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Updated: Jul 6, 2025

Vessel-Sparing Microsurgical Longitudinal Intussusception Vasoepididymostomy to Treat Epididymal Obstructive Azoospermia
Published on: May 27, 2022
Obstructive azoospermia caused by epididymis injury with testicle rupture on the other side
Takayuki Ueda1, Masato Yanagi1, Akifumi Katsu1
1Department of Urology Nippon Medical School Musashikosugi Hospital Kawasaki-City Japan.
Background:
Epididymal injuries without ipsilateral injuries of the testicles are rare. We report a case of a solitary right epididymal injury complicated by left testicular rupture.
Case Presentation:
A 21-year-old man experienced scrotal trauma caused by a motorcycle accident. Bilateral swelling and tenderness of the scrotum were observed. Ultrasonography and computed tomography revealed a ruptured left testicle; therefore, surgery was performed. During surgery, the left testicle was excised because it was completely ruptured, and the right testicle and epididymis were evaluated to identify the cause of swelling of the right scrotum. The right testis was not injured; however, the right epididymis was lacerated. Subsequently, the lacerated right epididymis was repaired using sutures. A semen analysis performed at 1, 4, and 7 months after surgery revealed the absence of sperm in the semen.
Conclusion:
Epididymal injuries should be considered as differential diagnoses for scrotal trauma.
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