Brain Doctor
All Journal Entries
Journals
Previous
|
Next
Various Medical Abstracts About Vasectomy
Feb 23, 2009 03:27PM
- 3 comments
Tags:
Tags:
Abstract: OBJECTIVE. To determine whether or not there is an association between testicular histologic changes and antisperm antibodies in vasectomized men. METHODS. Morphometry was performed on testicular biopsy specimens obtained from 19 vasectomized men and 21 fertile control subjects. Antisperm antibody status was determined on the serum of each patient and control subject using the indirect immunobead assay. RESULTS. Significant increases in seminiferous tubule wall thickness (p < 0.001), focal interstitial fibrosis (p < 0.001), and percent composition of interstitium (p < 0.01) were observed in vasectomized men as compared with control subjects. Serum antisperm activity was present in 74 percent of the vasectomized men but none in the control subjects (p < 0.001). There was no association between testicular histologic changes and immune status. CONCLUSIONS. Vasectomized men exhibit significant testicular histologic changes and increased autoimmune activity as compared with fertile control subjects. These histologic changes are not directly associated with antisperm antibody status, suggesting that some other pathophysiologic process must be responsible. Jarow JP, Goluboff ET, Chang TS, Marshall FF. Relationship between antisperm antibodies and testicular histologic changes in humans after vasectomy. Urology 1994;43:521-4.
My Comment: Because of the low titers of the sperm autoantibodies and the polyclonal nature of the serum, it has been extremely difficult to determine the nature and the number of sperm autoantigens involved in vasectomy-induced autoimmunity.
"When a patient elects to have a vasectomy, he must understand that pressure build-up proximal to the vasectomy site, congestion of the epididymis, and, indeed, epididymal blowouts are inevitable consequences of this surgical procedure. In more than 800 vasovasostomy patients whom we have seen, there is always some degree of epididymal engorgement and congestion. Indeed, after one explores these postvasectomy patients microsurgically, it becomes difficult to understand why the vast majority of such patients have no pain or discomfort." EI Shapiro and SJ Silber, Open-ended vasectomy, sperm granuloma, and postvasectomy orchialgia., Fertility and Sterility, 32: 5, 546-550, November
"In more than 50% of men (closer to75%), vasectomy leads to auto-immune pathology. The auto-immune response to sperms following vasectomy is triggered by the phagocytosis of sperm in the epididymis. In the humoral immune response, sperm agglutinating, sperm immobilizing, and antibodies to sperm nuclear protamines occur, as early as 3-4 days after vasectomy. The incidence reaches 60-70% within 1 year and remains almost the same even after 20 years. Shahani SK, Hattikudur NS, Immunological consequences of vasectomy., Archives of Andrology, 7: 2, 193-9, September, 1981.
My comment: The epididymal blowouts may be more common in men with intense auto-immune reactions to sperm after vasectomy compromises the blood/testes barrier via back pressure and antibody related inflammation. Men with higher pre-vasectomy sperm counts have been reported to have this sort of reaction, but pre-vasectomy sperm counts are not routinely done and no studies exist testing this potential risk factor for PVPS.
The process of spermatogenesis commences after the acquisition of a fully functional immune system. Therefore, all the sperm antigens could become potential autoantigens. Under physiological conditions, both blood-testis and blood-epididymis barriers prevent this undesirable autoimmunity by sequestering these sperm autoantigens from immune cells. Although vasectomy has been used as an effective means of birth control in men, immune response to the sperm antigen is the major consequence of obstruction following vasectomy. There are several reports in the literature illustrating the fact that this alteration in the patency of the vas deferens leads to the generation of ASA, which may result in irreversible auto-immune infertility (Flickinger et al, 1994). A similar phenomenon is also observed in virtually all the laboratory animals studied (Handley et al, 1990). These observations led to the use of the vasectomized mouse model to identify these sperm-associated autoantigens. Journal of Andrology, Vol. 26, No. 6, November/December 2005
Following vasectomy, spermatogenesis continues, the human epididymis and ductus deferens may distend and leak, and the extravasated spermatozoa stimulate formation of a sperm granuloma. Granulomas may occur at 60% of vasectomy sites and are usually asymptomatic and relieve intraluminal pressure. About 3-5% of patients experience pain. Intraluminal phagocytosis may explain why some reproductive tracts become depleted of spermatozoa. Distension of the epididymis is common after vasectomy and may lead to granuloma formation there. Up to 6% of patients have symptoms, but many with epididymal changes have no discomfort. Most episodes of painful epididymitis and granulomas resolve with conservative treatment, but < 1% require vasectomy reversal or, if this is ineffective, excision of the epididymis and obstructed ductus deferens.
My comment: Maybe men should be told this information before vasectomy...
My Comment: Because of the low titers of the sperm autoantibodies and the polyclonal nature of the serum, it has been extremely difficult to determine the nature and the number of sperm autoantigens involved in vasectomy-induced autoimmunity.
"When a patient elects to have a vasectomy, he must understand that pressure build-up proximal to the vasectomy site, congestion of the epididymis, and, indeed, epididymal blowouts are inevitable consequences of this surgical procedure. In more than 800 vasovasostomy patients whom we have seen, there is always some degree of epididymal engorgement and congestion. Indeed, after one explores these postvasectomy patients microsurgically, it becomes difficult to understand why the vast majority of such patients have no pain or discomfort." EI Shapiro and SJ Silber, Open-ended vasectomy, sperm granuloma, and postvasectomy orchialgia., Fertility and Sterility, 32: 5, 546-550, November
"In more than 50% of men (closer to75%), vasectomy leads to auto-immune pathology. The auto-immune response to sperms following vasectomy is triggered by the phagocytosis of sperm in the epididymis. In the humoral immune response, sperm agglutinating, sperm immobilizing, and antibodies to sperm nuclear protamines occur, as early as 3-4 days after vasectomy. The incidence reaches 60-70% within 1 year and remains almost the same even after 20 years. Shahani SK, Hattikudur NS, Immunological consequences of vasectomy., Archives of Andrology, 7: 2, 193-9, September, 1981.
My comment: The epididymal blowouts may be more common in men with intense auto-immune reactions to sperm after vasectomy compromises the blood/testes barrier via back pressure and antibody related inflammation. Men with higher pre-vasectomy sperm counts have been reported to have this sort of reaction, but pre-vasectomy sperm counts are not routinely done and no studies exist testing this potential risk factor for PVPS.
The process of spermatogenesis commences after the acquisition of a fully functional immune system. Therefore, all the sperm antigens could become potential autoantigens. Under physiological conditions, both blood-testis and blood-epididymis barriers prevent this undesirable autoimmunity by sequestering these sperm autoantigens from immune cells. Although vasectomy has been used as an effective means of birth control in men, immune response to the sperm antigen is the major consequence of obstruction following vasectomy. There are several reports in the literature illustrating the fact that this alteration in the patency of the vas deferens leads to the generation of ASA, which may result in irreversible auto-immune infertility (Flickinger et al, 1994). A similar phenomenon is also observed in virtually all the laboratory animals studied (Handley et al, 1990). These observations led to the use of the vasectomized mouse model to identify these sperm-associated autoantigens. Journal of Andrology, Vol. 26, No. 6, November/December 2005
Following vasectomy, spermatogenesis continues, the human epididymis and ductus deferens may distend and leak, and the extravasated spermatozoa stimulate formation of a sperm granuloma. Granulomas may occur at 60% of vasectomy sites and are usually asymptomatic and relieve intraluminal pressure. About 3-5% of patients experience pain. Intraluminal phagocytosis may explain why some reproductive tracts become depleted of spermatozoa. Distension of the epididymis is common after vasectomy and may lead to granuloma formation there. Up to 6% of patients have symptoms, but many with epididymal changes have no discomfort. Most episodes of painful epididymitis and granulomas resolve with conservative treatment, but < 1% require vasectomy reversal or, if this is ineffective, excision of the epididymis and obstructed ductus deferens.
My comment: Maybe men should be told this information before vasectomy...
This needs to be showed on a documentary on Discovery or similar......I had a vasectomy 5 years ago, Ifond out about these issues within a few weeks post op. f I had known earlierI porbably would have prefrred to keep my little fellow in my underwear! Since the op I have had a noticable lack of libido, I feel weaker,I havehad the most painful testicles for he irst two years (highly sensitive at best). The only plus side is that the vas deferens has completey joined back together.
What a bummer if this op can cause serious medical probems.
What a bummer if this op can cause serious medical probems.
Most of the men in my online post-vasectomy support group were told vasectomy had no long-term side effects and only about 1 in 30 was told of the risk of chronic testicular pain. To me, this is unethical. I have been writing articles about these issues and posting them all over the internet and started a website to warn men. I am not allowed to mention the location of the articles or the name of the website here as medhelp.org has a no solicitation policy.
Prospective vasectomy candidates should be told of the extensive research showing testicular fibrosis in all vasectomized mammalian species studied to date, including humans. Fibrosis is essentially scar tissue and must have an effect on the function of the testes. The testes have two main functions: Production of sperm and production of sexual hormones (primarily testosterone). The human studies do show a decrease in spermatogenesis reflecting testicular damage. Sertoli cell support of spermatogenesis has been implicated in this pathology as has pressure induced changes from obstruction by closing off the vas deferens via vasectomy.
The studies of testosterone levels after vasectomy have led to conflicting data. This is partly due to reliance on "normal ranges" that are very wide (300 to 1200 ng/dl) and lack of pre-vasectomy levels for comparison purposes, as well as lack of testing for free (bioavailable) testosterone levels. In addition, the studies that show transient increases in testosterone levels reflect damage as opposed to health, and declines in levels surely follow. How could a transient increase in testosterone levels after vasectomy reflect normal function? It is more likely a reflection of damage due to inflammation.
I believe vasectomy causes testicular fibrosis and damages Sertoli cells affecting spermatogenesis. The damage to the testes from obstruction or via immunologic effects may cause earlier "andropause" via relative declines in testosterone causing symptoms of hypogonadism in some men. The total serum testosterone may still be in the "normal" range of 300 to 1200 ng/dl, but a significant decline within the range can still cause symptoms.
You might consider getting you free and total testosterone levels checked.
Prospective vasectomy candidates should be told of the extensive research showing testicular fibrosis in all vasectomized mammalian species studied to date, including humans. Fibrosis is essentially scar tissue and must have an effect on the function of the testes. The testes have two main functions: Production of sperm and production of sexual hormones (primarily testosterone). The human studies do show a decrease in spermatogenesis reflecting testicular damage. Sertoli cell support of spermatogenesis has been implicated in this pathology as has pressure induced changes from obstruction by closing off the vas deferens via vasectomy.
The studies of testosterone levels after vasectomy have led to conflicting data. This is partly due to reliance on "normal ranges" that are very wide (300 to 1200 ng/dl) and lack of pre-vasectomy levels for comparison purposes, as well as lack of testing for free (bioavailable) testosterone levels. In addition, the studies that show transient increases in testosterone levels reflect damage as opposed to health, and declines in levels surely follow. How could a transient increase in testosterone levels after vasectomy reflect normal function? It is more likely a reflection of damage due to inflammation.
I believe vasectomy causes testicular fibrosis and damages Sertoli cells affecting spermatogenesis. The damage to the testes from obstruction or via immunologic effects may cause earlier "andropause" via relative declines in testosterone causing symptoms of hypogonadism in some men. The total serum testosterone may still be in the "normal" range of 300 to 1200 ng/dl, but a significant decline within the range can still cause symptoms.
You might consider getting you free and total testosterone levels checked.
I had a vasectomy several years ago and have noticed symptoms which I have attributed to it, perhaps wrongly. I have a dull pain in my testicles periodically and that does not bother me much. But, what does bother me are the symptoms I have in the days following ejaculation. I used to get tired after an ejaculation before I had my vasectomy, but now this tired feeling seems to have increased along with a bit of a belly ache. Most noticeable is my breath, which can knock out a horse in the days following an ejaculation.
Can my sperm somehow be getting into places it shouldn't and can my body's response be generating this bad breath? I'm totalling reaching here, but could I have a yeast infection in my sinuses that is somehow made worse by ejaculation?
Should I see a urologist or ear nose and throat doctor?
Thanks for any guidance
Can my sperm somehow be getting into places it shouldn't and can my body's response be generating this bad breath? I'm totalling reaching here, but could I have a yeast infection in my sinuses that is somehow made worse by ejaculation?
Should I see a urologist or ear nose and throat doctor?
Thanks for any guidance
Post a Comment