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Anastomosis of the Vas Deferens: An Experimental Study III. Dilatation of the Vas Following Obstruction
THE JoUR'.'V1.L OF UROLOGY
Vol. 81, No. 1, January 1959 Printed in U.S.A.
ANASTOMOSIS OF THE VAS DEFEREKS: AN EXPERIMENTAL STUDY III. DILATATION OF THE VAS FOLLOWING OBSTRUCTION STANWOOD S. SCHMIDT This report concerns the effect of vasectomy or similiar obstruction upon the diameter of the lumen of the vas, and the effect of relieving the obstruction by successful anastomosis of the vas. Following a suggestion that dilatation of the vas proximal to the point of ligation occurred, a series of ten human cases was studied. In each of these cases vasectomy had been done six months or more prior to examination, either in association with prostatectomy or for purposes of sterilization. The area of ligation was excised and cross sections were then made of the proximal and distal portions of the vas. In every case the proximal vas was found to be dilated when compared with the distal vas; the lumen averaged four to five times larger in diameter. The epithelium in both the distal and proximal vas was identical; flattening and atrophy did not occur (figs. 1-3). The opportunity arose in one of these cases to examine a successful anastomosis of the vas This study was made possible by a grant from The Population Council, Inc., New York City. Read at annual meeting of Western Section of American Urological Association, Inc., Palm Springs, Cal., February 3-6, 1958.
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deferens, one in which dilatation had occurred as a result of a vasectomy 21 years earlier. The anastomosis had been done 22 months previously and was clinically patent. Obstruction in the epididymis led to further operative treatment and excision of the anastomosed area. In this case the lumen of the vas was found to be of equal diameter both above and below the anastomosis. This demonstrates that the vas dilates from internal pressure after obstruction and that such dilatation is reversible (fig. 4). Other authors have noted a similiar dilatation m the epididymis. 1 • 2 SUMMARY
The vas deferens dilates following obstruction. This dilatation is reversible.
7'07 K St., Eureka, Cal. 1 Friedman, N. B. and Garske, G. L.: Inflammatory reactions involving sperm and the seminiferous tubules: Extravasation, spermatic granulomas and granulomatous orchitis. J. Urol., 62:
363-374, 1949. 2 Rieger, I. T. and Fuller, R. H.: Spermatic granuloma of the epididymis: Case report. J. Urol., 69: 819-822, 1953.
AKASTOMOSIS OF VAS DEFERENS TI
FIG. 1. A, proximal human vas 6 months after vasectomy. X 100. B, distal vas of same patient
FIG. 2. A, proximal human vas 18 months after vasectomy. X 100. B, distal vas of same patient
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STANWOOD S. SCHMIDT
Fm. 3. A, proximal vas of dog 30 days after unsuccessful attempt at anastomosis.Note sperm in lumen. X 35. B, distal vas of same dog.
Fm. 4. Longitudinal section through successful anastomosis of human vas done 2 years previously. Lumen can be seen on either side of actual point of anastomosis which is in center of picture. Suture material seen at right. Reaction is minimal. X35
Vol. 81, No. 1, January 1959 Printed in U.S.A.
ANASTOMOSIS OF THE VAS DEFEREKS: AN EXPERIMENTAL STUDY III. DILATATION OF THE VAS FOLLOWING OBSTRUCTION STANWOOD S. SCHMIDT This report concerns the effect of vasectomy or similiar obstruction upon the diameter of the lumen of the vas, and the effect of relieving the obstruction by successful anastomosis of the vas. Following a suggestion that dilatation of the vas proximal to the point of ligation occurred, a series of ten human cases was studied. In each of these cases vasectomy had been done six months or more prior to examination, either in association with prostatectomy or for purposes of sterilization. The area of ligation was excised and cross sections were then made of the proximal and distal portions of the vas. In every case the proximal vas was found to be dilated when compared with the distal vas; the lumen averaged four to five times larger in diameter. The epithelium in both the distal and proximal vas was identical; flattening and atrophy did not occur (figs. 1-3). The opportunity arose in one of these cases to examine a successful anastomosis of the vas This study was made possible by a grant from The Population Council, Inc., New York City. Read at annual meeting of Western Section of American Urological Association, Inc., Palm Springs, Cal., February 3-6, 1958.
206
deferens, one in which dilatation had occurred as a result of a vasectomy 21 years earlier. The anastomosis had been done 22 months previously and was clinically patent. Obstruction in the epididymis led to further operative treatment and excision of the anastomosed area. In this case the lumen of the vas was found to be of equal diameter both above and below the anastomosis. This demonstrates that the vas dilates from internal pressure after obstruction and that such dilatation is reversible (fig. 4). Other authors have noted a similiar dilatation m the epididymis. 1 • 2 SUMMARY
The vas deferens dilates following obstruction. This dilatation is reversible.
7'07 K St., Eureka, Cal. 1 Friedman, N. B. and Garske, G. L.: Inflammatory reactions involving sperm and the seminiferous tubules: Extravasation, spermatic granulomas and granulomatous orchitis. J. Urol., 62:
363-374, 1949. 2 Rieger, I. T. and Fuller, R. H.: Spermatic granuloma of the epididymis: Case report. J. Urol., 69: 819-822, 1953.
AKASTOMOSIS OF VAS DEFERENS TI
FIG. 1. A, proximal human vas 6 months after vasectomy. X 100. B, distal vas of same patient
FIG. 2. A, proximal human vas 18 months after vasectomy. X 100. B, distal vas of same patient
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STANWOOD S. SCHMIDT
Fm. 3. A, proximal vas of dog 30 days after unsuccessful attempt at anastomosis.Note sperm in lumen. X 35. B, distal vas of same dog.
Fm. 4. Longitudinal section through successful anastomosis of human vas done 2 years previously. Lumen can be seen on either side of actual point of anastomosis which is in center of picture. Suture material seen at right. Reaction is minimal. X35