title: Use of viscoelastic solution to improve visualization during urologic microsurgery: evaluation of patency after vasovasostomy.
abstract: OBJECTIVE
  Viscoat is a nonpyrogenic, sterile, viscoelastic solution used to protect the endothelium and enhance visualization during cataract and corneal surgery. Commonly used in ophthalmic surgery, we evaluated whether it could improve the optics during urologic microsurgery without adversely affecting outcomes.
  
  
  METHODS
  We retrospectively compared consecutive vasovasostomies performed by a single surgeon with (n = 23) and without (n = 50) the bilateral use of Viscoat. The examined parameters included patient age, vasectomy duration, intraoperative sperm characteristics, patency (ejaculation of motile sperm), time to patency, and postoperative semen characteristics. The comparisons of the sample mean values and proportions were assessed with analysis of variance, Wilcoxon, and chi(2) tests.
  
  
  RESULTS
  Subjectively, Viscoat improved visualization of the vasal lumen and suture placement and aided in resident and fellow instruction. The vasovasostomy cases performed with and without the use of Viscoat were similar with regard to the patient and intraoperative characteristics. The overall patency rates were similar between the two groups (91% vs 92%, P = .92) with a median follow-up of 7 months. In addition, the best total motile sperm count and the durability of the patency achieved were similar between the two groups.
  
  
  CONCLUSIONS
  Viscoat is a dispersive agent that does not adversely affect surgical patency after vasovasostomy. Subjectively, it helped with visualizing the lumen of the vas deferens during urologic microsurgery.
authors.affiliation: Department of Urology, University of California, San Francisco, School of Medicine, San Francisco, California, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Eisenberg
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Turek
mesh_terms: D000328:Adult; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008866:Microsurgery / Q000379:methods*; D012189:Retrospective Studies; D014649:Vas Deferens; D014669:Vasovasostomy / Q000379:methods*; D055682:Viscoelastic Substances
chemical_list: D055682:Viscoelastic Substances