Effect of vasectomy on the prostatic function as indicated by seminal maltase activity

Response of the adult prostate to prepubertal and postpubertal obstruction of the vas deferens in the rat

OBJECTIVES

To determine whether obstruction of the vas deferens alters several general measures of prostate development during puberty and during prostate maintenance in the adult rat. Previous reports have suggested the possibility that vasectomy results in alterations of prostate function in experimental animals and humans.

METHODS

Adult rats and 10-day-old rats were subjected to bilateral sham operations or bilateral vasectomy, and the prostates were extirpated either 14 or 60 days later. The total prostate weight and dorsolateral and ventral lobe total protein per milligram tissue, DNA per milligram tissue, and DNA per milligram protein were determined. Dorsolateral and ventral prostate lobe sections from each group were also stained with hematoxylin-eosin and subjected to histologic examination.

RESULTS

The histologic features of the adult rat prostate were not qualitatively altered by vasectomy whether it occurred before puberty or in adult animals with mature prostates. Furthermore, vasectomy did not significantly alter the prostate weight or the protein or DNA content of either the dorsolateral or ventral lobes of the prostate compared with the sham-operated animals of either age.

CONCLUSIONS

Vas deferens obstruction does not significantly alter the parameters associated with the development or maintenance of the adult rat prostate measured in this study.

Alpha-1,4-glucosidase activity and the presence of germinal epithelium cells in the semen for differential diagnosis of obstructive and nonobstructive azoospermia

Among azoospermics, the activity of seminal alpha-glucosidase (alpha G) is low in obstruction (OBS) cases, but there is no agreement regarding its value in others. With the hypothesis that a more marked decrease in alpha G activity occurs in OBS than in spermatogenesis arrest (SA), the enzyme was measured in the following groups: (1) vasectomized males (n = 15), (2) azoospermics with OBS (n = 7), (3) azoospermics with SA (n = 11), and (4) fertile males (n = 15). Patients within groups 2 and 3 had a testicular volume > or = 15 mL, no clinical evidence of abnormal epididymis, normal serum gonadotropins, and histological diagnosis. alpha G activities (mU/g protein, means +/- SD) by group were (1) 131 +/- 60, (2) 312 +/- 186, (3) 728 +/- 303, and (4) 1176 +/- 374. All between-group differences were significant (t test, p < .01), except for groups 1 vs. 2 comparison (.05 > p > .01). These results support the notion that SA is associated with a decrease in alpha G that is less marked that seen in OBS. The search for germinal epithelium cells in semen also allows discrimination between these two azoospermic groups.

Improvement in the assessment of human epididymal function by the use of inhibitors in the assay of alpha-glucosidase in seminal plasma

Seminal alpha-glucosidase has been used clinically as a marker of epididymal function. In this study enzyme inhibitors were used to increase the specificity of the human seminal alpha-glucosidase assay and improve its diagnostic value as an indicator of distal epididymal occlusion in cases of azoospermia. Sodium dodecylsulphate was added to the sample to eliminate the interfering acid isoenzyme secreted by the prostate gland, and castanospermine was used with semen pools to provide a semen blank for the assay by eliminating non-glucosidase-regulated degradation of the substrate. With both inhibitors included in the assay, glucosidase activity in semen samples from 17 fathers was measured to provide reference values for the clinic (lower threshold 18 mU per ejaculate). With the improved assay glucosidase was non-detectable in 8 out of 11 cases of proven and 5 out of 8 cases of suspected ductal obstruction; other azoospermic patients with distal occlusion had values below 11 mU per ejaculate.

Immunological and clinical consequences of vasectomy

Blood samples from 109 vasectomized and 100 non-vasectomized fertile men were tested for antisperm antibodies using Tray Agglutination Test (TAT) and Sperm Immobilization Test (SIT), Cell Mediated Immunity to sperm using Leukocyte Migration Inhibition Test (LMIT). Incidence of antisperm antibodies in vasectomized group was 76.2% by TAT and 13.8% by SIT whereas in control group was 11% (p less than 0.001) and 3% (P less than 0.01) respectively. Titre of TAT antibodies increased with post vasectomy period even beyond 20 years post vasectomy. High Incidence of TAT titre of greater than 1:250 was observed in vasectomized men with post operative complications. No significant incidence of positive LMIT to sperm antigens was detected in vasectomized group as compared to control group.

Origin of maltase and variations in infertile men

A specific assay based on the spectrophotometric determination of the release of p-nitrophenol from p-nitrophenol-alpha-D-glucopyranoside by maltase has been used to measure the activity of the enzyme in seminal plasma and in homogenates of accessory reproductive organs. Specific activity of seminal plasma maltase was 467 muU/mg of proteins in 68 fertile men, decreased significantly in varicocele (296 muU/mg), in azoospermia (246 muU/mg) and in vasectomized patients (62 muU/mg). Application of ion exchange chromatography on DEAE-Sephadex A-50 columns led to the demonstration that maltase activity of seminal plasma and of cytosols from normal reproductive organs was recovered in three different fractions. Maltase activity is thus frequently decreased in infertility.

Endocrine effects of vasectomy

In order to provide information on the endocrine effects of vasectomy, unconjugated pregnenolone, dehydroepiandrosterone, androstenedione, testosterone, dihydrotestosterone, oestrone and oestradiol were analysed in the blood plasma of twenty Mexican men on two occasions before and 1, 3, 6 and 12 months after vasectomy. Vasectomy appeared to be associated with a significant decrease in the plasma levels of pregnenolone, dehydroepiandrosterone and androstenedione and a significant increase in the levels of dihydrotestosterone and oestrone. A probably significant increase in oestradiol levels took place 12 months after vasectomy but not before. No consistent changes were found in testosterone (up to 12 months) or in FSH and LH levels (up to 6 months) after vasectomy. The unconjugated steroids indicated above, except oestrone, were also estimated, whenever possible, in seminal plasma specimens obtained from thirty-nine subjects (including the twenty indicated above) on the same occasions. Vasectomy was associated with a highly significant decrease of seminal plasma dihydrotestosterone levels on all occasions and a significant decrease in androstenedione levels after 6 and 12 months. After 12 months there was a decrease in dehydroepiandrosterone and an increase in oestradiol; these changes were both probably significant. In another preliminary study, the levels of pregnenolone sulphate, dehydroepiandrosterone sulphate, testosterone glucuronide, testosterone sulphate and dihydrotestosterone sulphate were estimated before and 1 month after vasectomy in the seminal plasma of fourteen to seventeen subjects. Testosterone glucuronide fell, probably significantly, but other conjugates were unchanged. The data indicate that vasectomy may be associated with significant changes in the circulating and in seminal plasma levels of several steroids. The gradual nature of some of the changes observed suggests the necessity of conducting in several centres large-scale, long-term studies on vasectomized subjects and on a carefully matched control group. During the last decade vasectomy has been widely practised in several parts of the world as a method of fertility control. However, information on the endocrine effects of this intervention appears to be scanty. In most of the human studies reported, a small number of individuals were investigated and the studies have been confined to the assessment of the short-term effects of the operation. Moreover, the hormonal indices assessed by the various investigators have been limited, in most cases, to gonadotrophins and testosterone in blood. The present study was designed to assess in the same subjects the levels of a number of unconjugated steroids, FSH and LH on two occasions before and 1, 3, 6 and 12 months after vasectomy. The studies were extended to include steroid analyses in seminal plasma in the hope that such assays might yield information as to the effects of vasectomy on the distribution of steroids in the fluids of the male reproductive tract.