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Human Reproduction, Vol. 17, No. 11, 2935-2937, November 2002
© 2002 European Society of Human Reproduction and Embryology

Aspermia and chronic testicular pain after imperforate anus correction. Cryopreservation of sperm cells extracted from whole orchiectomized testis: Case report

L. Negri1,3, E. Albani1, M. Di Rocco2 and P.E. Levi-Setti1

1 Unità Operativa di Medicina della Riproduzione and 2 Unità Operativa di Anatomia Patologica, Istituto Clinico Humanitas, Rozzano (Milan), Italy

This paper describes an unusual association of aspermia and untreatable, chronic testicular pain in a young man who underwent 14 surgical interventions for an imperforate anus. Physical examination and ultrasonography revealed left epididymal and vas enlargement, normal-sized testes, tubular ectasia of the left rete testis and a small intraprostatic paramedian left cyst. Retrograde ejaculation and urogenital infections were excluded, and the FSH and karyotype results were normal. The patient gave his consent to an exploratory intervention with possible radical left orchiectomy. The patency of the left distal seminal duct was unexpectedly normal, and no sperm were found in the epididymis or vas deferens despite their obstructive appearance. Sperm were only found in a ‘testicular touch’ preparation. The removed testis was immediately opened and most of the testicular lobules were removed, thus allowing the extraction of 25x106 sperm, which were cryopreserved in 35 straws. An 8-month follow-up examination documented the complete absence of pain and, during the next few months, it is planned to use the thawed sperm for ICSI. Radical orchiectomy plus the cryopreservation of sperm extracted from the whole testis must be considered in the case of the co-existence of chronic unilateral testicular pain and aspermia.

Key words: aspermia/cryopreservation/imperforate anus/TESE/testicular pain

3 To whom correspondence should be addressed at U.O. Medicina della Riproduzione, Istituto Clinico Humanitas, Via Manzoni 56,I-20089 Rozzano MI, Italy. E-mail: luciano.negri{at}humanitas.it


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