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Updated: Jan 30, 2026

Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
Testicular necrosis due to complicated epididymitis and ruptured sperm granuloma in a 13-year-old boy
Konstantinos Velaoras1, Christos Plataras1, Ioannis Alexandrou1
1Pediatric Surgery Department, Penteli Children's Hospital, Ippokratous 8, Penteli, Athens, Hellas, Greece.
Abstract:
Sperm cell granuloma, also termed epididymitis nodosa, is a form of chronic epididymitis that occurs secondary to inflammation, trauma, and/or a vasectomy. We present a rare such case that to our knowledge is unique in pediatric literature: a 13-year-old boy presented with clinical and sonographic findings of epididymo-orchitis. At first, the boy was admitted for a short course of conservative treatment and was discharged. Symptoms deteriorated, he was readmitted and surgery revealed a non-twisted testis, with normal vas and vessels that ended in a necrotic testicular parenchyma. Histology showed a case of epididymitis nodosa and ruptured sperm granuloma that caused vascular compression, thrombosis and testicular necrosis. Epididymitis nodosa should be considered in cases of testicular swelling when clinical course is unusual and conservative treatment fails.
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