A systematic review of transurethral resection of ejaculatory ducts for the management of ejaculatory duct obstruction

Mekhaimar, Ayah; Goble, Mary; Alnajjar, Hussain M.; Ralph, David; Muneer, Asıf; Ahmed, Kamran

doi:10.5152/tud.2020.20228

Cited by 9 publications

(4 citation statements)

References 41 publications

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“…Over the years, surgery has been used to effectively treat most EDO patients. A previous systematic review of TURED in infertile men with EDO revealed that semen volume improved in 83.0% of patients, while the mean postoperative spontaneous pregnancy rate increased to 25% [20]. Other studies have also demonstrated that the underlying etiology of EDO is an important predictor of surgical success, with partial EDO and cystic EDO reported to confer superior surgical efficacy than complete EDO and inflammatory calcification EDO, respectively [21,22].…”

Section: Discussionmentioning

confidence: 99%

Ejaculatory Duct Obstruction Affects Seminal Vesicle Contractile Efficacy and Smooth Muscle Ultrastructure in a Rat Model

Ren

Xing

et al. 2023

Andrologia

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The purpose of this study was to investigate the effects of ejaculatory duct obstruction (EDO) on contractile efficacy, smooth muscle ultrastructure, and α1A and M3 receptors of rat seminal vesicles (SVs). A total of 48 male rats, aged 14-15 weeks, were randomly divided into three groups, namely, the control, complete EDO, and partial EDO. SV tissues were collected at 4 and 8 weeks postoperatively for further experiments. Results revealed a marked reduction in SV contractile efficacy over time following obstruction in the complete EDO group. The contractile force and frequency decreased and increased in the partial EDO group at week 4, respectively, whereas contractile efficacy significantly reduced at week 8. Moreover, obstruction resulted in significant downregulation in expression of α1A and M3 proteins and mRNAs in rats from the complete EDO group over time. Rats in the partial EDO group initially exhibited an increase followed by a decrease. Analysis of the ultrastructure of SV smooth muscles confirmed the above changes. In conclusion, complete EDO can lead to a progressive decrease in contractile efficiency of SVs. On the other hand, partial EDO can first compensate for the contraction of SVs and gradually decompensate afterwards.

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Section: Discussionmentioning

confidence: 99%

Ejaculatory Duct Obstruction Affects Seminal Vesicle Contractile Efficacy and Smooth Muscle Ultrastructure in a Rat Model

Ren

Xing

et al. 2023

Andrologia

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“…The classic treatment for ejaculatory duct obstruction is transurethral resection of ejaculatory ducts ( 6 , 7 ). Although the therapeutic effect of this surgical method has been proven, it is more traumatic and more likely to have postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Efficacy analysis of 26 cases of ejaculatory duct obstruction treated by prostatic utricle neck endoscopy

Sun²,

Zhang³

et al. 2022

Front. Surg.

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ObjectiveTo evaluate the safety and efficacy of transvesical incision in the treatment of ejaculatory duct obstruction.MethodsThe clinical data of 26 male infertile patients with ejaculatory duct obstruction were retrospectively analysed at the First Affiliated Hospital of Zhengzhou University from June 2020 to August 2021. All patients were treated with seminal vesicle neck incision for ejaculatory duct obstruction. The general clinical characteristics, intraoperative conditions and postoperative effects on the patients were recorded, and the therapeutic effect was evaluated.ResultsThe ejaculatory duct was found through fenestration, and the seminal vesicle gland was smoothly entered in 25 patients (96.2%). Among them, 22 cases underwent bilateral endoscopy and three underwent unilateral endoscopy. Sperm appeared in 23 cases (88.5%) 3 months after surgery. The sperm concentration and motility postoperatively at 6 months were higher than that at 3 months postoperatively. No postoperative complications, such as epididymitis or retrograde ejaculation, occurred.ConclusionSearching for the ejaculatory duct via the neck of the prostatic utricle, assisted by a low-energy holmium laser, is a new method for the treatment of ejaculatory duct obstruction. Microscopic vision is clear using this approach and the postoperative complications are few, which has high value for clinical application.

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“…Men are found to have low seminal volume and azoospermia when complete obstruction is present. Fortunately, men can be treated for this condition by resection of the obstructing ejaculatory duct, which can achieve higher seminal volume, concentrations, and motility or by surgical sperm extraction combined with IVF [30].…”

Section: Key Pointsmentioning

confidence: 99%

Counseling for the man with severe male infertility

Belladelli

Muncey

Seranio

2022

Current Opinion in Urology

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Purpose of reviewThis review summarize the proper counseling for men with severe male factor infertility.Recent findingsMen who are experiencing infertility should have a semen analysis, the results of which may imply additional investigations, including genetic and hormonal. Moreover, possible modifiable factors that may harm men's reproductive health should be carefully evaluated. Finally, different treatment options are available.SummaryApproximately 15% of couples struggle with infertility. Complete evaluations of both men and women are required to determine the etiology of infertility and determine appropriate treatment.

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A systematic review of transurethral resection of ejaculatory ducts for the management of ejaculatory duct obstruction

Abstract: Ali Serdar Gözen, et al.; Robot-assisted vasovasostomy and vasoepididymostomy: Current status and review of the literature.

Cited by 9 publications

References 41 publications

Ejaculatory Duct Obstruction Affects Seminal Vesicle Contractile Efficacy and Smooth Muscle Ultrastructure in a Rat Model

Ejaculatory Duct Obstruction Affects Seminal Vesicle Contractile Efficacy and Smooth Muscle Ultrastructure in a Rat Model

Efficacy analysis of 26 cases of ejaculatory duct obstruction treated by prostatic utricle neck endoscopy

Counseling for the man with severe male infertility

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