Management of ejaculatory duct obstruction: Etiology, diagnosis, and treatment

Harry Fisch, Sarah M. Lambert, Erik T. Goluboff

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)604-610
Number of pages7
JournalWorld Journal of Urology
Volume24
Issue number6
DOIs
StatePublished - Dec 2006
Externally publishedYes

Keywords

  • Ejaculatory duct obstruction
  • Infertility
  • Transurethral resection of ejaculatory ducts

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