Retained silk may underlie late postvasectomy fistula - Report - MDSpire
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Retained silk may underlie late postvasectomy fistula

Surgery and histopathology identified retained silk ligature with chronic inflammation at the site of a rare fistula presenting 3 years following vasectomy.

  • By

  • Andrea Surnit

  • September 18, 2026

  • 4 min

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Clinical Report: Retained silk may underlie late postvasectomy fistula

Background

Vasectomy is a common procedure for male sterilization, but complications such as fistula formation can occur, particularly when nonabsorbable sutures are used. This case highlights the potential for delayed complications.

Data Highlights

No numerical data or trial data available in the article.

Key Findings

  • A 43-year-old male developed a vasocutaneous fistula three years after a bilateral no-scalpel vasectomy.
  • The fistula was associated with retained silk ligature and chronic inflammation.
  • Diagnosis was based on clinical examination, imaging, and histopathologic findings.
  • Surgical excision of the fistulous tract resulted in complete resolution of symptoms.
  • Histopathology revealed chronic inflammatory infiltrates and confirmed the presence of spermatozoa in the discharge.

Clinical Implications

Clinicians should consider the possibility of delayed vasocutaneous fistula in patients with persistent scrotal discharge following vasectomy, especially when spermatozoa are present.

Conclusion

This case presents a delayed vasocutaneous fistula formation associated with retained silk ligature.

Related Resources & Content

  1. Thiagarajan S., BMC Urology, 2026 -- Delayed vasocutaneous fistula following vasectomy associated with retained silk ligature: a case report with clinicopathological correlation
  2. Hernia — Slowly absorbable suture for fascial defect closure in open incisional hernia mesh-repair is associated with decreased long-term recurrence: a nationwide cohort study
  3. Techniques in Coloproctology — Detection of Epithelialization in High Transsphincteric Fistulas
  4. Frontiers in Surgery — Gastric Fistula Development Following 20 Months of Retained Postoperative Drain: A Case Study
  5. Hernia — Migration of Composite Mesh into the Sigmoid Colon After Ventral Hernia Repair
  6. Vasectomy: AUA Guideline (2026)
  7. U.S. Selected Practice Recommendations for Contraceptive Use, 2024 | Contraception | CDC
  8. Review of vasocutaneous fistulas and other rare complications after vasectomy
  9. https://www.nsvi.org/wp-content/uploads/2017/05/AUA-Guidelines-Vasectomy.pdf
  10. Vasectomy: Guidelines From the American Urological Association | AFP
  11. Vasectomy by ligation and excision, with or without fascial interposition: a randomized controlled trial [ISRCTN77781689] - PMC
  12. A comparison of vas occlusion techniques: cautery more effective than ligation and excision with fascial interposition - PMC
  13. Vasectomy occlusion techniques for male sterilization - PMC
  14. Delayed vasocutaneous fistula following vasectomy associated with retained silk ligature: a case report with clinicopathological correlation | BMC Urology | Springer Nature Link

Original Source(s)

Retained silk may underlie late postvasectomy fistula

  • by Andrea Surnit

  • September 18, 2026

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