“…The pathogenesis of the interstitial sperm leak is also uncertain; the relationship with traumas or surgical procedures like hemioplasty or suprapubic pros tatectomy has been stressed [6,11,18]. Traumas would cause increased tubular pressure and spermatic extrava sation [11], but this is not uniformly believed [12], Sperm cells are seldom found within granulomatous tissue, but they could be destroyed by an inflammatory reaction and identification would be possible only in the early phase [10], It is also difficult to explain why more a typical granulomatous reaction occurs within the tubules, in stead of in the interstitium [13], Lipid fractions of leaked spermatozoa could induce a granulomatous reaction with involvement of spermatic cell lines and intratubular for mation of granulomas [1,2,7], Circulating antibodies are not thought to be present because they would produce bilateral involvement, which is seldom found.…”