The patient received anti-inflammatory and antibiotic treatment, and was examined again one week after treatment. The testis were still painless and now hardened. Upon a second reexamination five days later, low perfusion to the testis was detected. This testicular necrosis led the patient into an emergency operation. Histology determined there was a ruptured sperm granuloma that led to the testicular thrombosis and necrosis. Specifically, the walls of the vas deferens contained many growths of small ducts and gland-like structures, which came about as a response to the displacement of the sperm and fluid. The exact cause of his ruptured sperm granuloma was not determined, but it was found to be most likely a secondary response to inflammation and/or trauma.Another complication with Sperm granulomas has been being mistaken for a tumor due to its tumor-like appearance. A 45 year old man presented with right testicular chronic pain. He had a vasectomy 7 years ago. Upon physical examination and an ultrasound, a solid nodule in the right epididymis was found, and medical staff suspected a tumor. After findings of sperm that had undergone phagocytosis, a final diagnosis of sperm granuloma was determined. Effects on sperm quality and fertility
It is unknown whether sperm granulomas are definitively detrimental to sperm quality and fertility in humans. However, studies in donkeys have shown that sperm quality is only marginally affected. There was a lower percentage of sperm with intact plasma membranes; however, no effects on motility or morphology were observed.
Additionally, in order to check sterility post-vasectomy, a semen analysis is performed after 3 months and 20 ejaculations to establish azoospermia (no sperm count in the ejaculate).Vasectomy can also be reversed, which is a more technically challenging procedure than a vasectomy that is performed by less urologists and is a heavier financial burden as it is usually not covered by insurances. Approximately 3-6% of people opt for a reversal due to the death of a child, change in partner, increase in financial abilities, or to find relief from postvasectomy pain syndrome. With advances in medical operations since the 1970s, there has since been increased interest in vasectomy reversals and greater chances of success for patency and pregnancy rates.Vasectomy reversal has a varying success rate. A recent study showed that the most important indicator of pregnancy after vasectomy reversal was the age of the female partner. The two most favorable predictors of success were having a female partner less than 40 years of age and having the reversal performed less than 15 years after vasectomy. Aside from the variation in success, vasectomy reversal also has major economic implications. The cost of a vasectomy reversal can range from $16,000-$30,000 and it is usually an out-of-pocket expense due to lack of insurance coverage. == References ==