Sperm granuloma
They consist of a central mass of degenerating sperm surrounded by tissue containing blood vessels and immune system cells.
The most common cause of sperm granuloma in pediatric and adolescent patients is often attributed to tumor obstruction, injury, or infection to the area.
[5] While sperm granuloma is considered a complication in most cases, it allows decompression of the vas deferens and epididymis at the vasectomy site.
)[6] Sperm granulomas are diagnosed using a microscope to examine tissues (histology) taken from the area, typically done with fine needle aspiration and occur within a few weeks of a vasectomy.
[2] Additionally, physicians might use high frequency ultrasounds to aid in properly diagnosing epididymal conditions such as sperm granulomas.
[8] Using these ultrasounds provide a better view of the anatomy of the epididymis, which could prevent misdiagnosis of conditions such as testicular tumors or supernumerary testis (the presence of more than two testes).
Moreover, the penetration of germ cells leads to inflammatory and autoimmune reactions that further increase the risk of sperm granuloma formation.
The pain usually radiates to the groin, the junctional area between the abdominal wall and the thigh, and can imitate the feeling of kidney spasms.
In cases where symptoms do not resolve in a reasonable amount of time and NSAID therapy is ineffective, the provider may choose to surgically resect the area where the pain is localized.
Additionally, the stumps of the vas deferens can be burned and closed off in order to reduce the pain the patient is experiencing and prevent it from happening again.
[11] When sperm granulomas are occasionally mistaken for other conditions, such as testicular tumors, a more complicated treatment approach such as an orchiectomy may be accidentally used.
[12] Cauterization is a vasectomy method used to seal the vas deferens by utilizing heat or electricity to burn the lumen.
[13] Specifically, the walls of the vas deferens contained many growths of small ducts and gland-like structures, which came about as a response to the displacement of the sperm and fluid.
The exact cause of his ruptured sperm granuloma was not determined, but it was found to be most likely a secondary response to inflammation and/or trauma.
Upon physical examination and an ultrasound, a solid nodule in the right epididymis was found, and medical staff suspected a tumor.
Non-human species exhibit the same causes for sperm granulomas, including infection, injury, and trauma to the epididymal region.
[12] This is consistent with the idea that these lesions form at the site where there is trauma or a chance for the sperm to leak outside of the vasa deferentia or epididymis.
