PATHOLOGICAL ANATOMY OF THE TESTICLE 483 



case in which healthy spermatozoa were recovered from a testicle which 

 had been thus obstructed for thirteen years. 



Direct extension of the gonorrheal process to the testicle is very rare. 

 When it occurs, it usually involves only those portions of the organ nearest 

 the epididymis, and seldom affects the whole organ. 



Non-gonorrheal. Epididymitis may occur in the same fashion as 

 above with the colon bacillus, staphyloeoccus, etc., as causative agents. 

 It is usually a second- 

 ary invasion of a gono 

 coccal process, or the 

 sequel of some trauma 

 or operative procedure 

 in the neighborhood of 

 the ejaeulatory ducts or 

 seminal vesicles. Its 

 clinical course and 

 pathological features 

 are like those of gonor- 

 rheal epididymitis. 



When any pyogenic 

 organism causes a n 

 acute inflammation of 

 the testicle proper, there 

 is a diffuse polymorpho- 

 nuclear infiltration of 

 the tissue, with edema 

 and congestion. Whether 

 the infection is by way 

 of the ducts or is hema- 

 togenous, the tubules 

 are filled with pus and 

 appear on the cut sur- 

 face as yellow dots. The Fig 4 Acute pyog enic inflammation of the testicle, 

 epithelium is degener- low power. The diffuse polymorphonuclear infiltration 



i IT i of all elements, with epithelial degeneration, and fibrosis 



ated and ^ desquamated. of the tubular walls, are seen. X 80. (Brady Urological 

 The condition may re- Institute collection.) 

 solve with scar forma- 

 tion, or abscesses may appear. In the latter case, perforation may occur, 

 into the sac of the tunica vaginalis, with periorchitis, or externally, with 

 fistula formation and often fungus testis. The testicle may be completely 

 destroyed, but, if only a portion has been involved, the remainder retains 

 its function. The interstitial cells persist, and if the exit is not ob- 

 structed, spermatogenesis will go on. 



Hematogenous. Mumps. An orchitis occurs in one case in three of 



