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June 12, 1972

Reanastomosis of the Vas Deferens

Author Affiliations

Islington, Ontario

JAMA. 1972;220(11):1498. doi:10.1001/jama.1972.03200110076025

To the Editor.—  Temporary spontaneous reanastomosis of the vas deferens, presented by Marshall and Lyons (219:1753, 1972), is of great interest to all those performing vasectomies.In order for a fistula to develop there must be active changes taking place in the tissues. The normal healing process results in a rather rapid production of granulation tissue followed by regressive changes and scar formation. This process is prolonged by chemical irritation from the suture materials, especially surgical silk. The reaction from absorbable materials is shorter. Completely biologically inert material, such as tantalum, produces no irritant effect, and scar formation is solely due to the ischemia produced by compression of the tissues.According to this hypothesis, late spontaneous anastomosis of the vas ends is more likely to occur with the use of silk ligatures. It also may occur after several months if there has been leakage of sperm from the proximal end