Cilip Christopher M, Pierorazio Phillip M, Ross Ashley E, Allaf Mohamad E, Fried Nathaniel M
Department of Physics and Optical Science, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
Lasers Surg Med. 2011 Sep;43(8):838-42. doi: 10.1002/lsm.21098.
A noninvasive approach to vasectomy may eliminate male fear of complications related to surgery (e.g., hematoma, infection, acute and chronic pain, sterilization failure) and increase its acceptance. Noninvasive laser thermal occlusion of the canine vas deferens has recently been reported. In this study, high-frequency ultrasound is used to confirm successful laser thermal coagulation and scarring of the vas in a short-term canine model.
Bilateral noninvasive laser coagulation of the vas was performed in a total of nine dogs using a laser wavelength of 1,075 nm, incident power of 9.0 W, pulse duration of 500 milliseconds, pulse rate of 0.5 Hz, and 3-mm-diameter spot. Cryogen spray was used to cool the scrotal skin surface and prevent burns during the procedure. A clinical ultrasound system with a 13.2-MHz high-frequency transducer was used to image the vas before and after the procedure. Burst pressure measurements were performed on excised vas to confirm thermal occlusion.
Day 0 and 28 burst pressures averaged 291 ± 31 mmHg and 297 ± 26 mmHg, respectively, significantly greater than ejaculation pressures of 136 ± 29 mmHg. Ultrasound showed a hyperechoic vas segment after thermal coagulation (Day 0) and scarring (Day 28). Doppler ultrasound showed normal blood flow through the testicular artery, indicating no collateral thermal damage to proximal structures.
High-frequency ultrasound may be used as a noninvasive diagnostic tool to assist in determining successful short-term laser thermal coagulation and scarring of the vas.
输精管切除术的非侵入性方法可消除男性对手术相关并发症(如血肿、感染、急慢性疼痛、绝育失败)的恐惧,并提高其接受度。最近有报道称可对犬的输精管进行非侵入性激光热闭塞。在本研究中,使用高频超声在短期犬模型中确认输精管激光热凝固和瘢痕形成是否成功。
对总共9只犬进行双侧输精管非侵入性激光凝固,使用的激光波长为1075nm,入射功率为9.0W,脉冲持续时间为500毫秒,脉冲频率为0.5Hz,光斑直径为3mm。术中使用冷冻喷雾冷却阴囊皮肤表面以防止烧伤。使用配备13.2MHz高频探头的临床超声系统在术前和术后对输精管进行成像。对切除的输精管进行爆破压力测量以确认热闭塞。
第0天和第28天的爆破压力平均分别为291±31mmHg和297±26mmHg,显著高于射精压力136±29mmHg。超声显示热凝固后(第0天)和瘢痕形成后(第28天)输精管节段呈高回声。多普勒超声显示睾丸动脉血流正常,表明近端结构无旁热损伤。
高频超声可用作非侵入性诊断工具,以协助确定输精管短期激光热凝固和瘢痕形成是否成功。