Long-Term Success Durability of Transurethral Resection of Ejaculatory Duct in Treating Infertile Men with Ejaculatory Duct Obstruction

Abdelal, Ibrahim Tharwat; Elatreisy, Adel; Mohey, Ahmed; Hassan, Gamal Mohammad Osman; Gharib, Tarek

doi:10.1089/end.2021.0840

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…In an Egyptian cohort of 30 males, spontaneous pregnancies were achieved in 10 cases (33.3%) after shortterm follow-up and in 8 cases (26.6%) after long-term followup. These success rates in spontaneous pregnancy are higher than natural pregnancy rates in our cohort (8%) [10]. It is worth noting that follow-up period our study was 12 months compared to the 7-year period in the aforementioned study.…”

Section: Discussioncontrasting

confidence: 55%

Transurethral resection of ejaculatory ducts (TURED) for the management of ejaculatory duct obstruction: a Saudi cohort

2023

Journal of Men's Health

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This retrospective study aimed to investigate the clinical characteristics, changes in semen parameters, and outcomes of adult patients with ejaculatory duct obstruction (EDO) who underwent transurethral resection of ejaculatory ducts (TURED). The study included 25 patients diagnosed with EDO who underwent TURED at King Faisal Specialist Hospital & Research Center in Saudi Arabia between January 2015 and December 2021. The results showed that 68% of the patients had complete ED obstruction, while 32% had partial obstruction. Primary infertility was reported in 68%of the patients, with 4% experiencing secondary infertility. The analysis revealed a significant increase in semen volume greater than 0.6 after TURED, while there was a significant decrease in volumes ranging from 0.1 to 0.3 and from 0.4 to 0.6. Patients with partial ED obstruction demonstrated a significant improvement in semen parameters compared to those with complete ED obstruction. The findings suggest that TURED is a safe and effective treatment option for EDO, leading to significant improvements in semen parameters and potentially resulting in spontaneous pregnancy. However, further research is needed to identify specific patient subgroups that may benefit the most from TURED. While magnetic resonance imaging (MRI) with an endorectal coil has been proposed for more detailed evaluation, transrectal ultrasound (TRUS) has been suggested as the standard examination technique.

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Section: Discussioncontrasting

confidence: 55%

Transurethral resection of ejaculatory ducts (TURED) for the management of ejaculatory duct obstruction: a Saudi cohort

2023

Journal of Men's Health

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“…Results from a study evaluating long-term efficacy of TURED for treatment of EDO-induced male infertility revealed a significant improvement in semen parameters of 63.3% of patients. Consequently, natural pregnancy was achieved in 26.6% of patients, although complete and noncystic EDO showed poor response [12]. Considering that the surgical treatment did not improve semen parameters and the pregnancy rate of some EDO patients, we hypothesized that EDO might induce secondary changes in SV function.…”

Section: Introductionmentioning

confidence: 99%

Ejaculatory Duct Obstruction Affects Seminal Vesicle Contractile Efficacy and Smooth Muscle Ultrastructure in a Rat Model

Ren

Xing

et al. 2023

Andrologia

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The purpose of this study was to investigate the effects of ejaculatory duct obstruction (EDO) on contractile efficacy, smooth muscle ultrastructure, and α1A and M3 receptors of rat seminal vesicles (SVs). A total of 48 male rats, aged 14-15 weeks, were randomly divided into three groups, namely, the control, complete EDO, and partial EDO. SV tissues were collected at 4 and 8 weeks postoperatively for further experiments. Results revealed a marked reduction in SV contractile efficacy over time following obstruction in the complete EDO group. The contractile force and frequency decreased and increased in the partial EDO group at week 4, respectively, whereas contractile efficacy significantly reduced at week 8. Moreover, obstruction resulted in significant downregulation in expression of α1A and M3 proteins and mRNAs in rats from the complete EDO group over time. Rats in the partial EDO group initially exhibited an increase followed by a decrease. Analysis of the ultrastructure of SV smooth muscles confirmed the above changes. In conclusion, complete EDO can lead to a progressive decrease in contractile efficiency of SVs. On the other hand, partial EDO can first compensate for the contraction of SVs and gradually decompensate afterwards.

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Azoospermia Due to Functional and Partial Ejaculatory Duct Obstruction: A Rare Case Report and Literature Review

Zheng,

Wang,

Jiang

et al. 2024

Am J Mens Health

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Ejaculatory duct obstruction (EDO) is a rare but treatable cause of male infertility. This case report describes a 28-year-old male with obstructive azoospermia. The patient came to our hospital after a fertility check-up revealed azoospermia. A subsequent semen analysis confirmed azoospermia. Transrectal ultrasonography (TRUS) and magnetic resonance imaging (MRI) revealed bilaterally enlarged seminal vesicles and thickened, calcified ejaculatory duct walls. The patient underwent transurethral seminal vesiculoscopy and transurethral resection of the ejaculatory ducts (TURED) for presumed partial EDO. Despite two transurethral seminal vesiculoscopy and TURED procedures, postoperative semen analysis still showed azoospermia. TRUS indicated non-contractile seminal vesicles and an unobstructed ejaculatory duct. The patient ultimately underwent percutaneous epididymal sperm aspiration for assisted reproductive technology and his spouse got pregnant. We identified a case of azoospermia caused by a rare combination of partial and functional ejaculatory duct obstruction. There are currently no reports of similar cases. This case report aims to provide valuable insights for diagnosing and treating EDO.

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Long-Term Success Durability of Transurethral Resection of Ejaculatory Duct in Treating Infertile Men with Ejaculatory Duct Obstruction

Cited by 3 publications

References 26 publications

Transurethral resection of ejaculatory ducts (TURED) for the management of ejaculatory duct obstruction: a Saudi cohort

Transurethral resection of ejaculatory ducts (TURED) for the management of ejaculatory duct obstruction: a Saudi cohort

Ejaculatory Duct Obstruction Affects Seminal Vesicle Contractile Efficacy and Smooth Muscle Ultrastructure in a Rat Model

Azoospermia Due to Functional and Partial Ejaculatory Duct Obstruction: A Rare Case Report and Literature Review

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