Traumatic bilateral testicular dislocation: a recovery of
spermatogenesis by orchiopexy 15 years after the
Hideo Sakamoto, M.D.,
Shinji Iwasaki, M.D.,
Miki Kushima, M.D.,
Takeshi Shichijo, M.D.,
and Yoshio Ogawa, M.D.
Department of Urology,
Department of Obstetrics and Gynecology, and
Division of Hospital Pathology, Showa University
Hospital, Tokyo, Japan
Objective: To report a patient with azoospermia who achieved an induction of spermatogenesis after undergoing
orchiopexy of long-standing bilateral traumatic dislocated testes.
Design: Case report.
Patient(s): A 33-year-old man.
Intervention(s): Imaging studies, orchiopexy, testicular biopsy, and a review of similar cases.
Main Outcome Measure(s): Recovery of spermatogenesis after orchiopexy.
Result(s): A patient with azoospermia with bilateral traumatic dislocated testes due to a motorcycle accident 15
years previously. A bilateral testicular dislocation in the superﬁcial inguinal pouch was diagnosed by palpation,
imaging studies, and exploration. A recovery of spermatogenesis was obtained after performing orchiopexy of
bilateral dislocated testes.
Conclusion(s): The recovery of spermatogenesis in patients with azoospermia with a bilateral testicular
dislocation therefore may be successfully obtained after appropriately performing orchiopexy. (Fertil Steril
2008;90:2009.e9–e11. Ó2008 by American Society for Reproductive Medicine.)
Key Words: Traumatic testicular dislocation, azoospermia, spermatogenesis, orchiopexy
A traumatic dislocation of the testis is a relative rare event
and is deﬁned as displacement of one or both normally lo-
cated testes out of the scrotum (1, 2). One third of such re-
ported cases show a bilateral dislocation (1, 2). A previous
study showed that a displacement of the testes out of the scro-
tum in adult mice, namely artiﬁcial cryptorchidism, impairs
spermatogenesis (3). Therefore, a long-standing change in
the environment around the dislocated postpubertal testes
such as an increase of temperature may inﬂuence spermato-
genesis. In fact, several case reports have revealed an impair-
ment of spermatogenesis in dislocated postpubertal testes for
>1 month (4–8). However, the relationship between a trau-
matic dislocation of the testis and spermatogenesis remains
to be elucidated, because the number of such reported cases
is limited (4–8).
We herein report an adult male with azoospermia who
achieved the induction of spermatogenesis and subsequent
successfully induced a natural pregnancy after undergoing
orchiopexy of bilateral traumatic dislocated testes at 15 years
A 33-year-old man was seen with a 4-year period of primary
infertility. He had a history of conservative treatment after
a motorcycle accident without other severe injuries at 18
years of age. Before the accident, he realized the existence
of bilateral testes in the scrotum. After the accident, he be-
came aware of an empty scrotum and bilateral groin masses;
however, he did not receive any treatment. On physical exam-
ination, the right and left testes were palpable as a tender
mass in the bilateral inguinal regions. Ultrasonography and
magnetic resonance imaging showed bilateral testes to both
be located in the superﬁcial inguinal region (Fig. 1). The vol-
umes of the right and left testes as calculated by ultrasonog-
raphy were 8.6 mL and 10.6 mL, respectively (9). A semen
analysis, even after its centrifugation, showed azoospermia.
The serum FSH, LH, and T values were 16.6 mIU/mL (nor-
mal range, 2.9–8.2 mIU/mL), 6.9 mIU/mL (normal range,
1.8–5.2 mIU/mL), and 2.62 ng/mL (normal range, 2.7–10.7
ng/mL), respectively. Neither a chromosomal abnormality
nor a microdeletion of the Y chromosome was detected. He
underwent orchiopexy and a testicular biopsy for bilateral
Received January 13, 2008; revised and accepted January 31, 2008.
H.S. has nothing to disclose. S.I. has nothing to disclose. M.K. has nothing
to disclose. T.S. has nothing to disclose. Y.O. has nothing to disclose.
Presented at the 69th Eastern Meeting of the Japanese Urological Asso-
ciation, Shinagawa, Japan, September 22–24, 2004.
Reprint requests: Hideo Sakamoto, M.D., Department of Urology, Showa
University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo,
142-8666 Japan (FAX: 81-3-3784-1400; E-mail: hs-showa-u@med.
0015-0282/08/$34.00 Fertility and Sterility
Vol. 90, No. 5, November 2008
doi:10.1016/j.fertnstert.2008.01.105 Copyright ª2008 American Society for Reproductive Medicine, Published by Elsevier Inc.