日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

A 22-year-old man was referred to our institution due to bilateral intrascrotal masses and a suspected testicular tumor. A magnetic resonance imaging scan revealed bilateral epididymitis; moreover, the polymerase chain reaction test was positive for chlamydia. Therefore, the patient was diagnosed with bilateral chlamydial epididymitis. A semen analysis prior to treatment revealed azoospermia and obstructive azoospermia due to chlamydial epididymitis. Subsequently, antibiotic treatment improved the epididymitis and semen findings. Chlamydial epididymitis has been reported to progress bilaterally with a chronic course due to mild symptoms, and has been known to cause narrowing of the seminal ducts, resulting in obstructive azoospermia; however, epidemiological data are still insufficient. In this study, we present a case report of obstructive azoospermia caused by chlamydial epididymitis with a literature review.