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Biomedical subjects

S S Schmidt

Publications and source records attributed to S S Schmidt.

At least 19 recordsLinked to original sources

The vas after vasectomy: comparison of cauterization methods.

A histologic study of the vas ends was carried out in 21 patients undergoing vasovasostomy. All had undergone prior vasectomy by the same surgeon, with a technique identical except for the type of cautery used to seal the vas ends. A superior sealing of the vas, as shown by fewer cases of vasitis nodosa and spermatic granuloma, followed use of the thermal cautery ("red-hot wire") than the electrosurgical cautery (23% vs 60.7% suboptimal sealing rate). The thermal cautery is a superior method of sealing the vas at vasectomy.

Cautery

Vasectomy.

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Adult

The Sturgeon Vas Cautery: the first 600 cases.

The Sturgeon Vas Cautery, an inexpensive, reusable battery-powered modular unit, has been used in 600 consecutive successful vasectomies with a minimum of complications and without equipment breakdown.

Electrocoagulation

Pseudocysts of the tunica albuginea: benign invasion by testicular tubules.

We describe a patient undergoing exploration for an epididymectomy in whom a unique apparently multicystic lesion of the testis resulted in orchiectomy. On microscopic examination the lesion was proved to be a benign, previously unreported condition wherein the tunica albuginea was split by an invasion of testicular tubules. We postulate that this condition is a developmental anomaly.

Cysts

Vasectomy.

Vasectomy is an excellent method of permanent contraception for the couple whose family is complete, who are mature and fully informed, and who will accept permanent sterility. It is also valuable in preventing bacterial epididymitis. Vasectomy is customarily performed in the office or clinic setting under local anesthesia. Many techniques may be used, but the cut-fulgurate-and-cover technique has never failed in my experience. Postoperative testing is mandatory, and negative results on two samples, collected one month apart, will ensure that delayed spontaneous recanalization has not occurred. The specific complications of vasectomy are spermatic granulomas of vas or epididymis, congestive epididymitis, and antisperm antibodies. Numerous studies have shown no deleterious effects upon the patient's general health. Manhood, pleasure, and sensation are unchanged, and the woman need no longer fear the possibility of an unwanted pregnancy.

Ambulatory Surgical Procedures

Transseptal crossed vasovasostomy.

We examined 11 patients with acquired obstructive azoospermia resulting from irreparable obstruction of 1 vas deferens and severe damage to the contralateral testis. All of the patients underwent transseptal crossed vasovasostomy with no morbidity. Of 8 patients evaluated with postoperative semen analyses 4 (50 per cent) demonstrated total sperm counts of 29 to 205 million and 2 pregnancies (25 per cent) have been reported, with followup ranging from 5 months to 2 years. The etiologies of the vasal obstruction included previous inguinal surgery in 7 patients, vasectomy in 1, ejaculatory duct obstruction in 1, ectopic ureter in 1 and vasal agenesis in 1. Factors leading to loss of the contralateral testis were torsion in 5 patients, mumps orchitis in 2, varicocele in 1, pediatric inguinal herniorrhaphy in 1, epididymal blow out in 1 and unknown in 1. A representative case involving a unilateral ectopic ureter emptying into the seminal vesicle and subsequent contralateral testicular torsion is presented. The results indicate that a transseptal crossed vasovasostomy should be done in patients satisfying the criteria presented.

Adult

Spermatic grauloma: an often painful lesion.

Spermatic granulomas are specialized abscesses which frequently occur at the site of vasectomy. Although some are often silent, others can be agonizingly painful. A series of 154 granulomas is presented. Of these, 83 were symptomatic and 63 required surgery for relief of pain.

Genital Diseases, Male

Vasovasostomy.

As vasectomy continues in popularity, requests for restoration of fertility increase in number. Anastomosis of the vas deferens is a demanding, technically difficult operation. The principles governing it are different from those of other anastomoses in the body. The suitably equipped surgeon can expect, with practice, to achieve a pregnancy rate of 50% or better for his patient's wife. The operation can easily be performed under local anesthesia in either an office or hospital operating room. Hospitalization is unnecessary, and merely adds unnecessary expense. Disability is minimal, and discomfort minor. The technique of Belker is recommended for practice, since it permits one to inspect the anastomosis from within afterwards.

Anesthesia, Local

The bipolar needle for vasectomy. I. Experience with the first 1000 cases.

A battery-powered, bipolar electrocoagulator has been specifically developed for sealing the cut ends of the divided vas at vasectomy. With a minimum of electric power, the electrocoagulator destroys only the mucosa and one or two muscle cell layers of the vas, which leads to optimal fibrosis of the cut ends. This instrument has been used in more than 1000 vasectomies without a known failure and with a minimum of complications. An analysis of these cases is reported with emphasis upon the method's success in sealing the vas.

Adult