Bilateral Spontaneous Reanastomosis of the Ductus Deferens

Abstract

A case report of spontaneous reanastomosis of the ductus deferens with a sperm granuloma in a 33-year old man 6 years after vasectomy is presented. The subjects wife became pregnant several months before the man sought a fertility investigation. The pregnancy terminated in a spontaneous miscarriage and the couple wished to avoid another such experience. A semen ogram showed after 30 days of continence a volume of .8 ml normal liquefaction a count of 45 million per ml viability of 65% (35% abnormal forms) and fair sperm motility. Bilateral exploration of the scrotal contents revealed a small scarred nodule approximately .5 cm in diameter on the right side; the nodule and a segment of the ductus deferens on either side of the nodule were removed. On the left no nodule could be found and a 5 cm segment of the duct was removed. Radiographs of the specimens showed continuity of both ducts that on the right having sperm granuloma. It is emphasized that the vasectomist must explain the possibility of spontaneous reanastomosis of the surgically interrupted ductus deferens to the patient. Both the husband and wife should sign a statement acknowledging this complication in order to avoid some of the marital discord that might occurr if the couple is unaware of the possibility of reanastomosis.