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Mp19-20 Impact of the 2012 American Urological Association Vasectomy Guidelines on National Trends in Post-vasectomy Outcomes in the United States

Year: 2018
Type: article
Abstract: While buffered formalin (BF) is the most common fixative used in pathology, its use for a testicular fixative has been discouraged due to concern that it may cause histologic artifact that could hamper assessment of spermatogenesis.We evaluated TB fixed in BF and those fixed in BS to assess any difference in histology quality.METHODS: 103 patients who underwent TB from January 2000 through December 2016 were identified.Representative slides from 12 patients, 6 fixed with BF and 6 fixed with BS, were evaluated by a genitourinary (GU) pathologist blinded to the fixative used.Nuclear, cytoplasmic, and basement membrane (NM, CM, BM) detail, and nuclear and cytoplasmic granularity (NG, CG), were graded as crisp (high quality) or blurred (low quality).In an attempt to minimize aging artifact in specimens, an additional two pairs of rat testicles were harvested.Each testis was sectioned in half; one half was fixed in BF and one half in BS to yield a total of 8 slides.These were evaluated by a GU pathologist blinded to the fixative used for each case using criteria above.RESULTS: Of 71 patients, 56 (78.8%) specimens were fixed in BF, 8 (11.3%) in Zinc formalin, and 7 (9.86%) in BS. 22 slides from 6 specimens fixed in BS and 12 slides from 6 specimens fixed in BF were graded based on above quality metrics.NM detail was crisp in all slides fixed in BF (12/12) and in 10 of 22 slides fixed in BS.NG was crisp in all slides fixed in BF (12/12) and in BS (22/22).CG was crisp in 10 of 12 BF slides and in 16 of 22 BS slides.CM detail was crisp in all BF fixed slides and in 20 of 22 BS fixed slides.BM detail was crisp in all BF slides (12/12) and in 12 of 22 BS slides.For the rat testes, the BF fixed tissue was described as crisp for each metric in all four slides (4/4).The BS fixed tissue had crisp CM detail (4/4), crisp CG (4/4), and BM detail (4/4).However, the NM detail was blurred in half of the tissue (2/4), and the NG was blurred in 3 of 4 slides.CONCLUSIONS: Slides from BF fixed specimens were found to be high quality in the evaluated metrics.CG was the only metric that was found to be low quality in one specimen fixed in BF.BS slides demonstrated more variability in quality across all metrics, with each specimen having at least one metric that was found to be blurred, or low quality.These findings were demonstrated in the rat testes as well.We conclude that spermatogenesis and testicular histology can be adequately evaluated with formalin fixation.
DOI: 10.1016/j.juro.2018.02.669
Language: English
Open Access status: bronze
OpenAlex ID: W2796270637
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