[A case of congenital ejaculatory duct obstruction]

We report a case of congenital ejaculatory duct obstruction treated successfully by transurethral incision. A 33-year-old man was referred for evaluation of primary infertility. His semen analysis showed volumes of 1.7 ml at average and azoospermia. Clinical examinations revealed right undescended testicle, absence of the left kidney and axial rotation of right kidney. Left vasogram showed dilated but intact seminal vesicle with no contrast material visible in the bladder. Following removal of right undescended testicle, transurethral incision of the left side of the prostatic urethral floor near the vermontanum was performed. Transurethral vesiculogram showed dilated but not cystic ejaculatory duct. Eight months postoperatively semen analysis showed a volume of 3.5 ml, a concentration of 61.3 x 10(6)/ml and motility rate of 51.8%. However, semen analysis 18 months postoperatively showed azoospermia again. After re-transurethral incision, his sperm concentration increased to 15.2 x 10(6)/ml. However, his wife didn't become pregnant yet.