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CLINICAL IMAGE
Year : 2018  |  Volume : 148  |  Issue : 4  |  Page : 460-461

Idiopathic pan genital tract calcification: A rare cause of aspermia & infertility


Department of Urology, Jawaharlal Institute of Medical Education & Research, Puducherry 605 006, India

Date of Submission01-Jul-2017
Date of Web Publication21-Jan-2019

Correspondence Address:
Ramanitharan Manikandan
Department of Urology, Jawaharlal Institute of Medical Education & Research, Puducherry 605 006
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1097_17

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How to cite this article:
Manikandan R, Dorairajan LN. Idiopathic pan genital tract calcification: A rare cause of aspermia & infertility. Indian J Med Res 2018;148:460-1

How to cite this URL:
Manikandan R, Dorairajan LN. Idiopathic pan genital tract calcification: A rare cause of aspermia & infertility. Indian J Med Res [serial online] 2018 [cited 2020 Aug 13];148:460-1. Available from: http://www.ijmr.org.in/text.asp?2018/148/4/460/250525

†Patient's consent obtained to publish clinical information and images.


A 33 yr old man presented to the department of Urology, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India, in June 2016, with primary infertility, progressively decreasing semen volume, ultimately leading to orgasmic aspermia with normal erectile function and libido. There was no history of haematuria, haematospermia, urinary tract infection, graveluria and any systemic medical illness. The urine microscopic analysis and cultures were unremarkable. Urine for acid-fast bacilli (AFB) was negative. Blood sugar, renal function tests and serum calcium levels were normal. Ultrasound evaluation of kidney and ureters were normal. Transrectal ultrasound (TRUS) [Figure 1], computed tomography (CT) [Figure 2] and magnetic resonance imaging (MRI) [Figure 3] revealed calcification of the entire genital tract. The patient underwent testicular sperm extraction followed by intracytoplasmic sperm injection (ICSI) technique for the management of infertility. The patient remained distressed due to aspermia, but there was no further progression of the disease by imaging in the last follow up one year later. Symptomatic young patients with calcification limited to seminal vesicle and ejaculatory duct are amenable to surgical treatment.
Figure 1: (A) Axial transrectal ultrasound (TRUS) image revealing calcification in the right seminal vesicle and vas deferens and (B) calcification in seminal vesicle in sagittal TRUS image (arrow).

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Figure 2: Coronal reformatted plain computed tomographic image of pelvis showing calcification in prostate, seminal vesicle, ejaculatory duct and vas deferens (arrow).

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Figure 3: T2-weighted magnetic resonance imaging (MRI) axial image with hypointensities in seminal vesicle bilaterally suggesting calcification (arrow).

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Conflicts of Interest: None.




    Figures

  [Figure 1], [Figure 2], [Figure 3]



 

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