Vas anastomosis: Fertility evaluation of a bovine-free component fibrin-glued procedure

Objectives: to evaluate a new fibrin glue (FG) with no bovine derived component for vas anastomosis (VA) and to compare this product to conventional fibrin-glued VA. In the commercially available FG the fibrinolysis inhibitor component, aprotinin, is bovine derived and the risk of Bovine Transmissible Encephalopathy (BTE) cannot be excluded. Methods: Bilateral delayed VA was performed in 40 Sprague-Dawley rats All animals underwent a FG assisted VA with three transmural sutures tied prior to FG application. The composition and preparation of FG was similar for all VA except the fibrinolysis inhibitor component which was as follow : l)Group 1 (20 rats): Aprotinin (3000KUI/ml) -2)Group 2 (20 rats): Tranexamic acid (10mgr/ml). Tranexamic acid is a synthetic antifibrinolytic. Four weeks post-operatively each rat was allowed a 3-week mating period with a Sprague-Dawley female rat. Then the animals were sacrificed for fertility study and sperm granuloma incidence at the anastomotic site. Results: Fertility rates (%) Sperm granuloma incidence (%) Group 1 : 80 (n=20) 40 (n=40) Group 2: 65 (n=20) 45 (n=40) NS NS Conclusion: Recent experimental reports have shown the effectiveness of fibrin-glued VA in a delayed protocol. Fertility performance is the true goal for all VA procedure. Our study proved similar results whatever a bovine derived or a synthetic fibrinorysis inhibitor component is used. The risk due to bovine derived products regarding BTE makes our study of much interest and deserves further experimental study.