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We report an unusual case of a leiomyoma of the spermatic cord. The tumor did not present as a mass but presented as a hard structure along the spermatic cord. To our knowledge, this is the first case report of a leiomyoma of the spermatic cord with such an unusual appearance.

A case of azoospermia due to pathological dilatation of seminal duct end is reported. A 34-year-old man visited our clinic complaining of infertility. He was diagnosed as having azoospermia by semen analysis. Cystic dilatation of seminal duct end was improved after transurethral resection of the cystic wall. His wife became pregnant on the 27th day after his operation.

Biopsy of contralateral testis of 20 patients with an unilateral testicular tumor was carried out to evaluate the morphological changes of the contralateral testis caused by the tumor. Serum beta-chorionic gonadotropin (beta-hCG), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and alpha-fetoprotein (AFP) levels before orchiectomy were examined as a function influencing morphological changes of the contralateral testis. Typical carcinoma in situ was found in a case of ipsilateral testis. The presence of a few atypical germ cells, however, was the only finding of the contralateral testis of three patients. Five of 20 patients revealed hypospermatogenesis in the contralateral intact testis. Most of the other patients also showed sloughing of germinal epithelium suggesting disorder of spermatogenesis. Johnsen's mean score count and tubular wall thickening were related to neither clinical stages, ESR, serum beta-hCG, AFP, LH nor FSH levels. Tubular wall thickening was observed in 8 of 10 patients with a tumor weighting over 150 g, but was found in only 1 of 10 patients with a lighter tumor (p less than 0.01).

Two cases of male infertility due to pathological dilatation of seminal duct end are reported. One patient was 33 years old. He was diagnosed with azoospermia by semen analysis. The cystic wall of the seminal duct end was incised by a cold knife on the urethral scope. After the operation, 100,000-500,000/ml sperms were found in his semen. The other patient was 31 years old. He was diagnosed with severe oligoasthenozoospermia. He was operated on in a similar operation. After operation, the findings of his semen analysis improved exceedingly, and his wife became pregnant.