Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention

Kayser, Ole; Harde, Jonas; Girolami, G.; Wedel, Thilo; Schäfer, Philipp

doi:10.3205/000157

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…Transurethral resection of the ejaculatory duct (TURED) is a classic surgical procedure with a definite curative effect and was first described by Farley and Barnes (Farley & Barnes, 1973). With the development of technology, new minimally invasive surgical procedures are available to treat EDO, including transurethral incision of the ejaculatory duct, transurethral seminal vesiculoscopy and transurethral balloon dilation (Chen et al, 2018;Kayser et al, 2012;Wang, Xie, Zheng, & Jiang, 2021). A systematic review of TURED's efficacy reported that significant improvement in semen volume was observed in 83.0% of EDO patients in 23 studies, with a postoperative natural pregnancy rate of 25% (Mekhaimar et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Establishment of an animal model of ejaculatory duct obstruction

Ren

Xing

et al. 2022

Andrologia

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This study aimed to establish animal models with different degrees of ejaculatory duct obstruction. Forty‐eight male rats aged 14–15 weeks were randomly divided into three groups (n = 16): control, complete ejaculatory duct obstruction (tied around the lower seminal vesicle gland and ductus deferens with a 2–0 silk ligature), and partial ejaculatory duct obstruction (padded with a wire guide). Mortality, complications, seminal vesicle morphology and histopathology were compared in the three groups at 4 and 8 weeks postoperatively. In the complete ejaculatory duct obstruction group, seminal vesicle weight decreased gradually with increased obstruction time compared with those of the control group (p < 0.05); moreover, stone‐like material was occasionally observed. In the partial ejaculatory duct obstruction group, there was an increase followed by a decrease in seminal vesicle weight in the postoperative period compared with that of the control group (p < 0.05). Histopathological lesions of seminal vesicles were observed in the complete and partial ejaculatory duct obstruction groups (8 weeks postoperatively). We successfully established animal models of complete and partial ejaculatory duct obstruction, which provide an easy‐to‐use tool for studying seminal vesicle changes after ejaculatory duct obstruction.

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Section: Introductionmentioning

confidence: 99%

Establishment of an animal model of ejaculatory duct obstruction

Ren

Xing

et al. 2022

Andrologia

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An update on the diagnosis and management of ejaculatory duct obstruction

et al. 2015

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Ejaculatory duct obstruction (EDO) remains a rare but surgically correctable cause of male sexual dysfunction and male infertility due to obstructive azoospermia, diagnosed in up to 5% of infertile men. EDO should, therefore, be considered within the list of differential diagnoses for men undergoing infertility investigations, with work up including clinical examination, transurethral ultrasonography, semen analysis, chromotubation, seminal vesiculography and seminal vesicle aspiration. Obstruction can be limited to the distal ends of the ducts or it can extend proximally to include the terminal portions of the vasa deferentia, with the site and length of the obstruction having implications for surgical intervention. Early endoscopic treatment can reverse symptoms and prevent the progression of partial obstruction to bilateral, complete obstruction, and transurethral resection of the ejaculatory duct remains the main treatment option for EDO. Alternative treatment options include endoscopic laser-assisted resection of the ducts, antegrade seminal-vesicle lavage to relieve EDO secondary to inspissated material or calculi, or dilatation of the ejaculatory ducts using 9F seminal vesicoscopy or balloon.

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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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Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention

Cited by 4 publications

References 26 publications

Establishment of an animal model of ejaculatory duct obstruction

Establishment of an animal model of ejaculatory duct obstruction

An update on the diagnosis and management of ejaculatory duct obstruction

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

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