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  • Title: The effects of vasectomy on the autonomic innervation of the human vas deferens.
    Author: Dixon JS, Gilpin CJ, Gilpin SA, Gosling JA, Grant JF.
    Journal: J Urol; 1987 May; 137(5):1014-6. PubMed ID: 2437328.
    Abstract:
    Neurohistochemical and fine structural techniques have been employed to examine the intramural autonomic innervation of the human vas deferens following surgical division of the duct one to 15 years previously. Samples from sites on the distal (testicular) and proximal (urethral) aspects of the original vasectomy have been compared with control specimens obtained at vasectomy as to the arrangement and distribution of autonomic nerves. In contrast with tissue from the proximal part and from controls, the distal samples revealed a marked reduction in the noradrenergic innervation of the muscle coat. In addition acetylcholinesterase-containing nerves associated with the basal aspect of the epithelium were usually absent from the distal portion of the vas deferens. These findings have been considered in relation to the contractile and secretory activities of the organ following vasovasostomy and may be of importance to the maturation and fertility of spermatozoa. Vas deferens specimens taken from 43 men during vasovasostomy were examined by histochemical techniques and electron microscopy for evidence of noradrenergic and acetylcholinergic nerve structures. The subjects had been vasectomized 1-15 years ago (mean 6.5 years). Controls were 22 men being operated for vasectomy. Light microscopy revealed fine noradrenergic nerve plexi throughout the muscle coat, in the proximal, urethral portions of the vas, and circling blood vessels in the adventitia, as well as in both proximal and distal control specimens. The distal, testicular specimens of previously vasectomized men contained only occasional adrenergic fibers. In proximal or urethral portions, fine cholinergic nerves occurred in the muscle coat; large ones in the adventitia near blood vessels, and numerous cholinergic fibers were located under the epithelium. In distal, testicular portions, cholinergic nerves were similar to controls and to urethral specimens from vasectomized men in the muscle layer only, but absent in lamina propria. Ultramicroscopic structure of these various nerve fibers is described in detail. It is to be noted that the distal portion of the vas is the testicular portion, as concerns innervation, and this is lost after vasectomy. It was remarkable to see evidence of reinnervation of cholinergic axons distally, however. It has been established that noradrenergic control is important for the motor and secretory activities of the vas. Physiological significance of adrenergic innervation is unknown. These results add evidence for the advice to men seeking vasectomy to consider it a permanent form of fertility control.
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