Flickinger C J, Howards S S, Herr J C
Department of Cell Biology, University of Virginia School of Medicine, Charlottesville 22908.
Microsc Res Tech. 1995 Jan 1;30(1):82-100. doi: 10.1002/jemt.1070300107.
Common principles can be discerned in the response of the epididymis to vasectomy, despite species differences. Increases in the size and number of lysosomes are the most frequent changes in the epididymal epithelium. The presence or absence of additional alterations such as changes in the height of the epithelium may be related to variations in distensibility of the vas deferens and epididymis. Direct measurements by micropuncture of epididymal and seminiferous tubule hydrostatic pressure indicate that, contrary to dogma, increased pressure in the distal epididymis after vasectomy is not generally transmitted to the seminiferous tubules. The epididymal interstitium shows microscopic changes indicative of chronic inflammation, with infiltration of macrophages, lymphocytes, and plasma cells, and rats with these lesions have higher antisperm antibody levels than animals lacking epididymal changes. Macrophages and neutrophils may enter the duct through the epididymal epithelium, at sites of rupture of the duct, and in the efferent ductules. Cyst-like spermatic granulomas occur in virtually all species where the epididymis or vas deferens ruptures with escape of spermatozoa. The sites and timing of granuloma formation may depend on the mechanical properties of the tract in different species, and they are probably important in the immune response to vasectomy. Postvasectomy sera in Lewis rats recognize a consensus repertoire of dominant autoantigens that closely resembles the antigens bound by sera from rats immunized with isologous spermatozoa. There are multiple routes for disposal of the sperm that continue to be produced after vasectomy.
尽管存在物种差异，但在附睾对输精管结扎的反应中仍可发现一些共同原则。溶酶体大小和数量的增加是附睾上皮最常见的变化。是否存在其他改变，如上皮高度的变化，可能与输精管和附睾扩张性的差异有关。通过微穿刺直接测量附睾和生精小管的静水压力表明，与传统观念相反，输精管结扎后附睾远端压力升高一般不会传导至生精小管。附睾间质显示出慢性炎症的微观变化，有巨噬细胞、淋巴细胞和浆细胞浸润，有这些病变的大鼠抗精子抗体水平高于无附睾变化的动物。巨噬细胞和中性粒细胞可能通过附睾上皮、在管道破裂部位以及输出小管进入管道。几乎在所有附睾或输精管破裂导致精子逸出的物种中都会出现囊肿样精子肉芽肿。肉芽肿形成的部位和时间可能取决于不同物种管道的机械特性，它们可能在对输精管结扎的免疫反应中起重要作用。Lewis大鼠输精管结扎后的血清识别出一组主要自身抗原的共有表位，与用同种精子免疫的大鼠血清所结合的抗原非常相似。输精管结扎后仍继续产生的精子有多种清除途径。
