Vasal irrigation with sterile water and saline solution for acceleration of postvasectomy azoospermia

Vasectomy is the safest and most reliable method of all the contraception methods, but azoospermia is not achieved immediately by this method. We decided to determine whether irrigation of the vas deferens with sterile water or hypertonic saline solution irrigation during vasectomy would reduce the time needed to obtain azoospermia. A total of 126 fertile men presented for vasectomy were divided in 3 groups. No-scalpel vasectomy was done for all of the participants and irrigation of the vas deferens was carried out during the procedure in 2 groups with either sterile water or hypertonic saline solution [9 g/L sodium chloride solution]. Forty-two participants underwent vasectomy without irrigation. Semen analysis was performed at 4, 8, 12, and 16 weeks after vasectomy. Azoospermia was achieved in all of the men with sterile water after 12 weeks, while at the end of the study [16 weeks] it was achieved in 37 [88.1%] of those with saline solution and in 11 [26.2%] of those without irrigation. There were significant differences in the rates of azoospermia between the participant with sterile water and saline solution at 8 weeks [38.1% versus zero; P < .001], 12 weeks [100% versus 30.9%; P < .001], and 16 weeks [100% versus 88.1%; P = .02]. No pregnancy developed during the follow-up and no complication was reported. Vasal irrigation with sterile water and hypertonic saline solution during vasectomy were effective in removing sperm from the distal vas and increasing the rate at which men achieved azoospermia. Sterile water was a promising option with no complications

Diagnostic accuracy of C-reactive protein and erythrocyte sedimentation rate in patients with acute scrotum

Our aim was to investigate the diagnostic efficacy of C-reactive protein [CRP] and erythrocyte sedimentation rate [ESR] in patients with acute scrotum. One hundred and twenty patients with an acute scrotum were evaluated and assigned into 3 groups: 46 had acute epididymitis [group 1], 23 had spermatic cord torsion [group 2], and 51 had other noninflammatory causes of acute scrotum. Serum samples of all patients taken at the time of admission were tested for CRP levels and ESR. An at least 4-fold increase in the serum CRP levels was seen in 44 patients [95.6%] in group 1 [mean, 67.77 +/- 47.80 mg/L]. In contrast, only 1 patient in group 2 had a significant increase in serum CRP level [mean, 9.0 +/- 4.90 mg/L]. The patients in group 3 did not experience any significant increase of CRP levels [mean, 7.0 +/- 2.2 mg/L]. The patients with epididymitis had higher CRP and ESR values than others [P <.001; P <.001]. The best cutoffs were 24 mg/L for CRP and 15.5 mm/h for ESR to differentiate between epididymitis and noninflammatory causes of acute scrotum. The sensitivity and specificity were 93.4% and 100% for CRP and 95.6% and 85.1% for ESR, respectively. Based on our findings, serum levels of CRP and ESR can provide helpful information easily and rapidly for differentiation between epididymitis and other causes of acute scrotum. We suggest CRP and ESR be measured before making a decision of surgical exploration