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The World Journal of Men's Health Jul 2021Vasectomy is a simple, safe, effective, and economical method used worldwide for long-term male contraception. As a surgical operation, it has short-term and long-term... (Review)
Review
Vasectomy is a simple, safe, effective, and economical method used worldwide for long-term male contraception. As a surgical operation, it has short-term and long-term complications such as hematoma formation, infection, sterilization failure, sperm granulomas, short-term postoperative pain (nodal pain, scrotal pain, and ejaculation pain), and chronic pain syndrome. Whether it increases the risk of autoimmune disease, cardiovascular disease, testicular cancer, or prostate cancer is still controversial. Changes in plasma concentrations of luteinizing hormone, follicle-stimulating hormone, and testosterone after vasectomy have also been studied, as well as the relation between vasectomy and sexual function. Sperm quality decreases very slowly after vasectomy, and vasovasostomy and intracytoplasmic sperm injection could help a couple achieve a pregnancy if they change their minds at any point. We include a follow-up strategy and suggestions for follow-up care at the end of this review.
PubMed: 32777870
DOI: 10.5534/wjmh.200073 -
Journal of Equine Veterinary Science Jun 2021This study aimed to describe and compare semen parameters (pre-freeze and post-freezing) and antisperm antibodies (ASA) of donkeys with epididymal sperm granuloma and...
This study aimed to describe and compare semen parameters (pre-freeze and post-freezing) and antisperm antibodies (ASA) of donkeys with epididymal sperm granuloma and healthy controls. Feral donkeys (n = 10) castrated in a concurrent study were enrolled in the present experiment. Three donkeys had unilateral granulomas, two donkeys had bilateral granulomas, whereas the remaining five had grossly normal epididymides. The granulomas were either single or multiple, firm, well-circumscribed, tan to red, and 1-5 mm in size. Upon incision, abundant, thick, tan to white-yellow fluid was recovered. Histopathology revealed epithelioid macrophages, multinucleated giant cells, and abundant sperm cell fragments with mineralized cellular debris. Each epididymis was dissected, and semen harvested for cryopreservation. Semen was assessed for sperm motility parameters, plasma membrane integrity, and mitochondrial membrane potential. All donkeys had semen cryopreserved in a standard manner. In addition, post-thaw semen from all donkeys was assessed for ASA (IgG and IgA), acrosome integrity and morphology. Post-thaw, the progressive sperm motility and the percentage of sperm with an intact plasma membrane were reduced in donkeys with sperm granuloma (P = 0.04). There was no difference in total sperm motility, morphology, or damaged acrosome across groups (P > 0.05). Three donkeys with sperm granuloma (60%) displayed increased IgG and IgA ASA. In conclusion, sperm granulomas only marginally affected sperm quality and resulted in IgG ASA binding to sperm with damaged plasma membrane. It remains to be determined if sperm granuloma and ASA affect fertility in donkeys.
Topics: Animals; Epididymis; Equidae; Granuloma; Male; Semen Analysis; Semen Preservation; Sperm Motility; Spermatozoa
PubMed: 33993945
DOI: 10.1016/j.jevs.2021.103450 -
Food and Chemical Toxicology : An... Dec 2023Previous researches have demonstrated that the silica nanoparticles (SiNPs), which are widely used in all aspects of life, are hazardous to the male reproductive system....
Previous researches have demonstrated that the silica nanoparticles (SiNPs), which are widely used in all aspects of life, are hazardous to the male reproductive system. However, the cellular and molecular mechanism underlying SiNPs toxicity to the epididymis remain unclear. In this present study, a total of 60 male mice were separated into 4 groups and then treated to SiNPs for 7 consecutive days at a dose of 0, 2.5, 10, and 20 mg/kg body weight. The results showed that SiNPs could alter the histological structure of epididymis and induce sperm granuloma formation, leading to decreased sperm quality and quantity. In addition, the ultrastructure and permeability of blood-epididymal barrier (BEB) were impaired after exposure to SiNPs, and a significant downregulation of integral membrane proteins at the BEB was detected. SiNPs were also found to raise the percentage of macrophages in the epithelium and interstitium of the epididymis, followed by increased expression of pro-inflammatory molecules including TNF α, IL-1β, and IL-6. Meanwhile, SiNPs induced oxidative stress in epididymis, as shown by the markedly elevated generation of reactive oxygen species (ROS) and malondialdehyde (MDA) and upregulated activity of superoxide dismutase (SOD). Further study showed that SiNPs activated the p38 MAPK signaling pathway, which accelerated clathrin-mediated endocytosis of integral membrane proteins and perturb vesicular trafficking. Taken together, exposure to SiNPs could induce sperm granuloma formation and impair the integrity of BEB in mice through activating the p38 MAPK pathway.
Topics: Animals; Male; Mice; Epididymis; Silicon Dioxide; Semen; Spermatozoa; Oxidative Stress; Nanoparticles; Membrane Proteins
PubMed: 37890760
DOI: 10.1016/j.fct.2023.114113 -
Andrologia Aug 2022The objective of this study was to identify factors that predict for sperm granuloma formation and the impact of sperm granuloma presence and quantity on vasectomy...
The objective of this study was to identify factors that predict for sperm granuloma formation and the impact of sperm granuloma presence and quantity on vasectomy reversal (VR) outcomes. A cross sectional retrospective review of prospectively collected data, on the impact of granuloma on VR outcomes from a single academic center was performed. The impact of age, obstructive interval, intraoperative vasal fluid findings, anastomosis type, body mass index, tobacco use and total motile count (TMC) was determined. A total of 1550 men underwent VR between January 2000 and August 2019. Granulomas were present unilaterally in 23.3% (n = 361) and bilaterally in 14.2% (n = 220). On univariate analysis, increasing patient age negatively correlated with a larger number of granulomas (p = .011). Granuloma presence was associated with finding intact and motile sperm from the vasal stump intraoperatively (p = .001), and vasoepididymostomy anastomosis (p < .001). However, granuloma presence (and quantity) did not correlate with obstructive interval or maximum TMC. Tobacco use and body mass index (BMI) were not associated with granuloma presence. On multivariate analysis, granuloma quantity was not associated with TMC. Obstructive interval and vasovasostomy anastomosis were associated with higher TMC, while BMI was negatively associated with TMC. In conclusion, increasing age was negatively correlated with granuloma formation. Granuloma presence was associated with more favourable intraoperative fluid findings and anastomosis type, but not post-VR TMC, suggesting men with and without granulomas undergoing skilled microsurgery will have similar patency rates. Heavier men should be encouraged for weight loss prior to vasectomy reversal as increasing BMI was associated with lower TMC.
Topics: Cross-Sectional Studies; Granuloma; Humans; Male; Microsurgery; Semen; Spermatozoa; Vasectomy; Vasovasostomy
PubMed: 35524153
DOI: 10.1111/and.14439 -
Frontiers in Endocrinology 2022Occludin (OCLN) is a tight junction protein and Ocln deletion mutation causes male infertility in mice. However, the role of OCLN in male reproductive system remains...
Occludin (OCLN) is a tight junction protein and Ocln deletion mutation causes male infertility in mice. However, the role of OCLN in male reproductive system remains unknown. In this study, we used an interdisciplinary approach to elucidate the underlying mechanism of male infertility in related to OCLN function, including knockout mice as well as a combined omics analysis and immunofluorescent labelling. Our results showed that the epididymis of -null mice displayed a phenomenon resembling epididymal sperm granuloma, which occurred especially in the junctional region between caput and corpus epididymidis. Sperm motility and fertilisation capacity were also impaired in these -null mice, accompanied by enlarged tubules in the proximal regions and degeneration in the distal regions of epididymis. Cellular localization analysis showed that OCLN immunofluorescence was enriched only in the apical junction of epithelial principal cells in the proximal regions of epididymis. Integrative omics analysis revealed the downregulation of gene clusters enriched in acid secretion and fatty acid metabolism in the -null epididymis, especially the enzymes related to the unsaturated arachidonic acid pathway. The number of proton-pump V-ATPase-expression clear cells, a key player of luminal acidification in the epididymis, declined drastically from prepubertal age before sperm arrival but not in the early postnatal age. This was accompanied by programmed cell death of clear cells and increased pH in the epididymal fluid of OCLN-deficient mice. The lipidomics results showed significantly increased levels of specific DAGs conjugated to unsaturated fatty acids in the Ocln-mutant. Immunofluorescent labelling showed that the arachidonic acid converting enzyme PTGDS and phospholipase PLA2g12a were prominently altered in the principal cells and luminal contents of the -mutant epididymis. Whereas the carboxylate ester lipase CES1, originally enriched in the WT basal cells, was found upregulated in the -mutant principal cells. Overall, this study demonstrates that OCLN is essential for maintaining caput-to-corpus epithelial integrity, survival of acid-secreting clear cells, and unsaturated fatty acid catabolism in the mouse epididymis, thereby ensuring sperm maturation and male fertility.
Topics: Animals; Male; Mice; Arachidonic Acids; Epididymis; Infertility, Male; Lipid Metabolism; Mice, Knockout; Occludin; Semen; Sperm Motility
PubMed: 36518247
DOI: 10.3389/fendo.2022.1069319 -
Scientific Reports Nov 2019Male meiotic germ cell including the spermatozoa represent a great challenge to the immune system, as they appear long after the establishment of normal immune tolerance...
Male meiotic germ cell including the spermatozoa represent a great challenge to the immune system, as they appear long after the establishment of normal immune tolerance mechanisms. The capacity of the testes to tolerate autoantigenic germ cells as well as survival of allogeneic organ engrafted in the testicular interstitium have led to consider the testis an immunologically privileged site. Disruption of this immune privilege following trauma, tumor, or autoimmune orchitis often results in male infertility. Strong evidence indicates that indoleamine 2,3-dioxygenase (IDO) has been implicated in fetal and allograft tolerance, tumor immune resistance, and regulation of autoimmune diseases. IDO and tryptophan 2,3-dioxygenase (TDO) catalyze the same rate-limiting step of tryptophan metabolism along a common pathway, which leads to tryptophan starvation and generation of catabolites collectively known as kynurenines. However, the relevance of tryptophan metabolism in testis pathophysiology has not yet been explored. Here we assessed the in vivo role of IDO/TDO in experimental autoimmune orchitis (EAO), a model of autoimmune testicular inflammation and immunologically impaired spermatogenesis. EAO was induced in adult Wistar rats with testicular homogenate and adjuvants. Control (C) rats injected with saline and adjuvants and normal untreated rats (N) were also studied. mRNA expression of IDO decreased in whole testes and in isolated Sertoli cells during EAO. TDO and IDO localization and level of expression in the testis were analyzed by immunostaining and Western blot. TDO is expressed in granulomas from EAO rats, and similar protein levels were observed in N, C, and EAO groups. IDO was detected in mononuclear and endothelial cells and reduced IDO expression was detected in EAO group compared to N and C rats. This phenomenon was concomitant with a significant reduction of IDO activity in EAO testis measured by tryptophan and kynurenine concentrations (HPLC). Finally, in vivo inhibition of IDO with 1-methyl-tryptophan increased severity of the disease, demonstrating down regulation of IDO-based tolerance when testicular immune regulation was disrupted. We present evidence that an IDO-based mechanism is involved in testicular immune privilege.
Topics: Animals; Autoimmune Diseases; Disease Models, Animal; Epididymis; Immune Privilege; Indoleamine-Pyrrole 2,3,-Dioxygenase; Kynurenine; Lymph Nodes; Male; Orchitis; Rats; Rats, Wistar; Sertoli Cells; Severity of Illness Index; Testis; Tryptophan; Tryptophan Oxygenase
PubMed: 31685866
DOI: 10.1038/s41598-019-52192-8 -
Molecular Human Reproduction Aug 2022Vasectomy is a widely used surgical technique creating an obstructive azoospermia. Although sperm cannot be ejaculated, the testis maintains sperm production in...
Vasectomy is a widely used surgical technique creating an obstructive azoospermia. Although sperm cannot be ejaculated, the testis maintains sperm production in vasectomized males. The continuous accumulation of sperm deposited in the epididymis and the vas deferens fraction necessarily need to be degraded and eliminated. While the elimination process is carried out by granulomas that form after vasectomy, the detailed mechanisms of sperm degradation are still not known. The aim was to assess whether sperm chromatin fragmentation (SCF), a mechanism that degrades the entire sperm genome at the toroid linker regions (TLRs), is activated after vasectomy in sperm cells. We vasectomized mice and evaluated the presence of TLR-specific double-strand breaks through pulsed-field gel electrophoresis and the Comet assay at 1, 2 and 3 weeks after surgery. Results for DNA damage (Olive tail moment) at single-cell level showed an increase of double-strand breaks after vasectomy for vas deferens sperm after 1, 2 and 3 weeks postvasectomy (21.78 ± 2.29; 19.71 ± 1.79 and 32.59 ± 1.81, respectively), compared to mock surgery (7.04 ± 1.03; 10.10 ± 1.29 and 8.64 ± 0.85, respectively; P < 0.001). Similar findings were obtained for cauda epididymis sperm (P < 0.001), but not for caput epididymis (P > 0.05). Pulsed-field gel electrophoresis showed the presence of double-stranded breaks between 15 and 145 kb, indicating that DNA breaks were produced mainly in the sperm TLRs. Results presented here suggest that SCF is a mechanism activated in vas deferens after vasectomy to degrade sperm DNA when they cannot be ejaculated, preventing their function.
Topics: Animals; Chromatin; DNA; DNA Breaks; Epididymis; Male; Mice; Semen; Spermatozoa; Vas Deferens; Vasectomy
PubMed: 35929777
DOI: 10.1093/molehr/gaac029 -
IJU Case Reports Jan 2020Sarcoidosis is a disease in which noncaseating granulomas form in several organs, particularly in the lungs and skin. Male genitourinary involvement in sarcoidosis is...
INTRODUCTION
Sarcoidosis is a disease in which noncaseating granulomas form in several organs, particularly in the lungs and skin. Male genitourinary involvement in sarcoidosis is uncommon.
CASE PRESENTATION
A 32-year-old male with painless bilateral scrotal swelling who was diagnosed with lung sarcoidosis presented to our hospital. Serum tumor marker levels were normal. Scattered hypoechoic mass lesions in both testes were noted on ultrasound examination. Biopsy of both testes revealed pathologically noncaseating epithelioid cell granuloma, and perihilar lymphadenopathy and a granulomatous lung nodule were found on chest computed tomography. Semen examination was performed after the biopsy, demonstrating oligospermia. A corticosteroid regimen was administered. After treatment, no abnormal accumulation in both testes was observed on gallium-67 scintigraphy, and semen examination demonstrated the mild improvement of the sperm count.
CONCLUSION
Treatments for testicular sarcoidosis vary, and malignancy and fertility must be considered.
PubMed: 32743456
DOI: 10.1002/iju5.12124 -
Toxicologic Pathology Dec 2019The 2019 annual National Toxicology Program Satellite Symposium, entitled "Pathology Potpourri," was held in Raleigh, North Carolina, at the Society of Toxicologic...
The 2019 annual National Toxicology Program Satellite Symposium, entitled "Pathology Potpourri," was held in Raleigh, North Carolina, at the Society of Toxicologic Pathology's 38th annual meeting. The goal of this symposium was to present and discuss challenging diagnostic pathology and/or nomenclature issues. This article presents summaries of the speakers' talks along with select images that were used by the audience for voting and discussion. Various lesions and topics covered during the symposium included aging mouse lesions from various strains, as well as the following lesions from various rat strains: rete testis sperm granuloma/fibrosis, ovarian cystadenocarcinoma, retro-orbital schwannoma, periductal cholangiofibrosis of the liver and pancreas, pars distalis hypertrophy, chronic progressive nephropathy, and renal tubule regeneration. Other cases included polyovular follicles in young beagle dogs and a fungal blood smear contaminant. One series of cases challenged the audience to consider how immunohistochemistry may improve the diagnosis of some tumors. Interesting retinal lesions from a rhesus macaque emphasized the difficulty in determining the etiology of any particular retinal lesion due to the retina's similar response to vascular injury. Finally, a series of lesions from the International Harmonization of Nomenclature and Diagnostic Criteria Non-Rodent Fish Working Group were presented.
Topics: Animals; Humans; Pathology; Toxicology
PubMed: 31645210
DOI: 10.1177/0192623319876929 -
Urology Case Reports Mar 2020Sperm granuloma is a common finding following vasectomy, with majority of the lesions located at the site of the vasectomy defect. Sperm granulomas are typically small...
Sperm granuloma is a common finding following vasectomy, with majority of the lesions located at the site of the vasectomy defect. Sperm granulomas are typically small and asymptomatic. We describe a case in which the nodule presented similarly to a supernumerary testis by radiographic features.
PubMed: 31867216
DOI: 10.1016/j.eucr.2019.101080