• Clinical and Experimental Reproductive Medicine
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• 제15권1호
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• pp.1-9
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• 1988

The contraception practice rate in Korea has steadily increased from 9% in 1964 to 72% in 1987. Accordingly, natural increase rate of population declined from 28.4 per 1,000 in 1964 to 12.4 per 1,000 in 1987. Notably in recent years, the acceptance of surgical contraception services has sharply increased in this country. Now the author analyzes various factors influencing successful vasectomy and vasovasostomy based on his experience in performing more than 8,000 vasectomies and 1,000 vasovasostomies during the past 25 years. These various factors consist of preoperative screening interview, surgical vasectomy technique, vas irrigation technique, open-ended vasectomy, complications from vasectomy, sperm granuloma formation, spermatogenesis and steroidogenesis after vasectomy, immunological consequences after vasectomy, prostatic diseases and vasectomy, late post-vasectomy syndrome, psychological effects after vasectomy, and success rates of vasovasostomy. Besides, the author makes more comments on the results of the clinical trials on new approaches to reversible vas occlusion technique with a new device of Intravasal Thread and to reversible suppression of spermatogenesis with long-acting sex hormones.

• Clinical and Experimental Reproductive Medicine
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• 제39권2호
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• pp.81-86
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• 2012

Objective: Sterilization (tubal sterilization and vasectomy) is a widely applied contraceptive method worldwide. Although most studies have described sterilization as a safe method, there are reports of tubal ligation (TL) and vasectomy complications. The aim of this study was to evaluate the effects of TL and vasectomy on the serum oxidative stress, specifically prooxidant-antioxidant balance (PAB) and malondialdehyde (MDA) levels, over time. Methods: Male and female rats were classified into vasectomy, sham-vasectomy, TL, and sham-TL groups, respectively. The PAB and MDA levels were measured on days 15 and 45 and months 3 and 6 after the intervention. For female rats, blood sampling was performed during the diestrous phase and estradiol and progesterone were also measured. Results: Serum PAB and MDA increased after TL (p<0.05). Vasectomy increased serum MDA remarkably after 45 days, 3 months, and 6 months (p<0.05). After vasectomy, serum PAB also increased although not significantly. Serum estradiol and progesterone decreased remarkably in the TL group compared to the sham group (p<0.05). Conclusion: Bilateral TL and vasectomy both increase the serum oxidative stress; however the imbalance after TL was very noticeable. As for the TL, the reduction of serum estrogen levels can be involved in this imbalance. Complications followed by TL or vasectomy could be due to increased levels of oxidants. Thus, prescribing antioxidants during and or after surgery may be a solution.

• 대한수의학회지
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• 제43권3호
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• pp.485-492
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• 2003

The pathological mechanism of impaired spermatogenesis after vasectomy has not been completely investigated. In this study, we examined pathological changes of the testis and the Fas-Fas ligand (FasL) mediated signaling pathway in apoptotic germ cell death after vasectomy in rats. Ten-weeks old Sprague-Dawley rats were underwent bilateral vasectomy and sacrificed after 1 day, 2 days, 3 days, 5 days, 1 week, 2 weeks, and 4 weeks of surgery and the testes were removed. Histopathological evaluation of spermatogenesis was performed by hematoxylin-eosin and periodic acid-Schiff-hematoxylin staining. To elucidate the pathophysiology of seminiferous tubule damage, terminal dUTP nick end labeling staining, electrophoresis assay of DNA fragmentation, and Western blotting analysis for Fas-FasL were performed. Relative weights of testes were decreased from 5 days after vasectomy. Germ cell degeneration were first found in the spermatogonia and spermatocytes at stages I-VI, and XII-XIV seminiferous tubules. Mean incidence of apoptotic germ cells after vasectomy progressively increased to peak in 5 days, and then gradually decreased to the control levels in 2 weeks after vasectomy. The expression of Fas-FasL reached maximum level at 5 days after vasectomy and then declined. In conclusion, impaired spermatogenesis after vasectomy associated with an increase in germ cell apoptasis, which is partly mediated by the activation of Fas-FasL.

• Clinical and Experimental Reproductive Medicine
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• 제2권1호
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• pp.19-38
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• 1975

A total of 185 vasovasostomies were carried out for 11 years. Various factors which are of importance in fluencing the successful vasovasostomies are analysed and presented as follows: In recent years, demand of reanastomosis of the vas deferens increased considerably. An average age of the subjects is 39, and that of their wives, 33 in this series. An average interval between vasectomy and vasovasostomy is 4 years. An average number of living chidren is 2.6 at the time of vasectomy. and 2.1 at the time of time of vasovasostomy. Merchant and public official are the most commonly encounterd occupation in the present series. Coital frequencies are 2.2/week after vasovasostomy. The most common reasons for requesting the vasovasostomy are remarriage and deaths of children, especially son. Success rate is considerably higher among younger group than that of the older. Success rate is somewhat higher among groups of shorter interval between the operations (vasectomy and vasovasostomy) than that of longer interval group. Success rate is higher among bilateral vasovasostomy group than that of any others. Success rate is higher in solid splint group and no splint group than hollow splint group. The closed dressing technique of the end of splint on the scrotum is found to be reasonably effective in preventing infection. Ordinary end-to-end anastomosis and folded side-to-side anastomosis techniques are proved to be the most ideal form of modified operation for the successful vasovasostomies. The most common causes of failure are infection, injuries of blood supply, avascular necrosis due to extensive mobilization, inadequate approximation of both vasal end, hematoma, changes of epididymal environment, and early ambulation in this series. Overall success rate of the author's series is found the 81 per cent, and impregnation rate is 35 per cent. Overall results reported by other workers are that success rate regarding appearance of sperm in the semen after operation is 64 per cent, and that of impregnation after vasovasostomy is 33 per cent. The results of semen assessment performed on same cases prior to vasectomy and following vasovasostomy showed that post-vasovasostomy sperm count scarcely reached three-quaters of pre-vasectomy count.

• 한국임상수의학회지
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• 제15권2호
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• pp.303-306
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• 1998

The three cases of cryptorchid are reported here in order to demonstrate the different surgical techniques that were carried out to remove crytochid testes in dogs and to introduce clinical cases on crytorchidism. Three dogs were presented in the clinic of Ecole Veterinaire de Lyon in May, 1998 with two in the left-sided unilateral abdominal cryptorchid and with one in bilateral inguinal mobile cryptorchid. There were two poodle at the age of more than 4 years old and 8 years old respectively with one boxer at 4 years old. In two abdominal cryptotchids, the skin was incised in caudal paramedian approach. Then, the linea alba were incised and cryptorchidectomy was peformed accompaning one with castration and the other with vasectomy by the request of the owners. In inguinal testicles, prescrotal skin incision was made to remove both testicles. The surgical outcome was good without any Their behaviors became agreeable as the proprietors reported. In the dog with vasectomy, the behavior changes were not noticeable.

• Clinical and Experimental Reproductive Medicine
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• 제8권2호
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• pp.29-33
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• 1981

Vesectomy has been increased as a popular method of birth control because it is simpler than other methods for men. But the vasectomy results in several problems such as relation to effect changes on the structure and function of the reproductive organ. The fate of non-ejaculated spermatozoa is postulated by some authors that those are disappeared by a progress of dissolution and reabsorption in the epididymis, and we have attempted to prove the true state of sperm-acrosome on the fine structure in vasectomized rats. The results were as follows: 1. Apical segments of the acrosome were swollen similar to the shape of club in many spermatozoa. 2. Discontinuities of the outer and inner acrosomal membranes were occasionally noted and there were complete losses of acrosomes in the certain place. 3. There was no evidence of significant changes in the nuclear structure, nor dilatation of the subacrosomal space. 4. Vasectomy might effect destructive changes in the acrosomes of the non-ejaculated spermatozoa in situ.

• Journal of Preventive Medicine and Public Health
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• 제12권1호
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• pp.70-78
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• 1979

1978년 1월부터 동년 12월까지 대한가족계획협회 부산 진료소에서 영구피임을 목적으로 정관수술과 난관수술을 받은 1,580명을 대상으로 하여 사회의학적인 특성을 조사한 바, 그 결과는 다음과 같다. 1. 영구피임수출수용자들의 연령은 $30{\sim}34$세군이 44.7%로 가장 많았으며 정관수술수용자들은 영도구(48.3%)에서, 난관수술수용자는 동구(38.0%)에서 각각 제일 많았다. 2. 교육정도는 정관수술수용자들은 고등학교졸업군(49.2%)에서, 난관수술수용자들은 국민학교 졸업군(47.0%)에서 각각 가장 많았다. 3. 영구피임술을 받기 전에 사용한 피임방법으로는 경구피임약 사용이 제일 많았으며 피임방법을 전혀 사용하지 않은 군은 54.1%었다. 4. 영구피임수술을 받기 전까지의 결혼생활 기간은 $5{\sim}9$년군이 가장 많았다. 5. 정관수술수용자들의 현존 자녀수는 2.54명이고 난관수술수용자는 3명이었다. 6. 평균임신회수는 정관수술수용자들은 2회, 난관수술수용자들은 3회였으며 인공유산회수는 1회가 가장 많았다. 7. 피임수술을 권고 받게 된 동기별로는 정관수술수용자들은 예비군훈련시 가족계획교육이, 난관수술수용자들에게는 어머니회에 의하였다는 것이 가장 많았다. 8. 대상자들의 주거상태는 셋방이 69.4%로서 가장 많았다.

• Clinical and Experimental Reproductive Medicine
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• 제10권1호
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• pp.7-24
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• 1983

On the basis of the semen analysis in 66 subjects, they were divided into six different groups: Group I consisted of 16 normal subjects with sperm counts of over 40 ${\times}10^6$/ml and motility of over 40 percent, Group II, 7 subjects with normal sperm counts, but motility of under 40 percent, Group III, 15 oligospermic patients with under 40 ${\times}10^6$/ml, Group IV 14 azoospermic patients, Group V, 10 patients with vasectomy and Group VI, 4 abnormal patients with 2 cases of hypoplastic testis, 1 case of Klinefelter's syndrome and 1 case of testis tumor. After seperation of semen into sperm and seminal plasma by centrifugation, the protein contents and the activities of hyaluronidase, ${\beta}$-N acetylglucosaminidase, ${\beta}$-glucuronidase, arylsulfatase, acrosin and azocoll proteinase in seminal plasma were measured. Vasectomy group has 30 percent less of total protein than normal group. For the comparison of enzyme activities of seminal plasma, it could be assumed that the enzymes in seminal plasma were not contaminated with the enzymes of spermatozoa by testing the enzymes of the seminal plasma from the vasectomy and azoospermic groups. It had been reported that hyaluronidase was only released from spermatozoa, however, the result obtained in this investigation showed that azoospermic and vasectomy group had high specific activities of hyaluronidase. The results indicated that hyaluronidase was not only from the testis but also from the male accessory sexual glands. Oligospermic group (Group III) showed the lowest total activity of hyaluronidase among them. The specific activities of ${\beta}$ -N-acetylglucosaminidase was high in oligospermic group (Group III) and low in vasectomy group (Group V). These results were contradictory with the pattern of hyaluronidase activities. This indicated that the spermatozoa which were stayed in epididymis would increase the activity of this enzyme. The specific activity of ${\beta}$ - glucuronidase was low in oligospermic and vasectomy groups. Group VI including testis tumor had remarkably high arylsulfatase activity. Arylsulfatase, a typical lysosomal enzyme, has been known to be released unusually large amounts from certain tumor cells. Arylsulfatase was also released with high activities from azoospermic and vascetomy group. This result indicated that this enzyme was also released from the sources other than testis. Acrosin, a proteolytic enzyme locating in the sperm acrosome, was not found throughout all the samples of seminal plasma. The activities of azocoll proteinase, a non-specific neutral proteinase was nearly identical in all the groups. This enzyme must have been released from the sources other than testis.

• Clinical and Experimental Reproductive Medicine
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• 제23권1호
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• pp.61-66
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• 1996

Vasectomy has become a popular method for male sterilization and this, in tum, has been followed by an increase in the number of patients requiring vasectomy reversal. Recently, many authors have reported a high success rate of vasovasostomy using microsurgical techniques. However, a significant discrepancy exist between the anatomical patency rate and pregnancy rate despite improvements in surgical techniques. Number of 420 patients who underwent vasovasostomy by a modified one layer reanastomosis from January 1986 to December 1994 were reviewed. Of the total, Complete follow up were possible in 115 patients. Of the 115 patients, 74 patients were treated by macroscopic reanastomosis, and microscopic technique were applied in 41 patients. Duration of vasal obstruction, gross apperance of vasal fluid, operative method, presence or absence of sperm and sperm granuloma, and results of postoperative semen analysis were analyzed as factors influencing the pregnancy rate. Success rates for patency and for pregnancy were 81% and, 42% respectively. Rate of pregnancy were increased if there were shorter periods of obstruction(<10years), bilateral observation of watery vasal fluid, presence of sperm bilaterally, bilateral presence of sperm granuloma at the vasectomy site, and normal results on postoperative semenalysis. With these results, we can conclude that all factors mentioned may affect the success rate of pregnancy following vasovasostomy.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.183-187
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• 2009

Purpose: Because of the volume of elective sterilizations performed in the world during the past decade, the vasectomy was a popular method for male sterilization in Korea and this, in turn, had been followed by an increase in the number of patient requiring vasectomy reversal with the high rate of subsequent divorce and remarriage. Recently, many authors have reported high success rates of vasovasostomy using microsurgical techniques and we performed modified two layer vasovasostomy with intravasal silicone tube to increase postoperative patency and pregnacy rate. Methods: Microscopic vasovasostomy was performed in 9 patients and their average age was $35.78{\pm}1.36years$(from 28 years to 44 years) from June 2006 to June 2008 at our department using modified two layer vasovasostomy with silicone tube insertion. Standard Guibor silicone tube, consisting of two 17.7 cm, 0.064 cm diameter, malleable, stainless steel probes connected by 29 cm of silicone tubing wedged onto disposable probes, were used in all cases. Results: Success rates were 88.8 % for patency and pregnancy 44.4 % for pregnancy in modified two layer vasovasostomy with silicone tube insertion. The patency rates were higher in cases of long postoperative day and in cases of short duration of vasectomy and vasovasostomy. Conclusion: We used a modified method to correspond the patency and pregnancy rate in microscopical modified two layer vasovasostomy using the intravasal silicone tube permanently. This method brings normal patency in microsurgical vasovasostomy because the silicone tube prevent obstruction of anastomosed site of the vas permanently.