Sperm granulomas

Definition - What is a sperm granuloma?

A sperm granuloma is a nodular structure outside of the spermatic cord that is painful to pressure and is caused by the leakage of sperm into the surrounding tissue. As a rule, it is a benign neoplasm. The sperm are trapped and broken down by the body's immune defense cells. However, due to a difficult to digest, acid-proof shell and the DNA, the breakdown of the sperm takes a very long time. The digesting cells, also called macrophages, transform themselves into epithelial cells and ultimately form the granuloma together with other cells.

These symptoms can be used to identify a sperm granuloma

Sperm granulomas are often perceived by the patient as a painful palpable lump in the scrotum. In doing so, they often report that it is particularly painful with pressure and movement. However, pain is not essential, so sperm granulomas are often not noticed by patients and only discovered by chance.

Sperm granulomas tend to grow slowly. If the resistance increases over the course of weeks, a tumor is suspected and should be examined by a doctor immediately. If the granuloma occurs as part of an inflammation, there may also be signs of inflammation such as reddening, swelling and increased temperature.

causes

Most commonly, sperm granulomas are a side effect of a vasectomy. During a vasectomy, the spermatic duct is cut through to sterilize the man. Sperm can get into the surrounding tissue during the operation and lead to a granuloma there. The risk of this side effect is relatively high at 40%.

Read more on the subject at: vasectomy

In rarer cases, sperm granulomas can occur in the context of other diseases, for example inflammation of the testicle or the vas deferens. In addition, injuries to the vas deferens or neighboring structures can lead to sperm escaping into the tissue. In rare cases, sperm granulomas occur without an identifiable cause and are not recognized by the patient. They are often discovered incidentally during autopsies or operations. They very rarely occur in the context of testicular cancer.

diagnosis

In addition to the medical history, a physical examination is always required to diagnose a sperm granuloma. The doctor, preferably a urologist, can feel the granuloma as a palpable resistance in the scrotum. The suspicion is confirmed if it is a painful resistance. The doctor can also perform an ultrasound scan to examine the structure and the surrounding tissue more closely.

A tissue sample should always be taken to confirm the diagnosis and to rule out a testicular tumor. The diagnosis is confirmed by the detection of epithelial cells under the microscope.

treatment

Sperm granulomas are benign neoplasms and are therefore harmless. As a rule, they do not require any therapy, unless they are perceived by the patient as very painful and uncomfortable. In most cases, the granuloma will spontaneously regress after a short time. Warm compresses or warm baths can help to speed up healing. Pain relievers such as ibuprofen or Voltaren can help.

Should the patient ultimately want treatment, the granuloma can be cut out during an operation. A tissue sample can be taken directly and a malignant tumor can be excluded. The operation is usually performed under local anesthesia and can be done on an outpatient basis.

Duration and forecast

The prognosis of a sperm granuloma is usually very good and in most cases does not lead to any complications. The likelihood of malignant degeneration is very low. In rare cases, chronic pain in the testicles and relapses can occur, so that repeated treatment is necessary. However, surgery usually carries more side effects and risks than leaving the granuloma in place.