Ejaculatory duct obstruction

Fisch, Harry; Kang, Young Mo; Johnson, Christopher W.; Goluboff, Erik T.

doi:10.1097/00042307-200211000-00012

Cited by 48 publications

(41 citation statements)

References 41 publications

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“…Infertility is defined as failure to conceive after 1 year of unprotected intercourse. Infertility is a relatively common problem that affects approximately 15% of the reproductive age range population [1] . More couples now seek infertility evaluations, which may reflect the increased availability of infertility-related services and an increased media focus on medical advances in reproductive technology.…”

Section: Introductionmentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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The main purpose of imaging evaluation in male infertility is to identify and treat correctable causes of infertility, such as obstruction of the seminal tract. Various imaging modalities are available to evaluate men with obstructive infertility including scrotal ultrasonography, transrectal ultrasound (TRUS), vasography, magnetic resonance imaging, seminal vesicle aspiration, seminal tract washout, and seminal vesiculography. To date the most reliable and accurate diagnostic technique for obstructive infertility is unclear. In this review article, we report the role of these modalities in diagnosis of obstructive infertility. Scrotal sonography is the initial modality, and if patient results indicate non obstructive azoospermia as varicocele or testicular pathology they will be treated according to standard protocols for management of these pathologies. If the patient findings indicate proximal obstructive azoospermia, they can be managed by vasoepididymostomy. If the scrotal ultrasound is normal, TRUS is the second imaging modality. Accordingly, they are classified into patients with criteria of obstructive infertility without urogenital cysts where TRUS-guided aspiration and seminal vesiculography can be performed and transurethral resection of the ejaculatory ducts (TURED) will be the management of choice. In patients with urogenital cyst, TRUS-guided cyst aspiration and opacification are performed. If the cyst is communicating with the seminal tract, management will be transurethral incision of the cyst. If the cyst is not in communication, the obstruction may be relieved after cyst aspiration. If the obstruction is not relieved, TURED will be the management of choice. Sperm harvested during aspiration may be stored and used in assisted reproduction techniques. If the results of TRUS are inconclusive or doubtful, endorectal magnetic resonance imaging should be performed to serve as a "detailed map" for guiding corrective operative interventions.

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Section: Introductionmentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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“…Only one case has been reported in the literature (7). EDO can be either congenital or acquired (2,3,8,9). Congenital EDO causes include Abstract.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis of retrograde ejaculation is established by finding numerous sperm within a post-ejaculatory urine specimen. However, dry ejaculate accompanied by painful ejaculation after TURP may suggest the possibility of other considerations including ejaculatory duct obstruction (EDO), especially when no sperm is identified within the post-ejaculatory urine specimen (2,3). Transrectal ultrasonography (TRUS) is a widely used technique to evaluate EDO, but vasovesiculography, which provides detailed anatomic information, may be adopted for the advanced confirmation of EDO in patients with a high suspicion of EDO, who have normal findings on TRUS (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Ejaculatory Duct Obstruction after Transurethral Resection of the Prostate

Kuo

Cha

Sun

2009

Acta Chirurgica Belgica

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Transurethral resection of the prostate is currently the most commonly employed surgical procedure for benign prostatic hyperplasia. Although several complications after the procedure have been well documented, ejaculatory duct obstruction is a rare complication. We describe this unusual complication in a 77-year-old male who presented with severe pain and a feeling of fullness in the lower abdomen and with dry ejaculate on three occasions after undergoing post-transurethral resection of the prostate. The patient's post-ejaculatory urinalysis demonstrated no sperm. Transrectal ultrasonography also showed no dilatation of the bilateral seminal vesicles or ejaculatory ducts. However, ejaculatory duct obstruction was finally diagnosed on vasovesiculography. The patient was successfully treated with transurethral resection of the ejaculatory duct and remained asymptomatic 6 months postoperatively. Although transrectal ultrasonography is currently widely used to evaluate ejaculatory duct obstruction, we suggest that vasovesiculography is still a feasible and useful tool that provides detailed anatomic information for the advanced confirmation of ejaculatory duct obstruction in patients with a high suspicion of ejaculatory duct obstruction who have normal transrectal ultrasonography findings.

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“…This may require subsequent vasoepididymostomy if an infertile patient's semen parameters fail to improve after TURED and this is suspected [27].…”

Section: Treatmentmentioning

confidence: 99%

Ejaculatory Duct Dysfunction and Lower Urinary Tract Symptoms: Chronic Prostatitis

McIntyre

Fisch

2010

Curr Urol Rep

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Chronic pelvic pain syndrome (CPPS) is the most prevalent form of prostatitis. It is characterized by pelvic pain, voiding symptoms, and ejaculatory symptoms in the absence of bacterial infection. This can be a difficult condition to treat. Many etiologies for CPPS have been proposed including immunologic, neurologic, endocrine, and psychological factors. This article examines a potentially correctable condition that may lead to CPPS, ejaculatory duct obstruction (EDO). EDO is easily correctable with minor surgery. In patients with symptoms of CPPS with associated ejaculatory pain, the diagnosis of EDO should strongly be considered.

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Ejaculatory duct obstruction

Cited by 48 publications

References 41 publications

Imaging in male-factor obstructive infertility

Imaging in male-factor obstructive infertility

Ejaculatory Duct Obstruction after Transurethral Resection of the Prostate

Ejaculatory Duct Dysfunction and Lower Urinary Tract Symptoms: Chronic Prostatitis

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