Quantitative pathologic changes in the human testis after vasectomy. A controlled study

IgG antisperm antibodies attached to sperm do not correlate with infertility following vasovasostomy

The sperm of 12 men postvasovasostomy was tested for antisperm antibodies by means of a mixed antiglobulin reaction (MAR) test. Agglutinating antibodies were found in 58% of these patients: 50% of the men whose partners became pregnant and 75% of those whose partners did not become pregnant. No significant difference in the level of antibody attachment could be found between the fertile group and the infertile group. Damage to the testis and epididymis following vasectomy seems more likely to interfere with subsequent fertility following vasectomy reversal.

Anatomy of the testis and epididymis in cryptorchidism

The types and incidence of deformities in the proximal seminal pathways have been carefully studied in 150 consecutive orchidopexies. 85% of the testicles were found in the subcutaneous tissue, 15% were in the canal or the abdomen. Malunion between the testis and the epididymis was the type of anomaly most frequently encountered. Deformities considered to affect fertility were seen in 70% of the gonads located proximal to the external inguinal ring and in 12% of the subcutaneous testicles. The difference is statistically significant.

Plasma reproductive hormones in normal and vasectomized Chinese males

Plasma reproductive hormones (testosterone, LH, FSH and prolactin) were measured in 298 normal healthy males aged 30-73 years from rural areas of Sichuan Province, People's Republic of China, and in 505 similar men vasectomized between 1 year and 25 years previously. Age-related increases in LH and FSH but not in testosterone or prolactin were noted in normal men. No adverse effects of vasectomy were observed apart from a 16% increase in mean LH levels in the vasectomized compared to non-vasectomized men of similar ages.

The influence of vasovasostomy on testicular alterations after vasectomy in Lewis rats

The occurrence of alterations in testicular weight and morphology after vasectomy and vasectomy reversal by vasovasostomy was studied in Lewis rats. Animals were studied 3, 4, and 7 months after bilateral vasectomy or a vasectomy followed 3 months later by vasovasostomy. Other rats served as sham-operated controls. The weights of the testes in vasectomy and vasovasostomy animals fell into two groups-small testes weighing less than 0.88 g and normal-sized testes of 1.2 g or more. When the extent of testicular alterations was estimated in sections for light microscopy by use of a semiquantitative testicular biopsy score count (TBSC), the morphology of the testes corresponded closely to the testis weight (r = .94), small testes having correspondingly low TBSC scores. In severely altered small testes, the seminiferous tubules were narrower than in sham-operated rats, and numbers of germ cells were greatly depleted. Many tubules contained only Sertoli cells and spermatogonia, although spermatocytes were present in a minority of tubules. A few seminiferous tubules contained multinucleate spermatids. Electron microscopy of severely altered tubules revealed closely apposed processes of Sertoli cells, which contained filaments, microtubules, and endoplasmic reticulum. In contrast, testes with normal weight in vasectomy and vasovasostomy groups resembled those of the sham-operated animals. Comparison of distributions of testicular biopsy score counts demonstrated differences between vasectomy and vasovasostomy groups as time after operation increased. At the 3-4-month intervals, approximately one-third of the testes were severely altered in both vasectomy and vasovasostomy groups.(ABSTRACT TRUNCATED AT 250 WORDS)

A 20-year experience with vasovasostomy

A total of 624 of 699 vasovasostomy patients was followed during the last 20 years. Better results were obtained when there was shorter duration of obstruction, bilateral straight vas-to-straight was anastomosis and bilateral presence of sperm in the vas fluid during vasovasostomy. Results of end-to-end and side-to-side macrosurgical anastomosis, as well as of 1-layer and 2-layer microsurgical anastomosis were similar. Macrosurgical success rates were 84 per cent for patency and 35 per cent for pregnancy in the 300 cases. Microsurgical success rates were 90 per cent for patency and 51 per cent for pregnancy in 324 cases. Failure of patency was caused mainly by anastomotic scar formation with sperm and suture granulomas. Failure of pregnancy was owing mainly to inadequate postoperative semen quality.