Sherlock D J, Holl-Allen R T
Br J Surg. 1984 Jul;71(7):532-3. doi: 10.1002/bjs.1800710720.
Eight patients were identified who had undergone successful vasectomy a mean of 4.6 years previously and in whom all were microscopically shown to have recurrent motile spermatozoa in their ejaculate. All had been referred following a pregnancy in their wives, and all agreed to undergo repeat vasectomy. Histological examination of the excised portions revealed the presence of spermatozoa in the distal end of one side; but also the presence of a well formed sperm granuloma in continuity with both divided ends of the vas. There does not appear to be any correlation with the suture previously used, nor incidence of infections or injury. Although recanalization is a recognized complication of vasectomy, the majority have occurred within months of the operation. The association of the delayed recanalization with sperm granuloma formation in these cases suggests an aetiological link, it being previously reported that such granuloma can develop up to six years postoperatively.
我们确定了8名患者,他们平均在4.6年前成功接受了输精管结扎术,并且经显微镜检查发现,他们的精液中均有复发性活动精子。所有患者均因妻子怀孕而前来就诊,且均同意接受再次输精管结扎术。对切除部分的组织学检查显示,一侧远端存在精子;但同时也存在一个与输精管两端相连的结构良好的精子肉芽肿。这似乎与先前使用的缝线、感染或损伤的发生率均无关联。虽然再通是输精管结扎术公认的并发症,但大多数发生在术后数月内。在这些病例中,延迟再通与精子肉芽肿形成之间的关联提示了一种病因学联系,此前有报道称,这种肉芽肿可在术后长达6年形成。