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Related Experiment Videos

Ejaculatory duct obstruction in infertile men.

J Paick1, S H Kim, S W Kim

  • 1Department of Urology and Radiology, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.

BJU International
|April 12, 2000
PubMed
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Ejaculatory duct obstruction (EDO) in infertile men is best diagnosed with transrectal ultrasonography (TRUS). Treatment outcomes vary by cause, with midline cysts yielding the best results after transurethral resection.

Area of Science:

  • Reproductive Medicine
  • Urology
  • Andrology

Background:

  • Male infertility is a significant concern, with ejaculatory duct obstruction (EDO) being a contributing factor in some cases.
  • Understanding the diagnostic pathways and treatment outcomes for EDO is crucial for improving fertility in affected men.

Purpose of the Study:

  • To analyze the experience with ejaculatory duct obstruction (EDO) in infertile men.
  • To evaluate diagnostic steps and management outcomes based on the etiology of EDO.

Main Methods:

  • A 7-year retrospective analysis of 50 infertile men diagnosed with EDO.
  • Diagnostic tools included history, physical examination, semen analysis, semen fructose, hormonal studies, testicular biopsy, transrectal ultrasonography (TRUS), and vasography.
  • Treatment involved transurethral resection or forced lavage via vasotomy.

Related Experiment Videos

Main Results:

  • Complete EDO characteristics were observed in 45 men; partial EDO showed variable seminal values with low semen fructose (< 1.4 g/L).
  • Common causes included midline cysts (16), tuberculosis (17), Wolffian malformation (4), and idiopathic (8).
  • Overall improvement in semen values and paternity rates were 61% and 26%, respectively. Midline cysts treated with transurethral resection showed the best outcomes.

Conclusions:

  • Transrectal ultrasonography (TRUS) is recommended as the primary diagnostic tool for suspected EDO.
  • Vasography can provide a more comprehensive diagnosis; semen fructose measurement aids in partial EDO detection.
  • For patients with atrophic seminal vesicles and a history of tuberculosis, microscopic epididymal sperm aspiration for in vitro fertilization is suggested.