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Evaluation and treatment of ejaculatory duct obstruction in the infertile male
R B Meacham1, D K Hellerstein, L I Lipshultz
1Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030.
Objective:
To evaluate the role of ejaculatory duct obstruction as a cause for male factor infertility and review the treatment of this condition.
Design:
A retrospective study was carried out involving male patients diagnosed as having ejaculatory duct obstruction as a contributing cause for their subfertility.
Setting:
Patients were evaluated and treated through a university-based male infertility clinic.
Patients, Participants:
Patients were evaluated for the presence of ejaculatory duct obstruction if they suffered from decreased ejaculate volume, sperm density, and sperm motility but had normal physical examinations and otherwise normal laboratory evaluations.
Interventions:
Patients were treated by transurethral resection of the ejaculatory ducts.
Main Outcome Measures:
Results of semen analysis and pregnancy rates.
Results:
An alteration in semen quality was achieved in 79% of patients after transurethral resection. An increase in sperm density or motility was achieved in 50%, whereas 29% showed an increase in ejaculate volume only. Pregnancy rate postoperatively was 29%.
Conclusions:
Ejaculatory duct obstruction as a cause of male infertility is more common than was previously recognized, especially among nonazoospermic patients. In properly selected patients, transurethral resection of the ejaculatory ducts can result in marked improvement in semen quality with subsequent pregnancy.