Granulomas are benign new tissue formations whose degeneration is almost impossible and which can occur, for example, in the form of a sperm granuloma. Sperm granulomas usually develop after a vasectomy, in which the epididymis or spermatic cord is injured and spermatozoa leak into the surrounding tissue. The exit attracts macrophages involved in the formation of the granuloma.
What is a sperm granuloma?
The spermatic funiculus is a bundle of nerves, vessels and the spermatic duct measuring around 20 centimeters. Also known as the spermatic cord, the anatomical structure runs through the male inguinal canal. In the case of sperm granuloma, the spermatic cord changes into a nodular, hard consistency. For definition of ch in English, please visit acronymmonster.com.
One after the other, spermatozoa escape into the surrounding tissue. Sperm granulomas are often discovered during an autopsy. These incidental findings affect about three percent of all men. The incidence of changes in the group of men who have had a vasectomy is up to 40 percent. Basically, the phenomenon is a spermatic cord disease that usually does not show any manifest symptoms.
Sometimes the only symptom is revealed by palpation. Pressure sensitivity in the area of the change is possible, but does not necessarily have to be present. Like all other granulomas, the sperm granuloma is a nodular neoplasm of epitheloid cells, mononuclear cells or giant cells caused by inflammation. The benign change is usually the result of chronic, allergic or infectious processes.
The primary cause of sperm granulomas is sometimes most often a vasectomy, which is performed on the spermatic cord during sterilization. The vas deferens is injured as a result of the sterilization operation. Occasionally, injuries to the epididymal ducts also occur. Through these injuries, spermatozoa leak into the surrounding tissue.
The sperm granuloma does not always have to be associated with a vasectomy. Inflammatory reactions can also injure the epididymis and spermatic cord and promote the escape of spermatozoa. The entry of spermatozoa into the tissue is considered the cause of every sperm granuloma. The spermatozoa carry a dense and enzymatically difficult to degrade DNA, which is surrounded by an acid-resistant shell.
Because of this structure, they survive in the milieu of the female reproductive organs. The individual components of the spermatozoa, above all the ceroid pigment, stimulate the immunological macrophages when they exit the epididymis.
The immune cells become epitheloid cells and thus promote the formation of a granuloma. Macroscopically, sperm granulomas are small, brown nodules that correspond to the foreign body type in the histological picture and consist of epitheloid cells and giant cells.
Symptoms, Ailments & Signs
Men with sperm granulomas suffer from a nodular, hard change in the area of the spermatic cord. In many cases, those affected feel the tissue change themselves and consult a doctor with the suspicion of a malignant change. In still other cases, the granuloma is so small that the patient does not notice it.
Since the granulomas often do not cause any accompanying symptoms, sperm granulomas can go unnoticed in the long term. Some men with sperm granulomas complain of stress-related pain, especially pressure pain. However, the pressure pain is not a mandatory symptom and can therefore be absent despite an existing granuloma. Mild pain is common in sperm granulomas caused by inflammation.
In the case of granulomas after a vasectomy, there is already pain due to the vasectomy, so that patients attribute the granuloma pain to the previous operation. Accordingly, many sperm granulomas are an incidental finding that is only identified in a different type of examination.
Diagnosis & course of disease
For a doctor, the sperm granuloma is usually clearly palpable. If there is tenderness in the hardened area, suspect a granuloma. Nevertheless, tumors must be considered in the differential diagnosis.
To secure the diagnosis and to rule out a malignant change, the doctor usually takes a tissue sample that shows the above-mentioned picture of giant and epitheloid cells in the histology. The prognosis for sperm granulomas is favorable. Often no intervention is required.
In many cases, the sperm granuloma is only discovered very late. This is particularly the case when the lump is still very small and cannot be felt by the patient. Furthermore, the sperm granuloma does not have to cause any particular symptoms, so that the disease often remains undetected for a long time. Other sufferers suffer from pressure pain, although the pressure pain can often occur in normal cases.
The sperm granuloma does not necessarily lead to complications. In some cases, it can also disappear on its own, so that no surgical intervention is necessary. However, many of those affected suspect a malignant tumor behind the sperm granuloma and can suffer from psychological problems or depression. There are usually no complications during the treatment itself.
The sperm granuloma is removed with a simple surgical procedure. Even after successful treatment, sperm granuloma can reappear, so repeat treatment may be necessary. The life expectancy of those affected is not reduced by the disease. The surgical intervention is associated with the usual risks and side effects of such an intervention.
When should you go to the doctor?
A sperm granuloma must always be treated by a doctor. Since it can be a degeneration and, in the worst case, a malignant tumor, it should always be treated by a doctor. This can lead to death if the tumor spreads to other parts of the body. The earlier the sperm granuloma is recognized and treated, the better the further course of this complaint.
A doctor should be consulted if the person affected suffers from changes in the tissue of the testicles. In many cases, there is also pain in the testicles, which occurs permanently and does not go away on its own. In many cases, however, the sperm granuloma is discovered by accident. For this reason, regular examinations of this area are very important. If slight pain or changes to the tissue occur, a doctor must be consulted immediately.
The sperm granuloma can be recognized and treated by a urologist or a dermatologist.
Treatment & Therapy
Sperm granulomas are harmless and usually do not cause any symptoms. In many cases, the granuloma regresses over time. Therefore, there is never an immediate intervention after the diagnosis. The doctor waits some time for the granuloma to go away on its own. Every operation puts a strain on the patient’s organism.
Therefore, the surgical removal of a sperm granuloma is only carried out in exceptional cases. During the operation, the affected area is opened. The new tissue formation is usually completely removed. Since a biopsy already takes place as part of the diagnosis, the entire granuloma is often removed as part of this first tissue sample.
Remnants of the sperm granuloma can usually remain in the body without promoting recurrence. In most cases, the remnants left behind form completely. The probability of malignant transformation in granulomas is relatively low. Therefore, there is no acute pressure to excise sperm granulomas.
The fact that affected men usually decide to have an excision anyway is mainly due to the unpleasant hardening and the sometimes occurring pressure pain. The operation is usually performed under local anesthesia.
Especially in the context of a vasectomy, sperm granulomas can hardly be prevented. However, the experience and quality of work of the sterilizing doctors can minimize the risk of any complications occurring.
Therefore, the conscientious selection of the surgeon before the vasectomy can be described in the broadest sense as a preventive measure. Inflammation-related granulomas can be prevented even less than sterilization-related sperm granulomas.
In the case of a sperm granuloma, those affected usually have only a few and only limited direct aftercare measures available. For this reason, those affected should ideally contact a doctor very early on and also initiate treatment so that complications or other symptoms do not arise in the further course. As a rule, a sperm granuloma cannot heal on its own, so a visit to a doctor is always necessary for this disease.
Most of those affected are dependent on a surgical procedure in order to be able to relieve the symptoms permanently and usually completely. In any case, the patient should rest and rest after the procedure, avoiding exertion or stressful and physical activities in order not to unnecessarily burden the body. In many cases, the support of the partner is also very important to prevent depression and other psychological problems. The sperm granuloma usually does not reduce the life expectancy of the affected person.
You can do that yourself
If men decide to have a vasectomy, they should inform themselves sufficiently in advance about the procedure and possible complications of the procedure. The risks of sterilization must be found out at an early stage to avoid surprises. The procedure should only be carried out by a specialist and should not take place abroad. Without a trained medical specialist, no changes should be made to the organism, as health problems and complications can occur.
In the event of abnormalities in the healing process or other disorders, consultation with the doctor treating you is necessary. Self-healing measures are not sufficient in this case. Likewise, there are no alternative healing methods that lead to freedom from symptoms. Overreacting to developments should be avoided and internal stress should be prevented as far as possible. The states of emotional distress exacerbate the overall situation and can contribute to its deterioration. It is therefore important to work with a doctor and at the same time the person concerned should pay attention to their own well-being.
An inner restlessness or irritability is not conducive to the overall process. Cognitive training or relaxation techniques help to deal with and cope with the disease. They can be used independently by those affected in stressful moments.