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  • Title: The effects of vasectomy on the testis.
    Author: Flickinger CJ.
    Journal: N Engl J Med; 1985 Nov 14; 313(20):1283-5. PubMed ID: 4058509.
    Abstract:
    The increased use of vasectomy for population control has led to a large number of animal studies on the morphologic, physiologic, and immunologic responses to this procedure. The extent, nature, and timing of morphologic alterations in the testis showed marked species variations and ranged from autoimmune orchitis to an absence of detectable changes. Physiologic studies indicated, contrary to expectation, that the hydrostatic pressure was elevated only in the distal part of the epididymis and not in the seminiferous tubules of several species. Immunologic studies have shown an increase in serum levels of antisperm antibody after vasectomy in a large number of species, but marked differences have been noted even between strains of a given species. In most cases, sperm appear to escape the duct system at some point, causing the formation of a spermatic granuloma. The location and time of development of granulomas after vasectomy may be related to regional differences in the distensibility of the duct system. Difficulties in obtaining tissue specimens have limited information about potential morphologic alterations in human testes after vasectomy, but spermatic granulomas have been reported. In addition, 50-70% of men are reported to have elevated serum levels of antisperm antibody after vasectomy. The relatively small proportion of men who become fertile after vasectomy reversal by vasovaostomy (40-70%) may involve antisperm antibodies in the serum or reproductive tract fluids. An immunologic response to extravasated spermatozoa may be involved in testicular alterations after vasectomy. The mechanism of the pathogenesis of testicular changes after vasectomy remains an important focus for research as the demand for vasectomy reversal continues to grow.
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