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

MDSpire News

At a Glance

Category	Detail
Condition	Vasocutaneous fistula
Key Mechanisms	Retained silk ligature and chronic inflammation
Target Population	Males post-vasectomy
Care Setting	Urology

Key Highlights

Case of a 43-year-old male with a 2-month history of discharge from the hemiscrotum
Persistent sinus with spermatozoa in discharge raised suspicion for vasocutaneous fistula
Surgical excision confirmed the diagnosis with retained silk ligature found
Histopathology showed chronic inflammatory infiltrates
Patient remained asymptomatic at 1 and 3 months post-surgery

Guideline-Based Recommendations

Diagnosis

Diagnosis should integrate clinical findings, microscopy, imaging, operative confirmation, and histopathology.

Management

Surgical excision of the fistulous tract and ligation of the proximal vas deferens.

Monitoring & Follow-up

Follow-up for symptom resolution and recurrence.

Risks

Potential for delayed vasocutaneous fistula formation due to retained suture material.

Patient & Prescribing Data

Males who have undergone vasectomy

Consideration of delayed fistula in patients with persistent scrotal sinus discharge.

Clinical Best Practices

Utilize a multi-modal approach for diagnosis rather than relying on a single diagnostic method.
Monitor for signs of chronic inflammation and fistula formation in post-vasectomy patients.