Evaluation and treatment of ejaculatory duct obstruction in infertile men

The purpose of this review is to survey the growing literature on ejaculatory duct obstruction and to provide a comprehensive overview of the current trends in the diagnosis and management of patients with this disorder.

Review of current literature on ejaculatory duct obstruction.

Ejaculatory duct obstruction is a surgically treatable cause of male infertility. It is usually suspected in an infertile male who has low ejaculate semen volume but normal testicular size and normal secondary male sexual characteristics.

Transrectal ultrasonography is the initial investigation method used to visualize and locate the presence of a cyst or calcifications that may contribute to the obstruction. Transurethral resection of the ejaculatory ducts represents the best treatment modality, resulting in marked improvement in the semen parameters and pregnancy rate in well selected cases.