Management of ejaculatory duct obstruction by seminal vesiculoscopy: Case Report and Literature Review

Abstract

Ejaculatory duct obstruction is a rare condition identified in up to 5% of infertile men. Patients with ejaculatory duct obstruction can present with aspermia, azoospermia or oligoasthenospermia, painful ejaculation, hematospermia, prostatic pain, or male infertility. Semen analysis, transrectal ultrasonography, pelvic computerized tomography and magnetic resonance imaging are often used in the diagnostic work up, but with limited accuracy. While transurethral resection of the ejaculatory ducts has good efficacy for distal duct obstruction, results for proximal obstruction are less impressive, and it might cause severe complications, such as rectal injury and urinary incontinence. Recently, the use of high quality endourological devices and an improved understanding of ejaculatory ducts anatomy gleaned through the use of sophisticated imaging tools have led to the development of novel minimally invasive treatment options for this condition. The present study aims to report an index case of ejaculatory ducts obstruction managed with seminal vesiculoscopy, and review the current literature regarding this topic.

Azoospermia - An Overview

“…As a result, semen cannot travel through the ducts, resulting in reduced fertility or infertility in afflicted individuals. [25] DIAGNOSIS OF AZOOSPERMIA NON-OBSTRUCTIVE AZOOSPERMIA: This most serious kind of male infertility is defined as an absence of sperm during ejaculation due to spermatogenesis failure. The lack of gonadotropin production or intrinsic testicular dysfunction might be the reason for the NOA analysis.…”

Painful Ejaculation - An Ignored Symptom

“…EDO may present with painful ejaculation co-existing with infertility. This group of patients is difficult to manage due to their complex anatomy [23][24][25].…”

Application of seminal vesiculoscopy on the treatment of seminal vesiculitis

“…The presence of a tapered structure between the ejaculatory duct and the prostatic urethra makes it difficult to prevent urinary reflux. Animal studies have shown that the relationship between the seminal vesicle and the ejaculatory duct is similar to that between the bladder and the urethra (30). If the opening of the ejaculatory duct is too large during the operation, it may cause urine reflux; if the opening is too small, it may lead to postoperative stenosis or even occlusion.…”