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P T Gilbert

Publications and source records attributed to P T Gilbert.

2 recordsLinked to original sources

Nd:YAG coagulation of the verumontanum: an endoscopic attempt at sterilization.

In order to develop a new and less invasive method of sterilization in men we performed photocoagulation of the verumontanum in 10 rams, using a Nd:YAG laser, wavelength 1,060 nm. Under general anesthesia a perineal urethro-cutaneous fistula was achieved, and, by means of a 16F laser-endoscope, transurethral coagulation of the ejaculatory ducts, located in the verumontanum, was carried out, using pulses of 1.5 sec in duration and 20-30 W in power. The animals were killed at different postoperative time intervals, ranging from 1 day to 8 weeks. Injection of methylene-blue into the testicular ducts of the resected prostate-bladder specimen and histologic studies of the coagulated tissue revealed that complete bilateral occlusion of the ejaculatory ducts had been achieved in 4 rams. Failures were due to over-extended irradiation of the verumontanum. Except for urinary tract infections occurring in 4 animals, no serious complications were encountered. Further investigations are still necessary to determine the role of lasers in male sterilization.

Animals↗

Laser-assisted vasovasostomy.

To find a less time-consuming alternative to conventional microsurgical vasovasostomy, we performed vasal anastomosis in four sterilized men by means of a Nd:YAG laser (wavelength 1,060 nm) under macroscopic conditions. After dissection of the vasal ends, the ends were approximated using 6-0 prolene sutures as intervasal stents. The apposed tissue edges were welded by laser pulses of 0.5 sec in duration and 10 W in power. Postoperative sperm counts proved normal in two patients; one of them reported a successful pregnancy in his wife 12 months after vasovasostomy. One patient had cryptospermia and one patient oligoasthenospermia. Laser-assisted vasovasostomy is a simple procedure and shortens the operative time. More patients still need to be studied to allow a favorable comparison with conventional suture techniques.

Adult↗