title: [Successful testicular sperm extraction in a non-obstructive azoospermic man with severe testicular microlithiasis : a case report].
abstract: A 45-year-old man was referred to our hospital for treatment of azoospermia. On physical examination, right testicular volume was 2 ml, left testicular volume was 3 ml, and pubic Tanner stage was 5. Scrotal ultrasonography revealed a high echoic lesion with acoustic shadowing at surfaces of bilateral testes. Semen analysis showed azoospermia and serum follicle stimulating hormone value was high (28.42 mIU/ml). He was diagnosed with non-obstructive azoospermia, and underwent microdissection testicular sperm extraction. Both testes were filled with shiny granular materials. In excised tissue of the testes, seminiferous tubules containing spermatozoa were found and motile spermatozoa were successfully retrieved. The histological examination revealed many small calcifications which had laminated structure. Spermatogenesis was slightly impaired, and Johnsen's score count was 9. Testicular microlithiasis has been reported to be an infrequent condition associated with conditions such as testicular tumors and testicular dysgenesis syndrome. Such a severe testicular microlithiasis has not been reported previously.
authors.affiliation: The Department of Urology, Osaka Police Hospital, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Takezawa
authors.forename: Takanori
authors.initials: T
authors.lastname: Kinjo
authors.forename: Takeshi
authors.initials: T
authors.lastname: Oida
authors.forename: Suguru
authors.initials: S
authors.lastname: Yoneda
authors.forename: Hironori
authors.initials: H
authors.lastname: Nomura
authors.forename: Norihide
authors.initials: N
authors.lastname: Tei
authors.forename: Shingo
authors.initials: S
authors.lastname: Takada
authors.forename: Kiyomi
authors.initials: K
authors.lastname: Matsumiya
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsujimoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Okamoto
mesh_terms: D053713:Azoospermia / Q000209:etiology*; D002137:Calculi / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D053625:Sperm Retrieval; D013733:Testicular Diseases / Q000150:complications* / Q000473:pathology