Transurethral seminal vesiculoscopy using a 6F vesiculoscope for ejaculatory duct obstruction: initial experience

Area of Science:

• Urology
• Reproductive Medicine
• Minimally Invasive Surgery

Background:

• Ejaculatory duct obstruction (EDO) is a treatable cause of male infertility.
• Transurethral resection of ejaculatory ducts (TURED) is standard but carries risks like impaired semen parameters and retrograde ejaculation.
• Vesiculoscopy shows promise as a less invasive diagnostic and therapeutic option for EDO.

Purpose of the Study:

• To evaluate the efficacy and safety of transurethral seminal vesiculoscopy (TRU-SVS) using a 6F vesiculoscope for diagnosing and treating EDO.
• To assess the impact of TRU-SVS on semen parameters and sperm recovery in infertile men with EDO.
• To compare the complication profile of TRU-SVS with traditional TURED.

Main Methods:

• A retrospective study of 21 patients with EDO who underwent TRU-SVS using a 6F vesiculoscope.
• Data collected included procedure time, hospital stay, intraoperative findings, and postoperative sperm detection rates.
• Complications such as epididymitis, retrograde ejaculation, incontinence, and rectal injury were monitored.

Main Results:

• The procedure was successfully completed in all patients with a mean operative time of 31.5 minutes and a mean hospital stay of 1.17 days.
• Sperm was detected postoperatively in 19 out of 21 patients within 12 months.
• No significant complications including retrograde ejaculation or incontinence were observed.

Conclusions:

• TRU-SVS with a 6F vesiculoscope provides direct access to the seminal vesicles for EDO diagnosis and treatment.
• This technique offers advantages of fewer complications and improved sperm recovery compared to TURED.
• TRU-SVS represents a safe and effective minimally invasive alternative for managing EDO in infertile men.