5 Key Takeaways

• 1

  A 43-year-old male developed a vasocutaneous fistula 3 years post-vasectomy, associated with retained silk ligature and chronic inflammation.

• 2

  Clinical examination, microscopy, ultrasonography, and surgical exploration were used to assess the persistent sinus and its connection to the vas deferens.

• 3

  Surgical excision revealed a fistulous tract linked to the previously ligated vasal stump, with retained silk suture embedded in fibrotic tissue.

• 4

  Histopathologic examination showed chronic inflammation, supporting the diagnosis, but did not establish the fistulous communication's anatomical pathway.

• 5

  The case highlights the importance of integrating multiple diagnostic modalities for establishing the diagnosis of delayed vasocutaneous fistula.