- Email: [email protected]
377 The Application of Laparoscopic Doppler Ultrasound During Laparoscopic Varicocelectomy in Infertile Patients
S111
WMSM 2016 Abstracts
candidates of varicocelectomy or other kind of inguinal operation, We introduced the new technique of vasal vessels preserving VE and evaluate the impact of this technical modification on the surgical success. Material and Methods: From May 2007 to May 2013, 80 patients had undergone microsurgical VE without preserving vasal vessels at the site of corpus or cauda. Between June 2013 and December 2014,VE with preservation of vasal vessels were performed in 33 patients at the site of corpus or cauda. Telephone follow-up had been carried out to retrospectively evaluate the surgical effect for all these 113 patients. The patency and pregnancy rate between two groups were compared. Results: Of all 113 patients, 88 (77.9%) patients had been followed up and 25 (22.1%) patients got out of touch. In the group of VE without preserved vassal vessels, 21 patients were out of touch (21/80). The overall patency rate was 78.0% (46/59). The natural pregnancy rate was 54.2% (32/59). In the group of VE with preserved vassal vessels, 4 patients were out of touch (4/33). The overall patency rate was 65.5% (19/29). The natural pregnancy rate was 20.7% (6/29). The patency rate between the VE with or without preserved vassal vessels groups haven’t reach to the statistically significance (P¼0.212). Conclusions: According to our study, vasal vessels preserving tension-free VE is feasible when the site of anastomosis was corpus or cauda. Vasal vessels preserving VE was necessary for patients who had undergone previous varicocele repair. The limitations of our research is relatively small samples, whether this technique can be routinely used still need large sample research. We are concerned that the rate of success decreases with the increase of sample size compare to non- vasal vessel-preserve procedure. Disclosure: Work supported by industry: no. 377 THE APPLICATION OF LAPAROSCOPIC DOPPLER ULTRASOUND DURING LAPAROSCOPIC VARICOCELECTOMY IN INFERTILE PATIENTS Guo, L.1; Sun, W.2; Zhang, X.2; Yuan, M.3 1 The Second hospital of Shandong University, China; 2The Second Hospital of Shandong University, China; 3The Second hospital of Shandong University, China Objectives: To compare the surgical outcomes and complications between laparoscopic Doppler ultrasound assisted laparoscopic varicocelectomy (LDU-LV) and conventional LV for infertile patients with varicoceles. To examine the microanatomy within suprainguinal portion of the spermatic cord. Materials and methods: 147 infertile patients with varicoceles were randomly divided into LDU-LV group and LV group. Operative and postoperative parameters, semen parameters and the pregnancy rate were compared. Results: The operative time was significantly longer and the incidence of postoperative hydrocele was lower in LDU-LV J Sex Med 2017;14:S1-S131
group than LV group. The other surgical outcomes, such as postoperative hospital stay, postoperative varicocele recurrence, sperm morphology and pregnancy rate showed no difference. Sperm count and sperm motility were significantly increased in both groups at 3, 6 and 12 months after surgery, and they were higher in LDU-LV than LV group in 12 months after surgery. A mean number of 3.73 internal spermatic veins (ISVs), 2.25 lymphatics and 1.11 internal spermatic arteries (ISAs) were identified per cord at supra-inguinal level in patients from LDU-LV group. 68.6% of the ISAs were accompanied closely by a single internal spermatic vein, 18.6% were surrounded by a dense network of adherent veins, only 12.8% were isolated and anterior to the veins. Conclusions: LDU-LV could safely and effectively ligate all spermatic veins, preserve spermatic arteries and lymphatics, thus improve sperm count and motility without leading to high recurrence and hydrocele. The number of ISVs at the suprainguinal level is highly variable. Most ISAs are accompanied closely by a single internal spermatic vein. Disclosure: Work supported by industry: no. 378 A SINGLE CENTER 4 YEARS EXPERIENCE WITH EGYDIO’S TECHIQUE FOR THE MANAGMENT OF PEYRONIE’S DISEASE Konstantinidis, K.1; Fliatouras, C.1; Drettas, P.1 1 Andrology Institute, Greece To present our 4 years experience with the Egydio’s technique for the surgical treatment of peyronie’s disease. From January 2010 since December 2013 480 patients underwent surgical lengthening procedure with the Egydio’s technique. Patients with stable Peyronie’s disease were included. Patients should be preoperatively potent or with mild erectile dysfunction according to the brief form of the IIEF questionnaire. All patients underwent ultrasound evaluation preoperatively. Mean curvature was 60 degrees and 18% of all patients reported mild erectile dysfunction. For the graft we used bovine pericardium in all cases. Two penrose loops were used to measure the tunical defect length and width representing in this way the dimensions of the graft. The follow up was scheduled in one week, 3 months and every 6 months thereafter. Mean operative time was 65 minutes. Partial plaque excision was performed in 25% of the patients. Partial glans necrosis was recorded in one patient, while hematoma was recorded in 9%. There was residual curvature requiring reoperation in 6,2% of the patients. In all 82% of the patients were satisfied with the result. Erectile dysfunction was reported in 28,4% of all patients (significant 3,2%). The Egydio geometrical technique for the treatment of penile curvature seems to be a simple, reproducible, safe and efficient operation. Disclosure: Work supported by industry: no.
WMSM 2016 Abstracts
candidates of varicocelectomy or other kind of inguinal operation, We introduced the new technique of vasal vessels preserving VE and evaluate the impact of this technical modification on the surgical success. Material and Methods: From May 2007 to May 2013, 80 patients had undergone microsurgical VE without preserving vasal vessels at the site of corpus or cauda. Between June 2013 and December 2014,VE with preservation of vasal vessels were performed in 33 patients at the site of corpus or cauda. Telephone follow-up had been carried out to retrospectively evaluate the surgical effect for all these 113 patients. The patency and pregnancy rate between two groups were compared. Results: Of all 113 patients, 88 (77.9%) patients had been followed up and 25 (22.1%) patients got out of touch. In the group of VE without preserved vassal vessels, 21 patients were out of touch (21/80). The overall patency rate was 78.0% (46/59). The natural pregnancy rate was 54.2% (32/59). In the group of VE with preserved vassal vessels, 4 patients were out of touch (4/33). The overall patency rate was 65.5% (19/29). The natural pregnancy rate was 20.7% (6/29). The patency rate between the VE with or without preserved vassal vessels groups haven’t reach to the statistically significance (P¼0.212). Conclusions: According to our study, vasal vessels preserving tension-free VE is feasible when the site of anastomosis was corpus or cauda. Vasal vessels preserving VE was necessary for patients who had undergone previous varicocele repair. The limitations of our research is relatively small samples, whether this technique can be routinely used still need large sample research. We are concerned that the rate of success decreases with the increase of sample size compare to non- vasal vessel-preserve procedure. Disclosure: Work supported by industry: no. 377 THE APPLICATION OF LAPAROSCOPIC DOPPLER ULTRASOUND DURING LAPAROSCOPIC VARICOCELECTOMY IN INFERTILE PATIENTS Guo, L.1; Sun, W.2; Zhang, X.2; Yuan, M.3 1 The Second hospital of Shandong University, China; 2The Second Hospital of Shandong University, China; 3The Second hospital of Shandong University, China Objectives: To compare the surgical outcomes and complications between laparoscopic Doppler ultrasound assisted laparoscopic varicocelectomy (LDU-LV) and conventional LV for infertile patients with varicoceles. To examine the microanatomy within suprainguinal portion of the spermatic cord. Materials and methods: 147 infertile patients with varicoceles were randomly divided into LDU-LV group and LV group. Operative and postoperative parameters, semen parameters and the pregnancy rate were compared. Results: The operative time was significantly longer and the incidence of postoperative hydrocele was lower in LDU-LV J Sex Med 2017;14:S1-S131
group than LV group. The other surgical outcomes, such as postoperative hospital stay, postoperative varicocele recurrence, sperm morphology and pregnancy rate showed no difference. Sperm count and sperm motility were significantly increased in both groups at 3, 6 and 12 months after surgery, and they were higher in LDU-LV than LV group in 12 months after surgery. A mean number of 3.73 internal spermatic veins (ISVs), 2.25 lymphatics and 1.11 internal spermatic arteries (ISAs) were identified per cord at supra-inguinal level in patients from LDU-LV group. 68.6% of the ISAs were accompanied closely by a single internal spermatic vein, 18.6% were surrounded by a dense network of adherent veins, only 12.8% were isolated and anterior to the veins. Conclusions: LDU-LV could safely and effectively ligate all spermatic veins, preserve spermatic arteries and lymphatics, thus improve sperm count and motility without leading to high recurrence and hydrocele. The number of ISVs at the suprainguinal level is highly variable. Most ISAs are accompanied closely by a single internal spermatic vein. Disclosure: Work supported by industry: no. 378 A SINGLE CENTER 4 YEARS EXPERIENCE WITH EGYDIO’S TECHIQUE FOR THE MANAGMENT OF PEYRONIE’S DISEASE Konstantinidis, K.1; Fliatouras, C.1; Drettas, P.1 1 Andrology Institute, Greece To present our 4 years experience with the Egydio’s technique for the surgical treatment of peyronie’s disease. From January 2010 since December 2013 480 patients underwent surgical lengthening procedure with the Egydio’s technique. Patients with stable Peyronie’s disease were included. Patients should be preoperatively potent or with mild erectile dysfunction according to the brief form of the IIEF questionnaire. All patients underwent ultrasound evaluation preoperatively. Mean curvature was 60 degrees and 18% of all patients reported mild erectile dysfunction. For the graft we used bovine pericardium in all cases. Two penrose loops were used to measure the tunical defect length and width representing in this way the dimensions of the graft. The follow up was scheduled in one week, 3 months and every 6 months thereafter. Mean operative time was 65 minutes. Partial plaque excision was performed in 25% of the patients. Partial glans necrosis was recorded in one patient, while hematoma was recorded in 9%. There was residual curvature requiring reoperation in 6,2% of the patients. In all 82% of the patients were satisfied with the result. Erectile dysfunction was reported in 28,4% of all patients (significant 3,2%). The Egydio geometrical technique for the treatment of penile curvature seems to be a simple, reproducible, safe and efficient operation. Disclosure: Work supported by industry: no.