Vasitis nodosa and spermatic granuloma of the skin: an histologic study of a rare complication of vasectomy

Abstract

A 29-year-old man noticed localized painful swelling of the scrotal skin after elective vasectomy. The lesion was excised and its histologic examination revealed a diffuse inflammatory, partly granulomatous infiltrate with numerous tubular structures in the dermis and subcutaneous tissues. These ductules were lined by cuboidal epithelial cells and contained spermatozoa. The inflammatory infiltrate consisted of lymphocytes, plasma cells and histiocytes, but also contained spermatozoa and a few spermatic granulomas. These changes were the sequelae of a vasocutaneous adhesion and fistula; the ductules were the result of epithelial regeneration from the vas deferens and the inflammation with spermatic granulomas was due to extravasated spermatozoa.

Complications of vasectomy

“…27,28 Vasocutaneous fistulae probably result following a sperm granuloma at the site of vasectomy, which adheres to the skin incision. 29 Vasocutaneous urinary fistula generally occurs in the presence of an underlying voiding dysfunction, such as neurogenic bladder or bladder outflow obstruction, leading to high pressure voiding and reflux of urine into the vas. 27,28 2.…”

A Case of Vasitis Nodosa with Biphenotypic Differentiation

“…Most cases of vasitis nodosa occurred within 2 months to 19 years post operation (17). It was thought to be a result of a breach in the lining epithelium due to increased intravasal pressure and subsequent epithelial regeneration (18). This is could be attributed to an attempt at re-establishing the communication in an obstructed lumen and restoring the reproductive capacity of the individual (19).…”

A Case of Vasitis Nodosa with Biphenotypic Differentiation

“…Most cases of vasistis nodosa occurred within 2 months to 19 years post operation (17). It was thought to be a result of a breach in the lining epithelium due to increased intravasal pressure and subsequent epithelial regeneration (18). This is could be attributed to an attempt at re-establishing the communication in an obstructed lumen and restoring the reproductive capacity of the individual (19).…”