RESUMEN
The inadvertent failure to achieve sterility in 8 to 40 vasectomy procedures afforded a rare opportunity to study the efficacy of placing the two cut ends of the vasa in different fascial planes. Interposition of the fascia was performed in 12 patients and was not performed in 28 others, with no significant difference in the failure rates of the two groups. Histologic examination of vasal tissue from one patient in each group revealed that a sperm granuloma can erode fascia and the wall of the vas.
PIP: In a series of 40 vasectomy patients, the procedures were performed through double vertical scrotal incisions. The vasa were separated from their sheaths and transected, but no part of the vas was removed. In 12 of the procedures, interposition of the fascia was performed and in the other 28, it was not. It has been felt that this interposition procedure created an impenetrable wall of fascia, preventing spontaneous anastomosis. The failure rate in this particular series was 21.4% for the patients in whom fascia was not interposed between the 2 cut ends of the vas; the failure rate for the 12 in whom fascia was interposed was 16.7%. There is no statistical difference in the failure rates for the 2 procedures. Thus, the interposition procedure does not seem to reduce the possibility of failure. Histologic examination of vasal tissue was made in 2 cases at the time of repeat vasectomy. 1 of these patients had undergone each of the 2 procedures. Microscopic pictures of the 2 cases are presented. The histologic examination showed that sperm granulomas can erode the fascia and the wall of the vas.
Asunto(s)
Fasciotomía , Conducto Deferente/cirugía , Vasectomía/métodos , Granuloma/diagnóstico , Humanos , Masculino , Recuento de Espermatozoides , Conducto Deferente/patologíaRESUMEN
The syndrome of inappropriate secretion of antidiuretic hormone was recognized in a sixty-year-old man with a poorly differentiated metastatic adenocarcinoma of the prostate gland. Elevated levels of antidiuretic hormone were found in the patient's serum and in the prostatic tumor but not in the cerebrospinal fluid. The patient's clinical course is detailed, and the pathophysiology of this syndrome is discussed.