Filarial Affections of the Male Genital Tracts

During the past few years very important advances have been made in our knowledge of the pathology of filariasis and its complications. In the present review, attention is drawn to some of the more recent advances, regarding the affections of the male genital tracts. The filarial worm (Wuchereria bancrofti) in its adult or mature stage is an inhabitant of the lymphatic system of man. O'Connor (1932) and his colleagues have recently brought forward convincing evidence that the filarial worm itself is the essential factor in the syndrome associated with W. bancrofti infection. Lymphatic filarial obstruction has been explained in terms of damage done to the main lymphatic trunks or to the corresponding lymphatic glands by the immature larvre or adult worms. But evidence has gradually accumulated that adults may' live in numbers in the smaller lymphatics of the limbs and on the distal side of lymphatic nodes. The conditions then arc such that so long as the lymph circulation remains reasonably normal every microfilaria from these adults must pass through the nodes concerned and the passage will induce a considerable cellular reaction in them. Persistent passage of embryos is then likely to be followed by fibrosis and lymphatic obstruction (Lane, 1931). If the length of the testicular lymphatics and their termination in the juxtaaortic lymph glands are kept in mind, it would not be difficult to understand the pathological changes that occur. In the following pages an attempt will also be made to consider the factors that determine the differences in the type of genital lesions.