A case of pregnancy following surgery for imperforate anus with absent prostate and seminal vesicles

Imperforate anus is known to cause male infertility, including ejaculatory disorder. There are no reports of successful pregnancy achieved through testicular sperm extraction (TESE)-intracytoplasmic sperm injection following surgery for imperforate anus with the absence of the prostate and seminal vesicles.

A 26-year-old male patient underwent radical surgery for imperforate anus in infancy. He had normal erections and orgasms. However, his ejaculated semen had urinary discharge, and only one motile sperm was observed in all fields. Pelvic magnetic resonance imaging revealed an aplastic prostate and seminal vesicle glands. He was diagnosed with retrograde ejaculation. Despite drug therapy with amoxapine, there was no improvement, and he underwent intravesical sperm retrieval. Despite these modalities, pregnancy was not successful. Subsequently, TESE was performed, resulting in the retrieval of sperm, which led to pregnancy through intracytoplasmic sperm injection. His wife gave birth to a girl at 38 weeks.

In this case, retrograde ejaculation due to imperforate anus was observed. We suspected retrograde ejaculation due to the aplasia of the prostate and seminal vesicles caused by imperforate anus or nerve damage due to surgery. Preserving fertility potential is extremely important for patients with imperforate anus and their families. We considered the cause and treatment of infertility treatment after surgery for imperforate anus.

We have experienced a case of successful pregnancy following imperforate anus surgery with congenital absence of the prostate and seminal vesicles. With appropriate treatment, patients with ejaculatory disorder after imperforate anus surgery can still impregnate a partner.