Spermatogenic granuloma - Causes, symptoms and treatment. MF.
Spermatogenous granuloma is a pathological formation of granulomatous tissue in the testicle parenchyma, which develops due to the penetration of sperm there.
Causes of spermatogenic granuloma
The etiology of the disease becomes clear even with its name. The immediate cause of the disease is the ingress of spermatozoa from the vas deferens into the stroma of the testicle. This can occur with traumatic damage to the scrotum or after surgery on the testicle.
In this situation, aseptic chronic inflammation develops, as the sperm is a foreign agent for the testicle parenchyma. After the inflammatory process subsides, a connective tissue begins to form at the site of penetration of the spermatozoon, which, growing, compresses the vas deferens. This leads to stagnation of spermatozoa at the site of their formation.
Symptoms of spermatogenic granuloma
In the initial stages of the disease, patients begin to worry about dull, aching pains in one of the half of the scrotum. They increase with pressure on this anatomical site, as well as during ejaculation. Over time, the testicle begins to increase in size. At this stage it is already possible to palpate the elastic or stony formation, which is located in one of the halves of the scrotum. If at the initial stages palpation of the given education still delivers certain discomfort to the patient, then eventually the granuloma, like the testicle, becomes painless.
Together with the pain syndrome, the symptoms of ejaculation disorder begin to appear and progress in patients. If in the initial stages of the disease with ejaculation there is only a slight soreness, then eventually patients start complaining about the difficulty in completing sexual intercourse and a small amount of sperm. If the pathological process is bilateral, then these symptoms develop several times faster than when localizing spermatogenic granulomas on one side only.
If the size is large, the pathological neoplasm can have a mechanical effect on the urethra, and as a result, the urination process is disrupted. Such symptoms can simulate the clinical picture of prostate adenoma, which sometimes results from improper treatment.
If the patient has this clinical symptomatology, he should immediately seek help from a urologist to avoid serious consequences of the disease.
Diagnosis of spermatogenic granuloma
For diagnosis of spermatogenic granulomas, sometimes only anamnesis of the patient and clinical examination is sufficient. However, there are disputable cases when granuloma should be differentiated from tuberculosis, syphilitic processes or oncological pathology. In such a situation, a biopsy of this formation is performed with the fence of a small patch of pathologically altered tissue. With a microscopic examination of the biopsy specimen, a large amount of granulation tissue can be detected without the bacteria of syphilis or tuberculosis. It is this picture that indicates the spermatogenic granuloma.
Spermatogenous granuloma under the microscope
Ultrasonic examination of the scrotum can be used to identify the boundaries of formation. It must be carried out when the patient is preparing for an immediate intervention.
Treatment of spermatogenic granuloma
The only justified method of treating this disease is surgery. The volume of the operation consists in dissection of the skin of the scrotum, access to the pathologically altered tissue and excision of the latter. In this case, it is necessary to be extremely cautious, because the testicle tissue is impregnated with a huge number of blood vessels and nerves. When cutting the first, serious bleeding can occur, and if the second one is damaged, the innervation of the scrotum and penis is disturbed.
Surgery for the removal of spermatogenic granulomas
Treatment with folk remedies
In no case should you use folk methods of treatment with spermatogenic granuloma. As a rule, healers recommend using compresses to dissolve the formation. It must be remembered that compresses on this part of the body can threaten a man with sterilization, since spermatozoa should be kept in a cool environment. And because of the temperature increase they are deactivated, which leads to temporary, and even permanent infertility.
Features of Nutrition and Lifestyle
After surgery the patient does not need any specific nutrition and regime. It is possible only in the first few days to recommend to the patient the wearing of swimming trunks that help to reduce the scrotal edema, which, as a rule, develops in the postoperative period.
Rehabilitation after illness
With the purpose of prompt recovery and adequate healing of the wound in place of the latter, it is recommended that patients undergo physiotherapy sessions. To date, the influence of UHF and darsonvalization is used. Some urologists are opponents of such treatment, motivating this fact by the fact that the testicles should be in an environment with a lowered temperature. Therefore, physiotherapeutic procedures are used only for problem healing wounds.
Complications of spermatogenic granuloma
The most dangerous complication of this disease is infertility. It, as a rule, develops at bilateral process. Because of the block of the vas deferens, stasis of the spermatozoids in the testicle occurs. Over time, because of the large number, they simply cease to be produced, which is the cause of the atrophy of the spermatogenic epithelium. And even after a successful surgery, the testicles no longer return their function to the production of spermatozoa.
Preventing the spermatogenic granuloma
First of all, it is necessary to beware of the factors that can contribute to the development of this disease. Most often, this traumatic damage to the scrotum. Therefore, athletes who engage in traumatic sports, for example, hockey players, it is necessary to wear personal protective equipment. If the trauma has occurred, then to prevent the disease it is necessary to periodically check with the urologist for the timely detection of the disease.
Rev.doctor urologist Astashin Е.Е.