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[Surgical therapy for azoospermia with ejaculatory duct obstruction]
Chun-hua Deng1, Shao-peng Qiu, Xiang-zhou Sun
1Department of Urology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|December 2, 2005
Summary
Transurethral resection of ejaculatory ducts (TURED) effectively treated azoospermia caused by ejaculatory duct obstruction (EDO). The procedure improved semen parameters in 67% of patients and led to pregnancies in 20%.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Background:
- Ejaculatory duct obstruction (EDO) is a cause of obstructive azoospermia.
- Diagnosis of EDO involves semen analysis, fructose measurement, and transrectal ultrasonography (TRUS).
Purpose of the Study:
- To evaluate the efficacy and safety of transurethral resection of ejaculatory ducts (TURED) for treating azoospermia due to EDO.
Main Methods:
- Twenty patients diagnosed with EDO underwent TURED.
- Diagnostic methods included medical history, physical examination, semen analyses, semen fructose measurement, endocrine assessment, testicular biopsy, and TRUS.
- Fifteen patients were followed for over 3 months post-TURED with repeated semen analyses.
Main Results:
- Pre-treatment semen analysis revealed low volume, azoospermia, low pH, and absent/low fructose.
- TRUS identified midline cysts (11 cases), lateral cysts (2 cases), or dilated ejaculatory ducts (7 cases) as causes of EDO.
- Post-TURED, 67% of followed patients showed improved semen parameters, and 20% achieved pregnancy.
Conclusions:
- TURED is a potentially safe and effective treatment for azoospermia resulting from EDO.
- The procedure offers a viable option for improving fertility in men with EDO.