Sperm granuloma and reversibility of vasectomy

Ninety-two consecutive patients who had undergone bilateral vasectomy 1 month to 28 years earlier were studied at the time of vasectomy reversal for sperm output, dilatation of the vas-deferens lumen, and sperm granuloma. Thirty-nine men had unilateral or bilateral sperm granuloma. The presence of of a sperm granuloma virtually assured normal sperm in the vas fluid no matter how long ago the vasectomy was performed. In the absence of a sperm granuloma, the interval since vasectomy had an important influence on the quality of vas fluid. The presence of a sperm granuloma was associated with significantly less dilatation of vas-deferens lumen at the testicular end. The site of the vasectomy and the amount of vas deferens removed did not influence sperm quality. A sperm granuloma on only one side resulted in normal spermatozoa in the vas fluid on that side, whereas the side without the sperm granuloma had abnormal spermatozoa or no spermatozoa in the vas fluid. It is concluded that when sperm granuloma follows vasectomy it vents the high pressure otherwise created by vasectomy and prevents disruption of sperm output in the vas fluid.