Abstract
A 29-year-old man with primary infertility for 2 years presented for further evaluation. Repeated spermiograms showed azoospermia and an acidic pH. Sonographically, both testes showed normal size and parenchyma, but the vas deferens was bilaterally not palpable. Magnetic resonance imaging showed a cystically dilated left vas deferens and a dilated left seminal vesicle. The right vas deferens could not be visualized. Testicular sperm extraction (TESE) was successful and showed only slight impairment of the spermatogenesis with a Johnson score of 9.