Endoscopic management of ejaculatory duct obstruction

Aggour, A.; Mostafa, Hany K.K.; Maged, Wael Ali

doi:10.1007/bf02550229

Cited by 10 publications

(7 citation statements)

References 9 publications

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“…It has been also shown that transrectal vesiculography and retrograde opacification could be performed to assess the normal patency of the vas deferens [36,37], but this can only be done immediately prior to endoscopic resection. Selection of patients with an isolated EDO, without combined proximal obstruction, would probably improve results of transurethral resection of the ED, which restores a normal sperm count in only 20±60 % of azoospermic patients [38,39,40,41,42,43,44] Mega-VS and functional causes of ejaculatory duct obstruction. Mega-VS and functional causes of ejaculatory duct obstruction (EDO) are far rarer [30] The obstruction is due to a disorder of seminal vesicle contraction.…”

Section: Ejaculatory Duct Obstructionmentioning

confidence: 98%

US findings in male hypofertility and impotence

et al. 2001

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IntroductionUltrasonography of the male genital tract is routinely performed to assess several diseases in man. A major field is prostate transrectal sonography combined with US-guided biopsies used to improve, in combination with PSA assay, early detection and staging of prostate cancer. Two other fields have gained clinical importance. The first is male hypofertility. Improvement of in vitro fertilization techniques has led to a huge increase in pretreatment investigation by imaging of hypofertile men, with emphasis on azoospermic patients, to try to find the cause of infertility, before contemplating invasive techniques for only diagnostic purposes, such as testicular biopsy or surgical deferentography. It also concerns non-azoospermic patients in whom the search for a deleterious factor is more and more routinely conducted to improve the quality of the semen. Scrotal and transrectal ultrasonography with high-frequency probes and use of color Doppler imaging have proved to be very reliable adjuncts to clinical examination to assess the presence of an obstruction (total or partial) of the seminal tract, to detect inflammatory changes in the deep genital tract and to detect and quantify a venous reflux in the spermatic veins. The second field is male sexual impotence. Initial enthusiasm concerning noninvasive investigation of impotent men by color Doppler sonography to detect a vascular abnormality (arterial or venous) of the penile vasculature has been tempered by the fact that surgical or interventional treatments used to treat penile artery stenoses or incompetence of the veno-occlusive system were found to give poor results, and now these treatments have been superseded by the advent of medical treatments based on intracavernosal injection of vasoactive drugs and more recently by the possibility of circumventing vasculogenic impotence by a peroral treatment, namely Viagra. US has thus become useful in only highly selected patients presenting with sexual impotence.

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Section: Ejaculatory Duct Obstructionmentioning

confidence: 98%

US findings in male hypofertility and impotence

et al. 2001

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“…However, despite technological advances in urologic equipment, endoscopic catheterization of the ejaculatory ducts was not widely used for various reasons: first of all it was difficult to perform, due to the location of the orifices of the ducts, in the posterolateral portion of the seminal colliculus (Veru Montanum) and the fragility of the ducts themselves. It also carried the risk of ascendant infections [19,20].…”

Section: Methodsmentioning

confidence: 99%

Percutaneous vesiculodeferentography in the diagnosis of male infertility: A review of our results and the data reported in the literature

Solivetti

Drusco²,

Pizzi

et al. 2008

Journal of Ultrasound

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Vesiculodeferentography was used in the past to evaluate suspected cases of obstruction of the seminal ducts. Over the years, numerous attempts have been made to improve the technique used to perform this examination and to render it less invasive. Its use is currently indicated in selected cases, where it is combined with functional studies like seminal tract washout and followed by immediate interventions to correct the alterations revealed. Vesiculodeferentography includes collection of the contents of the seminal vesicles, which can later be used in vitro assisted fertilization procedures.Sommario La vesciculodeferentografia, esame utilizzato in passato nei casi di sospette ostruzioni delle vie seminali, è stato negli anni oggetto di numerosi studi allo scopo di migliorarne la tecnica di esecuzione e renderla meno invasiva. Attualmente è indicata solo in casi selezionati, in associazione a un'indagine funzionale quale il Seminal Tract Washout e prevedendo un contemporaneo e o in via subordinata, successivo e atto terapeutico.Ovviamente, peraltro, la procedura e ipso facto e prevede il prelievo di materiale dalla seminale e ciò può consentire una successiva procedura di fecondazione assistita in vitro. ª

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“…Based on larger studies, TURED appears to lead to a 12.5%-31% spontaneous pregnancy rate depending on the etiology of EDO (2,10,(27)(28)(29)(30)(31)(32). In general, outcomes include improved semen parameters in 63%-83% of patients in general, or in 59% of patients with complete EDO and in 94% with partial EDO (2,11,(27)(28)(29). More specifically, 90.5% may have an increased semen volume (32), 50% of patients may have improvement in sperm count (10), and 60.5% may convert from azoospermia to having sperm in their ejaculate.…”

Section: Transurethral Resection Of Ejaculatory Ductmentioning

confidence: 99%

“…Some papers do not report complications or deny any complications from TURED (23,30). However, complication rates have been reported from 4%-26% (2,11,27,28,31,32,35).…”

Section: Transurethral Resection Of Ejaculatory Ductmentioning

confidence: 99%