The subject of tuberculosis of the seminal tract has for years been highly controversial. Some of the questions at issue have been: Which is the primary seat, the epididymis or the seminal vesicles? Does the pathologic process within the scrotum start in the globus major or the globus minor? Does it reach these through the blood stream, by the lymphatics or down the vas deferens? Has heliotherapy or hygiene any value? Is castration preferable to epididymectomy? Should operation be attempted if the bladder, kidneys or lungs are involved? Seminal vesiculectomy has hardly been mentioned.
In the literature one will find a great array of papers in which leading surgeons and urologists have expounded views at variance on the subject of genital tuberculosis. In my early days on the surgical staff of the Johns Hopkins Hospital, castration was the rule in genital tuberculosis. Later we employed the Bardenheuer operation of epididymectomy.
YOUNG HH. TUBERCULOSIS OF THE GENITAL TRACT. JAMA. 1935;104(9):722–726. doi:10.1001/jama.1935.02760090026008
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