Fertility and sterility · 2002
Focused ultrasound ablation of the epididymis with use of thermal measurements in a canine model.
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Fried Nathaniel M, Roberts William W, Sinelnikov Yegor D, Wright E James, Solomon Stephen B
Аннотация
OBJECTIVE: To explore the epididymis as an alternative anatomical target to the vas deferens for noninvasive male sterilization using therapeutic focused ultrasound.
DESIGN: Controlled preclinical study.
SETTING: Canine animal model in an academic research environment.
PATIENT(S): Four healthy male mongrel dogs (30-35 kg).
INTERVENTION(S): A transducer mounted on a plastic clip delivered ultrasound energy to the canine epididymis. Thermocouples placed transcutaneously into the epididymis, intradermally, and on the skin surface recorded temperatures during ablation with a wide range of acoustic powers and sonication times (control, 3 W/120 s, 5 W/90 s, 7 W/60 s).
MAIN OUTCOME MEASURE(S): Thermocouple temperature measurements determined the optimal range of ablation parameters that produced successful thermal occlusion of the epididymis without adverse effects (e.g., skin burns, testicular injury).
RESULT(S): A large "therapeutic window" was determined (power = 3-7 W, time = 20-120 seconds) over which noninvasive thermal occlusion of the epididymis can be achieved. Thermal occlusion rates were higher, and complications lower, than found previously with vas deferens ablation.
CONCLUSION(S): The epididymis represents a larger and easier target than the vas deferens for performing noninvasive male sterilization using focused ultrasound. Long-term azoospermia studies will be necessary to confirm permanent sterilization with this technique.
DESIGN: Controlled preclinical study.
SETTING: Canine animal model in an academic research environment.
PATIENT(S): Four healthy male mongrel dogs (30-35 kg).
INTERVENTION(S): A transducer mounted on a plastic clip delivered ultrasound energy to the canine epididymis. Thermocouples placed transcutaneously into the epididymis, intradermally, and on the skin surface recorded temperatures during ablation with a wide range of acoustic powers and sonication times (control, 3 W/120 s, 5 W/90 s, 7 W/60 s).
MAIN OUTCOME MEASURE(S): Thermocouple temperature measurements determined the optimal range of ablation parameters that produced successful thermal occlusion of the epididymis without adverse effects (e.g., skin burns, testicular injury).
RESULT(S): A large "therapeutic window" was determined (power = 3-7 W, time = 20-120 seconds) over which noninvasive thermal occlusion of the epididymis can be achieved. Thermal occlusion rates were higher, and complications lower, than found previously with vas deferens ablation.
CONCLUSION(S): The epididymis represents a larger and easier target than the vas deferens for performing noninvasive male sterilization using focused ultrasound. Long-term azoospermia studies will be necessary to confirm permanent sterilization with this technique.