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High Intensity Focused Ultrasound Ablation of the Vas Deferens in a Canine Model

2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 6 Linguagem: Inglês

10.1016/s0022-5347(05)65046-x

1527-3792

William W. Roberts, David Y. Chan, Nathaniel M. Fried, E. James Wright, Theresa L. Nicol, Thomas W. Jarrett, Louis R. Kavoussi, Stephen B. Solomon,

Sexual function and dysfunction studies

No AccessJournal of UrologyINVESTIGATIVE UROLOGY1 Jun 2002High Intensity Focused Ultrasound Ablation of the Vas Deferens in a Canine Model WILLIAM W. ROBERTS, DAVID Y. CHAN, NATHANIEL M. FRIED, E. JAMES WRIGHT, THERESA NICOL, THOMAS W. JARRETT, LOUIS R. KAVOUSSI, and STEPHEN B. SOLOMON WILLIAM W. ROBERTSWILLIAM W. ROBERTS , DAVID Y. CHANDAVID Y. CHAN , NATHANIEL M. FRIEDNATHANIEL M. FRIED , E. JAMES WRIGHTE. JAMES WRIGHT , THERESA NICOLTHERESA NICOL , THOMAS W. JARRETTTHOMAS W. JARRETT , LOUIS R. KAVOUSSILOUIS R. KAVOUSSI , and STEPHEN B. SOLOMONSTEPHEN B. SOLOMON View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65046-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: High intensity focused ultrasound is an ablative technology capable of producing thermal coagulative necrosis of sub-surface structures without injuring intervening tissues. We assessed the feasibility of using high intensity focused ultrasound to produce occlusion of the canine vas deferens. Materials and Methods: A high intensity focused ultrasound transducer was incorporated into a hand held clip specially designed to grasp the vas deferens transcutaneously. Slots within the jaws of the clip ensured that the vas deferens and high intensity focused ultrasound target zone were properly co-located. We ablated 10 vasa using a range of power and time parameters. At 2 weeks after ablation each vas, epididymis and testis was surgically harvested en bloc. Retrograde vasography was performed to assess vasal occlusion, followed by pathological analysis. Results: High intensity focused ultrasound occlusion of the vas deferens was confirmed in 4 specimens ablated with parameters at the upper end of the parameter range, 2 of the 2 ablated with 7 W. for 60 seconds and 2 of the 4 ablated with 7 W. for 30 seconds. Histological injury was noted in 8 of the 10 ablated specimens. Skin burns that developed over 4 of the targeted vasa were conservatively managed. Bilateral sham procedures in a control dog resulted in patent vasa and no associated skin burns. Conclusions: We demonstrated the feasibility of noninvasive, transcutaneous high intensity focused ultrasound occlusion of the vas deferens with ablation powers at the upper end of the tested range, that is 7 W. Modifications of the hand held clip and optimization of ablation parameters would likely improve the success rate of this procedure. Refinement of this technology may provide a rapid noninvasive alternative to conventional vasectomy. References 1 : Surgical sterilization in the United States: prevalence and characteristics, 1965–95. National Center for Health Statistics. Vital Health Stat1998; 23: 1. Google Scholar 2 : Safety and effectiveness of vasectomy. Fertil Steril2000; 73: 923. Google Scholar 3 : Sterilization: Canadian choices. 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Google Scholar From the Brady Urological Institute and the Departments of Pathology and Radiology, The Johns Hopkins Medical Institutions, Baltimore, Maryland© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 167Issue 6June 2002Page: 2613-2617 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordstestisultrasonographyvas deferensdogsvasectomyMetricsAuthor Information WILLIAM W. ROBERTS More articles by this author DAVID Y. CHAN More articles by this author NATHANIEL M. FRIED More articles by this author E. JAMES WRIGHT More articles by this author THERESA NICOL More articles by this author THOMAS W. JARRETT More articles by this author LOUIS R. KAVOUSSI More articles by this author STEPHEN B. SOLOMON More articles by this author Expand All Advertisement PDF DownloadLoading ...