scholarly journals Predictors of success after bilateral epididymovasostomy performed during vasectomy reversal: A multi-institutional analysis

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Jesse Ory ◽  
Sirpi Nackeeran ◽  
Udi Blankstein ◽  
Joshua T. White ◽  
Ethan Grober ◽  
...  
Keyword(s):  
Success Rate ◽  
Odds Ratio ◽  
Semen Analysis ◽  
Motile Sperm ◽  
Predictors Of Success ◽  
Success Rates ◽  
Vasectomy Reversal ◽  
North American Cohort ◽  
The U.S ◽  
Fluid Characteristics

Introduction: Vasectomy reversal (VR) represents an excellent option for paternity in men who desire to expand their family following vasectomy. Traditional VR via vasovasostomy has a success rate upwards of 90%1,2 but when sperm or sperm parts are not present in vasal fluid, epididymovasostomy (EV) must be performed instead. Our objective was to determine which factors influence success after bilateral EV. Methods: A prospectively maintained database with data from the U.S. and Canada was used to identify men who underwent bilateral EV at time of VR. Success was defined as motile sperm in any postoperative semen analyses. Multivariable logistic regression was used to identify predictors of success. Results: A total of 200 men had at least one postoperative semen analysis, and 171 men were included in the analysis. Average age was 44.7 years, with average followup of seven months. Median time elapsed between vasectomy and EV was 15 years (interquartile ramge [IQR] 10–18). Overall success rate was 50%. Despite the study being adequately powered, factors such as years since vasectomy (odds ratio [OR] 1.01, confidence interval [CI] 0.95–1.06), age (OR 0.96, 0.91–1.01), intraoperative presence of motile sperm (OR 0.81, CI 0.41–1.62), and epidydimal fluid characteristics did not predict success. Conclusions: Bilateral EV at time of VR is successful in 50% of cases in a multi-institutional, North American cohort. Microsurgeons can be reassured that neither time elapsed nor epididymal fluid characteristics negatively impact success rates as long as sperm or sperm parts are present. Surgeons performing VR should be comfortable and prepared to perform EV if indicated.

scholarly journals Microscopic evaluation of the vasal fluid for sperm at the time of vasectomy reversal: Do we really need to check?

2021 ◽  
Vol 15 (8) ◽  
Author(s):  
Ethan D. Grober ◽  
Sammi Tobe
Keyword(s):  
Surgical Outcomes ◽  
Sperm Quality ◽  
Large Series ◽  
Motile Sperm ◽  
Predictive Utility ◽  
Microscopic Evaluation ◽  
Vasectomy Reversal ◽  
Fluid Characteristics

Introduction: During vasectomy reversal (VR), intraoperative microscopic evaluation of the vasal fluid for sperm presence/quality can inform of the possibility of epididymal obstruction and need for a vasoepididymostomy (VE). In an effort to validate the utility of microscopic vasal fluid evaluation, the current initiative correlates gross vasal fluid characteristics with sperm presence and quality in a large series of VRs. Methods: A total of 1267 VRs yielded a total of 2522 vasal-units (right/left sides) for analysis. During VR, vasal fluid was sampled from the testicular-end vas and the fluid was characterized (thick-paste/opaque/translucent/clear). Each aspirate underwent microscopic evaluation for sperm quality and categorized as: motile sperm/intact-non-motile sperm/sperm parts/no sperm. The predictive utility of the gross vasal fluid characteristics with respect to microscopic sperm presence and quality was analyzed. Results: Among the 2522 vasal-units analyzed, the side-to-side (left-right) concordance of vasal fluid quality and microscopic vasal sperm quality was 72% and 52%, respectively. When thick-pasty fluid was observed, no sperm were seen in the samples in 53% of cases and if present, only non-motile sperm were observed. Even in the setting of more favorable vasal fluid characteristics (clear, translucent, and opaque fluid), no sperm were seen in 6–11% of cases, suggesting the possibility of epididymal obstruction and the need for VE. Conclusions: Intraoperative microscopic evaluation of the vasal fluid for sperm is a necessary practice during VR to optimize surgical outcomes. Reliance on gross vasal fluid characteristics in isolation may lead to unrecognized epididymal obstruction, and the need for a VE, in approximately 11% of cases.

The case for early post-vasectomy semen analysis combining small non-motile sperm and azoospermia

2018 ◽  
Vol 12 (1) ◽  
pp. 50-53
Author(s):  
Jane Hendry ◽  
Robert Small ◽  
Abdullah Zreik ◽  
Niamh Smyth ◽  
Joby Taylor
Keyword(s):  
Patient Compliance ◽  
Semen Analysis ◽  
Motile Sperm ◽  
Success Rates ◽  
Level Of Evidence ◽  
Verbal Instructions ◽  
Time Period ◽  
Sampling Protocols ◽  
The Impact ◽  
Over Time

Background: Post-vasectomy semen analysis timing and criteria guidelines have evolved over time. Through analysis of our unit’s practice of post-vasectomy semen analysis from earlier sampling protocols at 8 weeks to single sampling at 12 weeks then 16 weeks, the impact on success rates and patient compliance were assessed. In addition, the use of small numbers of non-motile sperm and azoospermia combined rates as a marker of sterility were examined. Methods: All patients who underwent vasectomy in 2011 (8 and 12-week samples), 2013 (12-week samples) and 2016 (16-week samples) were included. Patients were given written and verbal instructions explaining the sample delivery protocol and samples. χ2 Testing was used to compare patient compliance and the results of post-vasectomy semen analysis with significance set at P<0.05. Results: In total 1124 vasectomies were performed, with 21% ( N=232) of patients non-compliant with submitting samples at the requested time period. Azoospermia rates increased with a longer time to post-vasectomy semen analysis from 82% to 95%, P<0.001; however, declining compliance meant the proportion of patients given clearance remained the same (70% vs. 68%, P=0.32). Rates of small non-motile sperm declined over an increasing time to post-vasectomy semen analysis. Therefore combined azoospermia and small non-motile sperm rates remained stable over an increasing sampling time (95% vs. 99%, P=0.39). Conclusion: The use of earlier post-vasectomy semen analysis is recommended as patient compliance decreases with the time from vasectomy. When azoospermia and small non-motile sperm rates are combined the rates of success of the procedure remain the same over time therefore earlier testing at 8 weeks is feasible without compromising clearance rates. Level of evidence: Not applicable for this single centre audit.

Lost to Follow-up Among Patients who Underwent Vasectomy reversal with Double Layer Microscopic Techniques in 2011-2015

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Ponco Birowo
Keyword(s):  
Success Rate ◽  
Double Layer ◽  
Semen Analysis ◽  
Advantages And Disadvantages ◽  
Fertility Status ◽  
Vasectomy Reversal ◽  
The Cost ◽  
Lost To Follow Up ◽  
Microscopic Techniques

<p>Vasectomy already been accepted by the society as easy and effective method for male contraceptive. However, some patients want to restore their fertility status due to divorce or re-marriage cases. Techniques in performing vasectomy reversal are varying with their own advantages and disadvantages. One of the techniques is double layer microscopy vasectomy reversal. We evaluate the success rate of this technique based on the semen analysis. The success rate was good with around 98.5% patients with complete follow up had sperm in their semen analysis<a href="file:///C:/Users/Mohamad%20Mostafa/Desktop/Knowledge%20E/In%20Press%20Conferences/ASPIRE-2016/Source-Manuscripts/v2-%20Revised/21.%20Lost%20to%20Follow-up%20Among%20Patients%20who%20Underwent%20Vasectomy%20%20PB%2004082016.docx#_msocom_1">[MP1]</a> . However, total success of follow up were very low (5 out of 19 patients) even though the cost of reversal vasectomy was quite expensive (around 3.000$USD). Lost to follow up rate of reversal vasectomy was 26%.</p>

scholarly journals Predictors of Success of Different Treatment Modalities for Management of Ectopic Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sümeyra Nergiz Avcioğlu ◽  
Sündüz Özlem Altinkaya ◽  
Mert Küçük ◽  
Selda Demircan Sezer ◽  
Hasan Yüksel
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Success Rate ◽  
Multiple Dose ◽  
Treatment Modalities ◽  
Predictors Of Success ◽  
Success Rates ◽  
Factors Affecting ◽  
The Difference ◽  
Single Dose Treatment

Aim. The purpose of this study was to investigate factors affecting the success of different treatment modalities for the management of ectopic pregnancy (EP).Methods. One hundred and ninety-seven patients with EP, were included in the study. Patients were treated with either intramuscular methotrexate (Mtx) or surgical treatment.Results. Mtx was applied in 97 (49.2%) patients. In 67 patients (69.1%), a single dose of Mtx and in 30 patients (30.9%) a multiple dose of Mtx was applied. Forty-seven (70.14%) patients were successfully treated with a single-dose Mtx. In the multiple-dose group, the success rate was 70% (21/30 patients). The difference between the success rates was not statistically significant. When the initial serumβhCG value was <1000 mIU/mL, the overall success rate of Mtx treatment was determined to be 86.11%; however, the rate decreased to 42.3% when theβhCG value was >3000 mIU/mL. On the other hand, if the EP mass diameter was <25 mm, the success rate was 89.28% and decreased to 52.63% when it was≥25 mm.Conclusion. The results of the study showed that single-dose treatment with Mtx could be as successful as multiple doses. Overall success of Mtx treatment depended on initialβhCG value and EP mass diameter.

scholarly journals Modified Long-Axis In-Plane Ultrasound Technique Versus Conventional Palpation Technique For Radial Arterial Cannulation: A Prospective Randomized Controlled Trial

2019 ◽  
Author(s):  
Jiebo Wang ◽  
Zhongmeng Lai ◽  
Xianfeng Weng ◽  
Yong Lin ◽  
Guohua Wu ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Success Rate ◽  
Radial Artery ◽  
Odds Ratio ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Radial Artery Cannulation ◽  
Ultrasound Technique ◽  
Artery Cannulation ◽  
Cannulation Success

AbstractBackgroundA low first-pass success rate of radial artery cannulation was obtained when using the conventional palpation technique(C-PT) or ultrasound-guided techniques, we therefore evaluate the effect of a modified long-axis in-plane ultrasound technique (M-LAINUT) in guiding radial artery cannulation in adults.MethodsWe conducted a prospective, randomized and controlled clinical trial of 288 patients undergoing radial artery cannulation. Patients were randomized 1:1 to M-LAINUT or C-PT group at fujian medical university union hospital between 2017 and 2018. Radial artery cannulation was performed by three anesthesiologists with different experience. The outcome was the first and total radial artery cannulation success rates, the number of attempts and the cannulation time.Results285 patients were statistically analyzed. The success rate of first attempt was 91.6% in the M-LAINUT group (n=143) and 57.7% in the C-PT group (n=142; P<0.001) (odds ratio, 7.9; 95% confidence interval, 4.0-15.7). The total success rate (≤5 min and ≤3 attempts) in the M-LAINUT group was 97.9%, compared to 84.5% in the palpation group (p <0.001) (odds ratio, 8.5; 95% confidence interval, 2.5-29.2). The total cannulation time was shorter and the number of attempts was fewer in the M-LAINUT group than that in the C-PT group (p <0. 05).ConclusionModified long-axis in-plane ultrasound-guided radial artery cannulation can increase the first and total radial artery cannulation success rates, reduce the number of attempts and shorten the total cannulation time in adults.

1937: Vasectomy Follow-Up: Clinical Significance of Rare Non-Motile Sperm in the Post-Op Semen Analysis

2004 ◽  
Vol 171 (4S) ◽  
pp. 511-512
Author(s):  
Ashis K. Chawla ◽  
Ben Bowles ◽  
Armand Zini
Keyword(s):  
Clinical Significance ◽  
Semen Analysis ◽  
Motile Sperm

Entscheidungsprozesse beim Übersetzen: Routine und Reflexion bei Novizen und Berufsübersetzern

Fachsprache ◽  
2017 ◽  
Vol 32 (3-4) ◽  
pp. 100-121
Author(s):  
Friederike Prassl
Keyword(s):  
Decision Making ◽  
Success Rate ◽  
Knowledge Integration ◽  
Popular Science ◽  
Failure Rates ◽  
Science Text ◽  
Success Rates ◽  
Preliminary Results ◽  
Decision Making Processes ◽  
Cognitive Involvement

This article focuses on the decision-making processes involved in research and knowledge integration in translation processes. First, the relevance of decision taking intranslation is discussed. Second, the psychology of decision making as seen by Jungermann et al. (2005) is introduced, who propose a categorization of decision-making processes intofour types: “routinized”, “stereotype”, “reflected” and “constructed”. This classification is then applied to the translations by five professional translators and five novices of five segments occurring in a popular-science text. The analysis reveals that the decision-making types are distributed differently among students and professional translators, which also has to be seen against the background of whether the decisions made were successful or not. The preliminary results of this study show that students resort to reflected decisions in most cases, but with a low success rate. Professionals achieve a higher success rate when making reflected decisions. As expected, they also make more routinized decisions than students. The professionals’ success rates improve with increasing cognitive involvement, while their failure rates are relatively high when making routinized decisions, an aspect worthwhile considering in translation didactics.

scholarly journals Examining the Role of Acculturation in E-Cigarette Use among U.S. Immigrant Adults

2021 ◽  
Vol 18 (7) ◽  
pp. 3658
Author(s):  
Sunday Azagba ◽  
Lingpeng Shan
Keyword(s):  
Host Country ◽  
Odds Ratio ◽  
Multivariable Analysis ◽  
Population Data ◽  
Cultural Norms ◽  
Cigarette Use ◽  
Length Of Residence ◽  
Native Populations ◽  
The U.S

Evidence suggests that as immigrants’ length of residence in the host country increases, they may integrate their behavior and norms to align with the new community’s cultural norms. The current study examined e-cigarette use among immigrants in the U.S., and whether the length of residence in the U.S. is associated with e-cigarette use among immigrants compared to the native-born population. Data were drawn from the 2014/15 and 2018/19 Tobacco Use Supplement to the Current Population Survey. Multivariable logistic regression was used to compare differences in e-cigarette use between native-born populations and immigrants, when immigrants’ length of residence in the U.S. was considered. Among immigrants, the prevalence of ever and current e-cigarette use increased significantly from 2.5% and 0.5% in 2014/2015 to 3.2% and 0.8% in 2018/2019, respectively. Multivariable analysis showed that immigrants had significantly lower odds of ever e-cigarette use compared to the mainland-born citizen (0–5 years in the U.S., adjusted Odds Ratio (aOR) 0.57, 95% Confidence Interval (CI) 0.46–0.69; 6–10 years, aOR 0.51, 95% CI 0.41–0.63; 11–20 years, aOR 0.45, 95% CI 0.39–0.53; 20+years, aOR 0.68, 95% CI 0.62–0.76). Similar results were found for current e-cigarette use, with immigrants being less likely to be current users. Findings that e-cigarette use among all immigrants—regardless of years living in the U.S.—was consistently lower than among the native-born population run contrary to the notion that as length of stay increases, health behaviors between immigrants and native populations of the host country become similar.

scholarly journals Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor bleeding

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jongbeom Shin ◽  
Boram Cha ◽  
Jin-Seok Park ◽  
Weonjin Ko ◽  
Kye Sook Kwon ◽  
...  
Keyword(s):  
Success Rate ◽  
Salvage Therapy ◽  
Upper Gastrointestinal Bleeding ◽  
Effective Control ◽  
Success Rates ◽  
Gastrointestinal Tumor ◽  
Bleeding Rate ◽  
Tumor Bleeding ◽  
Hemostatic Powder ◽  
Upper Gastrointestinal

Abstract Background Gastrointestinal tumor bleeding remains a clinical challenge because it is difficult to treat with conventional endoscopic hemostatic options. Recently, an endoscopic hemostatic powder (UI-EWD) was developed and reported to provide effective control of upper gastrointestinal bleeding. The aim of current study was to evaluate the feasibility and efficacy of this novel hemostatic powder in tumor bleeding. Methods A total of 41 consecutive patients with upper gastrointestinal tumor bleeding were included. UI-EWD was applied in all patients as an auxiliary hemostatic method as a salvage therapy or monotherapy during endoscopic treatment. Hemostasis success rates, adverse event related to UI-EWD, and rates of re-bleeding were evaluated. Results In all cases, UI-EWD application was successful at tumor bleeding sites. Immediate hemostasis occurred in 40/41 (97.5%) patients, and re-bleeding within 28 days occurred in 10 of 40 (22.5%) patients that achieved initial hemostasis. The success rate of immediate hemostasis for UI-EWD monotherapy was 100% (23/23). The re-bleeding rate at 28 days after UI-EWD monotherapy was 26.1% (6/23). No adverse events associated with UI-EWD application were encountered. Conclusions The success rate of UI-EWD for immediate hemostasis in cases of GI tumor bleeding was excellent and UI-EWD produced promising results with respect to the prevention of re-bleeding. Based on these results, we suggest that UI-EWD be considered an effective salvage therapy or even monotherapy for GI tumor bleeding.

447 What Age is Best to Perform Myringoplasty?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Wilks ◽  
R Mcleod ◽  
V Unadkat
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Meta Analysis ◽  
Paediatric Population ◽  
Cochrane Library ◽  
Clear Correlation ◽  
Success Rates ◽  
Prisma Statement ◽  
Transitional Point ◽  
The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

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