TY - JOUR
T1 - Management of ejaculatory duct obstruction
T2 - Etiology, diagnosis, and treatment
AU - Fisch, Harry
AU - Lambert, Sarah M.
AU - Goluboff, Erik T.
PY - 2006/12
Y1 - 2006/12
N2 - Abnormalities of the distal ejaculatory ducts related to infertility have been well-documented. Although there are no specific findings associated with ejaculatory duct obstruction, several clinical findings are highly suggestive. A diagnosis of ejaculatory duct obstruction is suggested in an infertile male with oligospermia or azoospermia with low ejaculate volume, normal secondary sex characteristics, testes, and hormonal profile, and dilated seminal vesicles, midline cyst, or calcifications on TRUS. Other causes of infertility may be concomitantly present and need to be evaluated and treated. Trans urethral resection of ejaculatory ducts (TURED) has resulted in marked improvement in semen parameters, and pregnancies have been achieved. Proper patient selection and surgical experience are necessary to obtain optimal results. In case of testicular dysfunction, chances of success are minimal. Extended follow-up periods are needed after TURED to examine the long-term effects of this procedure. Better understanding of the anatomy and pathology of the ejaculatory ducts will continue to refine diagnostic and therapeutic procedures for this disorder.
AB - Abnormalities of the distal ejaculatory ducts related to infertility have been well-documented. Although there are no specific findings associated with ejaculatory duct obstruction, several clinical findings are highly suggestive. A diagnosis of ejaculatory duct obstruction is suggested in an infertile male with oligospermia or azoospermia with low ejaculate volume, normal secondary sex characteristics, testes, and hormonal profile, and dilated seminal vesicles, midline cyst, or calcifications on TRUS. Other causes of infertility may be concomitantly present and need to be evaluated and treated. Trans urethral resection of ejaculatory ducts (TURED) has resulted in marked improvement in semen parameters, and pregnancies have been achieved. Proper patient selection and surgical experience are necessary to obtain optimal results. In case of testicular dysfunction, chances of success are minimal. Extended follow-up periods are needed after TURED to examine the long-term effects of this procedure. Better understanding of the anatomy and pathology of the ejaculatory ducts will continue to refine diagnostic and therapeutic procedures for this disorder.
KW - Ejaculatory duct obstruction
KW - Infertility
KW - Transurethral resection of ejaculatory ducts
UR - http://www.scopus.com/inward/record.url?scp=33845434141&partnerID=8YFLogxK
U2 - 10.1007/s00345-006-0129-4
DO - 10.1007/s00345-006-0129-4
M3 - Article
C2 - 17077974
AN - SCOPUS:33845434141
SN - 0724-4983
VL - 24
SP - 604
EP - 610
JO - World Journal of Urology
JF - World Journal of Urology
IS - 6
ER -