By utilizing the rabbit model, previous studies have found good evidence indicating that vasectomy-induced spermatogenic damage is pressure-mediated: the damage occurs when the occluded reproductive tract is unable to accommodate additional spermatozoa produced by the testis. More studies with the more commonly used rat model have shown, however, controversial results on whether and why the damage occurs. In this study, 12 mature male Sprague-Dawley rats were subjected to unilateral vasectomy: double ligation without severing of the vas deferens exposed via a small inguinal incision; 37 days after the operation, the testes, epididymides, vasa deferentia juxta-epididymal segments , and sperm granulomas at the vasectomy site were removed to obtain methacrylate resin-embedded sections and morphometric studies carried out with light microscopy. It seems therefore that the spermatogenic damage induced by vasectomy in rats is pressure-mediated as well, and that variation in the damage depends mainly on the postoperative development of the sperm granuloma. Li Ma, Yang Guo. These authors contributed equally to this work.
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Is open-ended testicular vasectomy better? - Vasectomy Questions & Answers | ruthann1.com
The presence of a sperm granuloma at the vasectomy site prevents epididymal pressure build-up, perforation, and the formation of an epididymal sperm granuloma. It thus enhances reversibility of the vasectomy and lessens the likelihood of epididymal discomfort. In two prospective vasectomy series, a sperm granuloma was intentionally allowed to form by not sealing the testicular end of the vas. The sperm granuloma resulted in no instance of orchialgia, but created a greater risk of spontaneous recanalization. This latter problem could only be solved by more careful sealing of the upper end of the vas.
Purpose: We studied the impact of the interval from vasectomy to reversal and presence of sperm granuloma on outcomes of reversal. Materials and Methods: A total of microsurgical vasectomy reversals performed by a single surgeon were stratified according to obstructive intervals of less than 5 years, 5 to 10 years, 10 to 15 years and greater than 15 years. The effects of obstructive interval on patency and pregnancy rates were assessed using multivariate logistical regression.
Refertilizing and sperm quality are better in cases of sperm granulomata and, as opposed to previous assumptions, reduced fertility is not found in cases of sperm granulomata in patients with sperm antibodies. Fewer complaints are observed after open end vasectomy despite the particularly high incidence of sperm granulomata. Unfortunately, the literature does not appear to contain randomized investigations as guidelines for the choice of surgical method for vasectomy. New investigations have hinted at the beneficial effect of refertilization. Granulomas are knot like tumors localized in the testis, epididymis, or ductus deferens and usually measure mm.