Presentation
The patient presents with chronic left testicular pain and discomfort. History of a prior vasectomy.
Patient Data
There is left and right epididymal head tubular ectasia.
There is a dilated and tortuous left and right ductus deferens, a normal post-vasectomy finding.
There is a small, simple, right hydrocoele.
There are no sperm granulomata.
The scrotal ultrasound is otherwise normal.
Cine loops demonstrate the unusual "dancing megasperm" within the left dilated ductus deferens and epididymal head.
Case Discussion
Features consistent with the post-vasectomy findings of tubular ectasia of the epididymal head and body bilaterally. The ductus deferens are dilated and tortuous bilaterally. The cine loops demonstrate "dancing megasperm", representing clustered, trapped, spermatozoa oscillating within the dilated ductus deferens and epididymal head during ultrasound interrogation of the scrotum.
Tubular ectasia and "dancing megasperm" represent chronic post-vasectomy complications in the ejaculatory pathway.
In this instance, there are no post-vasectomy sperm granulomata.
Post-vasectomy chronic pain syndrome may account for the patient's pain.
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