Sperm granuloma

Post-traumatic leakage of sperm provoking a granulomatous reaction.

A sperm granuloma is a lump of leaked sperm that appears along the vasa deferentia or epididymides in vasectomized individuals. While the majority of sperm granulomas are present along the vas deferens, the rest of them form at the epididymis. Sperm granulomas range in size, from one millimeter to one centimeter. They consist of a central mass of degenerating sperm surrounded by tissue containing blood vessels and immune system cells.[1] Sperm granulomas may also have a yellow, white, or cream colored center when cut open. While some sperm granulomas can be painful, most of them are painless and asymptomatic.[2] Sperm granulomas can appear as a result of surgery (such as a vasectomy), trauma, or an infection (such as sexually transmitted diseases).[3] They can appear as early as four days after surgery and fully formed ones can appear as late as 208 days later.[4]

Sperm granulomas are a common complication of different types of vasectomy. In vasectomies, the vas deferens are cut and the two ends are tied to prevent sperm from passing. Sperm granuloma may then form at the point where the vas deferens were cut, due to the possibility of sperm leaking out at this site. History of trauma or inflammation of the epididymis can also lead to a sperm granuloma.[2] Sperm granulomas are seen as the body's immune response to sperm being outside of their normal location, and are therefore seen as a protective mechanism.

Sperm granulomas are quite common after surgery, occurring in up to 40% of patients. On the contrary, sperm granulomas comprise only 2.5% of the general population.[5] Amongst adolescents and pediatric patients, sperm granulomas are considered a rare phenomenon as this population does not undergo vasectomy often. 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. This allows for successful future reversal of vasectomy given the good quality sperm in the vas fluid. Any surgery in the genital area can lead to castration anxiety (fear of loss or damage to the genital organ.)[6]

  1. ^ McDonald SW (2000). "Cellular responses to vasectomy". International Review of Cytology. 199: 295–339. doi:10.1016/s0074-7696(00)99006-5. ISBN 9780123646033. PMID 10874581.
  2. ^ a b Cite error: The named reference Yang_2021 was invoked but never defined (see the help page).
  3. ^ Deane LA, Suding PN, Lekawa ME, Narula N, McDougall EM (June 2007). "Sperm granuloma of the inguinal vas deferens mimicking recurrent incarcerated inguinal hernia". Urology. 69 (6): 1209.e1–1209.e3. doi:10.1016/j.urology.2007.03.046. PMID 17572223.
  4. ^ Cite error: The named reference Gade_1990 was invoked but never defined (see the help page).
  5. ^ a b Theisen K, Chaudhry R, Davis A, Cannon G (December 2016). "Epididymal Inflammatory Pseudotumor With Downstream Sperm Granuloma in an Adolescent Patient: A Case Report and Review of the Literature". Urology. 98: 158–160. doi:10.1016/j.urology.2016.06.003. PMID 27292565.
  6. ^ Qureshi F (October 1984). "Vasectomy". Australian Family Physician. 13 (10): 734–5, 737. PMID 6508643.