Department of Urology, Faculty of Medicine, Kyoto Univeersity
Abstract
1. Clinical and pathological research on Sperm a invasion was undertaken with due references to literature on 13 cases by the Tokyo Jikeikai school of medicine. 2. One among 13 cases had a complication of tuberculous epididym itis. 3. As to the ages of patients, fiftyfive was the oldest while youngest was twenty-one, 10 cases (77%) out of 13 cases were found in "twenties and thirties" (the greatest in number) in which the sexual organs were at their prime. 4. There were eleven cases of the right side an d two cases of the left side, domestic and foreign literature did not state which side contracted the disease more easily. 5. The cheif complaint is pain and for swelling of the testicles, but th i s pain is not severe, also pain in the lower abdomen due to deferentitis is evident too. 6. Previous gonorrhoea cases 4, orchitis two, trauma of externa l genital organs 3 cases, all interrelated with the contraction of the principal disease. There was only one tuberculous case. 7. Clinica l diagnosis indicated 6 tuberculous cases, 5 nonspecific inflammation while the remaining two cases showed tubercular indications as the cases progsessed. The following 3 points (No. 8-10) must be considered in differenti a l diagnosis. 8. Infected Area Exceedingly many cases of globus minor. 9. Size The majority being as large as the head of t h e forefinger or a walnut. 10. Hardness : The majority being hard while the surface is smooth and not similar to tuberculous cases. If tuberculous indications are prevalent, there is a necessity to examine the prostatic gland. 11. As to the patholo gical features, the epithelium of the epididymal duct is destroyed, deteriorates, flattness, metaplasia, expansion, contraction and obstruction of the duct becomes evident. By ut i l izing Putt's differentiating staining method, spermatozoa in the stroma were closely observed. Currently, almost all domestic literature have been devoid in mentioning the discovery of many cases of sperma within the bloodvessel and lymphatic channel. The existence of acid fast pigment as stated only in foreign publications we r e observed in the granulation tissue in seven out of 13 cases. 12 From the above, six to seven cases of uncomplicated type and mixed type were perceived. 13. As to the cause based upon various theories as here to fore and personal experiments, the activity of the sperma itself is primary and that inflammations, trauma causing the change in the epithelium, and contraction, obstruction of the duct is only a secondary factor which only fosters the activity of sperm in the interstitium
