Schistosomiasis of the male pelvic organs. Severity of infection as determined by digestion of tissue and histologic methods in 300 cadavers.

Abstract

In order to assess the effects of schistosomiasis in the prostate gland, seminal vesicles, and the intraabdominal portion of the vas deferens, we examined these organs at 200 consecutive autopsies of African males. Portions of these organs as well as of the bladder, were digested in KOH; the proportion of eggs of Schistosoma haematobium found in these organs was: seminal vesicles, 54.5%, spermatic duct, 39.9%, and prostate gland, 20.5%. Eggs of Schistosoma mansoni were rarer in these tissues (bladder, 1%; seminal vesicles, 15.5%; spermatic duct, 8%; and prostate gland, 1%). The mean number of S. haematobium eggs/gm of tissue was substantially greater than for S. mansoni. To compare the histologic technique with that of digestion of tissue, we studied a further 100 consecutive autopsies--77% showed evidence of schistosomiasis by 1 or the other method. The bladder was affected in 65%; prostate gland, 21%, seminal vesicle, 70%; and the vas deferens in 42%. The detection of schistosomiasis was almost as good by the traditional histologic as by the digestion technique. Neither method revealed all infections. The frequency and severity of the lesions in these tissues was studied by standard histologic technique: tissues from the last 100 consecutive cases showed definite inflammatory lesions especially in the seminal vesicles, but less than in the prostate gland. In none, however, was the reaction marked. There was good correlation between the mean number of eggs by the histologic and digestion methods, the exception being the prostate gland. No correlation could be shown between the number of eggs and inflammation; only a few eggs may provoke a marked response or the reverse may occur. Eggs were found mainly in the muscle layer of the seminal vesicles, but also in the mucosa and even the lumen. The number of eggs did not vary much with age of infected person; however after age 60 the mean number of eggs in the bladder and seminal vesicles dropped markedly.