, Ping Ping, Li-Xin Zhou, Yi-Dong Liu, Xiang-Ming Mao, Fu-Jun Zhao, Xiang-Feng Chen, Qiang Dong, Zhong-Yi Sun, Tie Zhou, Zhi-yong Liu, Xiang-Zhou Sun, Tao Jiang, S Li Philip
Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility...
July 2014: Zhonghua Nan Ke Xue, National Journal of Andrology
Y El Harrech, N Abaka, O Ghoundale, D Touiti
Self-mutilations of the external genitals in psychiatric patients also known as Klingsor syndrome is a rare urologic trauma. Men with religious conflicts, low self-esteem, unresolved transsexual issues and feelings of guilt are the most vulnerable. This condition requires immediate surgical intervention. Currently replantation involves meticulous microsurgery and has become the primary method for managing these patients. In this paper, we report a case of self amputation of penis in a patient with a psychiatric history significant for schizopfrenia...
October 2013: Urology Annals
N O Milanov, R T Adamian, A S Zelianin, O I Startseva, A L Istranov
The article highlights possibilities and common aspects of microsurgical tissue transplantation in reconstructive urology. The authors share the experience of more than 2000 of microsurgical autotransplantations of revascularized and reinnervated free flaps. The method allows the new approach to such urological conditions as traumatic penis amputation, posttraumatic and inflammatory urethra strictures, inborn genital hypoplasia, impaired sexual identification, etc. The issue analyses the results of treatment of 152 patients with inborn urogenital pathology (220 autotransplantations of revascularized flaps) and 146 patients with acquired urogenital diseases (188 autotransplantations of revascularized flaps) during the period from 1991 to 2011 years...
2013: Khirurgiia
Emiliano Passacantilli, Giulio Anichini, Gennaro Lapadula, Maurizio Salvati, Jacopo Lenzi, Antonio Santoro
BACKGROUND AND OBJECTIVE: Since the 1960s, lasers have been used in neurosurgery for surgical removal of intracranial tumors. Because of its limited penetration (2 mm) through tissues and its wavelength, which is useful in water medium, the 2-µ thulium laser has been applied primarily in urology. Its features are attractive for application under microscope magnification during neurosurgical procedures. The aim of this study was to evaluate the usefulness of the 2-µ thulium laser during microsurgical removal of intracranial meningiomas...
March 2013: Lasers in Surgery and Medicine
Stephen M Larsen, Jonas S Benson, Laurence A Levine
PURPOSE: Microdenervation of the spermatic cord is an effective treatment for men with intractable scrotal content pain. We evaluated a single center experience, analyzing patients in whom prior surgical attempts had failed to correct pain who subsequently underwent microdenervation of the spermatic cord. MATERIALS AND METHODS: A retrospective chart review of 68 patients who underwent microdenervation of the spermatic cord from 2006 to 2010 was performed. Prior ipsilateral surgical procedures with the intent to correct scrotal content pain were selected, identifying 31 testicular units...
February 2013: Journal of Urology
Sijo J Parekattil, Ahmet Gudeloglu
The introduction of the operative microscope for andrological surgery in the 1970s provided enhanced magnification and accuracy, unparalleled to any previous visual loop or magnification techniques. This technology revolutionized techniques for microsurgery in andrology. Today, we may be on the verge of a second such revolution by the incorporation of robotic assisted platforms for microsurgery in andrology. Robotic assisted microsurgery is being utilized to a greater degree in andrology and a number of other microsurgical fields, such as ophthalmology, hand surgery, plastics and reconstructive surgery...
January 2013: Asian Journal of Andrology
Akanksha Mehta, Philip S Li
Microsurgical training is imperative for urologists and clinical andrologists specializing in male infertility. Success in male infertility microsurgery is heavily dependent on the surgeon's microsurgical skills. Laboratory-based practice to enhance microsurgical skills improves the surgeon's confidence, and reduces stress and operating time, benefiting both the patient and the surgeon. This review provides guidelines for setting up a microsurgical laboratory to develop and enhance microsurgical skills using synthetic and animal models...
January 2013: Asian Journal of Andrology
M L E Overgoor, T P V M de Jong, P T Cohen-Kettenis, M A Edens, M Kon
PURPOSE: In this study we prospectively investigated the contribution of restored penile sensation to sexual health in patients with low spinal lesions. MATERIALS AND METHODS: In 30 patients (18 with spina bifida, 12 with spinal cord injury, age range 13 to 55 years) with no penile sensation but good groin sensation the new TOMAX (TO MAX-imize sensation, sexuality and quality of life) procedure was performed. This involves microsurgical connection of the sensory ilioinguinal nerve to the dorsal nerve of the penis unilaterally...
February 2013: Journal of Urology
Liang Zhao, Chun-Hua Deng, Xiang-Zhou Sun, Yu Chen, Wen-Wei Wang, Liang-Yun Zhao, Ling-You Zeng, Xiang-An Tu
This study is to evaluate the effectiveness of a modified single-armed suture technique for microsurgical vasoepididymostomy (VE) in patients with epididymal obstructive azoospermia. From September 2011 to December 2011, microsurgical two-suture longitudinal intussusception VEs were performed using our modified single-armed suture technique in 17 men with epididymal obstructive azoospermia at our hospital. Two of these patients underwent repeated VEs after previous failed VEs, and one patient underwent unilateral VE because of an occlusion of the left abdominal vas deferens...
January 2013: Asian Journal of Andrology
M Salehipour, A Ariafar
Penile amputation is an uncommon urological emergency. Although rare, traumatic amputation of penis is a challenging injury to treat. However, modern microsurgical reconstruction techniques have improved success rate of penile replantation and become the procedure of choice for managing these patients. Herein, we report on a case of penile amputation following an industrial accident.
October 2010: International Journal of Occupational and Environmental Medicine
Fuping Li, Kohei Yamaguchi, Keisuke Okada, Kei Matsushita, Makoto Ando, Koji Chiba, Huanxun Yue, Masato Fujisawa
Varicocele is currently the most common irregularity identified in males that is associated with impaired spermatogenesis. It primarily presents in the form of decreased sperm count and motility, abnormal morphology, and significantly increased sperm DNA fragmentation. Several studies have shown that surgical repair improves semen parameters and increases the odds of spontaneous pregnancy. However the exact effect of surgical repair treatment remains controversial. Therefore, the aim of our study was to evaluate the effectiveness of microsurgical repair by comparing common semen parameters and sperm DNA fragmentation index (DFI)...
October 2012: Systems Biology in Reproductive Medicine
Anand Shridharani, Gina Lockwood, Jay Sandlow
PURPOSE OF REVIEW: Varicoceles are a common finding in adolescent boys and men. Most are asymptomatic, although up to 10% may cause testicular pain. This study will review the use of varicocelectomy in the treatment of testicular pain in men with clinical varicoceles, as well as provide prognostic indicators for successful outcome. RECENT FINDINGS: Recent studies that examined the impact of varix ligation on preoperative testicular pain were reviewed. Most studies are retrospective and uncontrolled; although objective outcome measures were used in the majority...
November 2012: Current Opinion in Urology
Gianni Ughi, Lucio Dell'Atti, Consuelo Ricci, Giovanni Pietro Daniele
BACKGROUND: The effectiveness of different procedures for varicocele varies in terms of recurrence, sperm-count improvement, pregnancies and deliveries. OBJECTIVES: To determine if microsurgical varicocelectomy plus antegrade sclerotherapy under local anaesthesia is the first choice surgical modality to treat this disease. METHODS: Since 1983 out of more than 1000 patients treated for primitive varicocele, we considered 800 patients with a follow-up of two years...
June 2012: Archivio Italiano di Urologia, Andrologia
Riccardo Autorino, Fernando J Kim, Jens Rassweiler, Marco De Sio, Maria J Ribal, Evangelos Liatsikos, Rocco Damiano, Luca Cindolo, Pierluigi Bove, Luigi Schips, Abhay Rané, Carmelo Quattrone, Jorge Correia-Pinto, Estevão Lima
UNLABELLED: Study Type--Therapy (case series) Level of Evidence 4. What's known on the subject? and What does the study add? Over the last few years, minimally invasive urological surgery has evolved towards less invasive, 'scarless' procedures. New surgical concepts, such as those of natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been introduced. Mini-laparoscopy has been rediscovered in an attempt to reduce the invasiveness of standard laparoscopy...
December 2012: BJU International
Maria San Gabriel, Sam W Chan, Naif Alhathal, Junjian Z Chen, Armand Zini
BACKGROUND: There is good evidence to show that varicocele repair can improve conventional sperm parameters, as well as, sperm DNA integrity, in infertile men with a clinical varicocele. OBJECTIVE: To examine the effect of varicocelectomy on sperm quality, specifically, sperm nuclear chromatin integrity and sperm mitochondrial DNA (mtDNA) copy number. DESIGN, SETTING, AND PARTICIPANTS: A prospective study done between March 2007 and January 2008...
August 2012: Journal of Assisted Reproduction and Genetics
Giovannalberto Pini, Francesco Porpiglia, Salvatore Micali, Jens Rassweiler
OBJECTIVES: To review the development of miniaturized laparoscopic instruments with particular attention to the urological field and focusing on nomenclature, history and outcomes. METHODS: A comprehensive literature search was conducted in order to find articles related to Minilaparoscopy, Needlescopy, Microlaparoscopy. The most relevant papers over the last 30 years were selected in base to the experience from the panel of experts, journal, authorship and /or content...
April 2012: Archivos Españoles de Urología
Stefani De Stefani, Gianmarco Isgrò, Virginia Varca, Annarita Pecchi, Giampaolo Bianchi, Giorgio Carmignani, Lorenzo E Derchi, Salvatore Micali, Livia Maccio, Alchiede Simonato
OBJECTIVE: To retrospectively evaluate the clinical outcomes of 20 patients diagnosed with a nonpalpable or small testicular mass (2 cm) at 2 academic urological department. Testis-sparing surgery (TSS) is currently performed routinely for the management of nonpalpable testicular masses. High reliability of frozen section examination (FSE) and high-frequency ultrasound (US) and the adoption of microsurgical techniques improved safety and feasibility of this technique. METHODS: From January 2004 to March 2011, 23 patients underwent microsurgical TSS...
April 2012: Urology
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