Creation and evaluation of a three-dimensional-printed synthetic vas deferens for microsurgical training.

Introduction: Individuals choose to undergo vasectomy reversal for a variety of reasons, including remarriage or due to the death of a child. To be proficient in this procedure, the surgeons need to be high volume and the trainees require a safe environment to develop their microsurgical skills. To overcome this challenge, we used three-dimensional (3D) printing to create a synthetic model of the vas deferens with properties similar to the human vas deferens.

Forty years of IVF.

This monograph, written by the pioneers of IVF and reproductive medicine, celebrates the history, achievements, and medical advancements made over the last 40 years in this rapidly growing field.

The 4 Questions to Ask and Answer Regarding ICD-10: First of a 2-Part Series.

Introduction: On October 1, 2015 the International Classification of Diseases and Related Health Problems, 9th revision (ICD-9) will be replaced by the 10th revision (ICD-10) for coding medical encounters in the United States. This transition will fundamentally change how medical care is documented, how health care is delivered and how delivery systems operate. We will shed light on the ICD-10 transition and answer 4 questions we believe to be important to this transition.

The 4 Questions to Ask and Answer Regarding ICD-10: Second of a 2-Part Series.

Introduction: On October 1, 2015 the United States will transition from the decades-old 9th revision of the International Classification of Diseases (ICD-9) set of diagnoses for coding medical encounters and inpatient procedure codes to the far more contemporary, vastly larger and much more detailed 10th revision of those code sets (ICD-10). In this second part of a 2-part series we will address the 2 remaining questions about this transition, namely why you should check your codes to ensure correct coding and how to best prepare for the transition.

Methods: A search was undertaken to determine how ICD-10 codes are organized and the best techniques to choose correct codes, and how to best prepare for the transition.

Effect of cryptorchidism and retractile testes on male factor infertility: a multicenter, retrospective, chart review.

This multicenter retrospective chart review study performed on 162 cryptorchid patients and on 34 subjects with retractile testes suggests that cryptorchidism and retractile testes can alter spermatogenesis, with more serious damage observed in bilateral cryptorchidism. This spermatogenetic impairment is probably related to the lack of an appropriate or timely surgical correction.

Herniorrhaphy with polypropylene mesh causing inguinal vasal obstruction: a preventable cause of obstructive azoospermia.

Objective: To report a multiinstitutional experience of men presenting with infertility secondary to inguinal hernia repair using polypropylene mesh.

Summary Background Data: An estimated 80% of inguinal hernia operations involve placement of a knitted polypropylene mesh to form a "tension-free" herniorrhaphy. The prosthetic mesh induces a chronic foreign-body fibroblastic response creating scar tissue that imparts strength to the floor and leads to fewer recurrences.

False fracture of the penis.

Penile fracture is an uncommon, but well-described, entity that requires emergent treatment. The classic, "text-book" history, a blow to the erect penis accompanied by a "snap," pain, and immediate detumescence, is not universally present. We report 2 cases of "false" penile fracture, a condition that closely mimics "true" penile fracture.

Robotic assisted microsurgical vasal reconstruction in a model system.

Our objective was to determine whether or not male reproductive microsurgery is adaptable to current robotic technology. We devised a model vas deferens system using rat vasa deferentia and completed vasal anastomosis with full-thickness and mucosal robotically placed, Sharpoint 10-0 bicurve nylon sutures. Experienced and inexperienced microsurgeons performed separate anastomoses.

Prostatitis and male infertility: evidence and links.

Prostatitis and infertility are common disorders in men and many researchers have investigated a possible link between the two disorders. After almost 3 decades of research the answer to this question remains unknown, although ample evidence exists to support a relationship between male infertility and prostatitis. This paper discusses this evidence and then derives a rational treatment approach to the man with infertility and prostatitis.

The influence of obstructive interval on patency rates following microsurgical epididymovasostomy.

To determine whether or not obstructive interval (OI) negatively affects patency rates in epididymovasostomy (EV) as a sole procedure alone, we reviewed medical records from obstructive azoospermia (OA) patients who underwent unilateral or bilateral epididymovasostomy. For the purpose of analysis, patients were placed into short OI (15 years or less) or long OI (more than 15 years) categories. Patency rate for the short OI group was 58%, compared to 15% for the long OI group (P<0.

Repair of a diaphragmatic injury during hand assisted laparoscopic nephrectomy using an onlay patch of polypropylene and polyglactin mesh.

Purpose: We describe a simple and time efficient technique for repairing a diaphragmatic injury occurring during right hand assisted laparoscopic radical nephrectomy.

Materials And Methods: A dual layer polypropylene and polyglactin mesh was created extracorporeally by sewing a 2 x 2 piece of polypropylene mesh to a 2 x 2 piece of polyglactin mesh with 4, 4-zero interrupted polyglactin sutures. This dual layer was then positioned manually over the diaphragmatic rent and secured with a laparoscopic stapling device.

The role of testicular biopsy in the modern management of male infertility.

Purpose: We evaluate the traditional role of isolated testicular biopsy as a diagnostic tool, as opposed to the value as a therapeutic procedure for azoospermic men.

Materials And Methods: The medical records of azoospermic patients who were evaluated, and treated between 1995 and 2000 were retrospectively analyzed for history, physical examination findings, endocrine profiles, testicular histology and sperm retrieval rates. Based on these parameters, cases were placed into diagnostic categories that included obstructive or nonobstructive azoospermia.

What nonresponse to intracavernous injection really indicates: a determination by quantitative analysis.

Purpose: In addition to its usefulness as a therapeutic modality, intracavernous injection may also be done in a diagnostic capacity. While a good response to an intracavernous injection test rules out venous leakage, a failed erectile response to the test in the office setting may not be completely representative of the patient erectile state. We determined by quantitative analysis the likely significance of failure to respond to intracavernous injection testing.