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Aspermia Due to Multiple Abnormalities in a Young Adult

A 15-year-old young adult referred to our department because of lack of ejaculation in spite of erection occuring after masturbation. Three years before examination he had been involved in a road accident resulting in fractures of the pelvic bones and tearing of the posterior urethra. Although posterior urethra reconstruction was performed, the patient still experienced impaired urinary flow and urinary tract infections. Physical examination was within normal limits. The genital organs appeared normal, but no was deferens was palpated. Routine blood tests and the endocrinological profile were within normal ranges. Following masturbation, the urine was found to be devoid of spermatozoa but showed presence of fructose which could indicate retrograde ejaculation. Pyelography was normal but cystourethrography showed deformation and stricture of the posterior urethra (Fig. 1). Exploration of the scrotum was carried out. The testes and the epididymides appeared normal while the vasa deferentia were fibrotic and atresic. It was impossible to perform vasography in spite of several trials. Biopsies of both testes revealed maturation arrest (Fig. 2).