title: Stereological analysis of the human testis after vasectomy indicates impairment of spermatogenic efficiency with increasing obstructive interval.
abstract: OBJECTIVE
  To quantify germ cell loss and the extent of testicular fibrosis in vasectomized patients of varying obstructive intervals.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Specialized male reproductive surgery and endocrinology service.
  
  
  METHODS
  Thirty-four vasectomized patients 1-20 years after surgery and 10 normal subjects.
  
  
  METHODS
  Thirty-four testicular biopsies taken at the time of vasectomy reversal (vasovasostomy). Control biopsies taken from 10 normal men at the time of vasectomy.
  
  
  METHODS
  Stereological assessment of testicular germ cell populations and testicular fibrosis.
  
  
  RESULTS
  Vasectomy caused a significant decrease in germ cells in the later stages of spermatogenesis, with significant reductions in pachytene spermatocytes (by 18%), round spermatids (by 40%), elongating spermatids (by 23%), and elongated spermatids (by 39%). The loss of spermatids showed a significant relationship with obstructive interval. A significant 2.7-fold increase in total (peritubular plus interstitial) fibrosis was observed, which showed a positive relationship with obstructive interval. Decreased germ cell populations and fibrosis did not seem to be related to sperm antibody levels nor to sperm counts obtained up to 2 years after vasovasostomy.
  
  
  CONCLUSIONS
  Vasal obstruction results in significant reductions in germ cells in the later stages of spermatogenesis and increases in testicular fibrosis, both worsening with an increasing obstructive interval. Testicular damage after vasectomy might impact upon the prospects for reversal.
authors.affiliation: Prince Henry's Institute of Medical Research, Clayton, Victoria, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Raleigh
authors.forename: Liza
authors.initials: L
authors.lastname: O'Donnell
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Southwick
authors.forename: David M
authors.initials: DM
authors.lastname: de Kretser
authors.forename: Robert I
authors.initials: RI
authors.lastname: McLachlan
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis; D005355:Fibrosis; D006728:Hormones / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013076:Sperm Count; D013087:Spermatids / Q000473:pathology; D013091:Spermatogenesis; D013094:Spermatozoa / Q000276:immunology; D013737:Testis / Q000473:pathology*; D013997:Time Factors; D014659:Vasectomy; D014669:Vasovasostomy
chemical_list: D000906:Antibodies; D006728:Hormones