Transrectal Ultrasound in the Evaluation of Men with Low Volume Azoospermia

Worischeck, Joseph H.; Parra, Raul O.

doi:10.1016/s0022-5347(17)36387-5

Cited by 42 publications

(20 citation statements)

References 16 publications

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“…Men with obstructive azoospermia typically have normalsized testes, possible epididymal fullness, and a normal serum follicle stimulating hormone (FSH). Men with nonobstructive azoospermia present frequently with small or soft testes and an elevated FSH [8][9][10] . Seminal tract obstruction can be classified according to the level of obstruction, into proximal seminal tract obstruction, including epididymis and scrotal portions of the vas deferens and distal seminal tract obstruction including inguinal, pelvic and ampullary portions of the vas deferens, and ejaculatory ducts.…”

Section: Causes Of Male Infertilitymentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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The main purpose of imaging evaluation in male infertility is to identify and treat correctable causes of infertility, such as obstruction of the seminal tract. Various imaging modalities are available to evaluate men with obstructive infertility including scrotal ultrasonography, transrectal ultrasound (TRUS), vasography, magnetic resonance imaging, seminal vesicle aspiration, seminal tract washout, and seminal vesiculography. To date the most reliable and accurate diagnostic technique for obstructive infertility is unclear. In this review article, we report the role of these modalities in diagnosis of obstructive infertility. Scrotal sonography is the initial modality, and if patient results indicate non obstructive azoospermia as varicocele or testicular pathology they will be treated according to standard protocols for management of these pathologies. If the patient findings indicate proximal obstructive azoospermia, they can be managed by vasoepididymostomy. If the scrotal ultrasound is normal, TRUS is the second imaging modality. Accordingly, they are classified into patients with criteria of obstructive infertility without urogenital cysts where TRUS-guided aspiration and seminal vesiculography can be performed and transurethral resection of the ejaculatory ducts (TURED) will be the management of choice. In patients with urogenital cyst, TRUS-guided cyst aspiration and opacification are performed. If the cyst is communicating with the seminal tract, management will be transurethral incision of the cyst. If the cyst is not in communication, the obstruction may be relieved after cyst aspiration. If the obstruction is not relieved, TURED will be the management of choice. Sperm harvested during aspiration may be stored and used in assisted reproduction techniques. If the results of TRUS are inconclusive or doubtful, endorectal magnetic resonance imaging should be performed to serve as a "detailed map" for guiding corrective operative interventions.

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Section: Causes Of Male Infertilitymentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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“…Rarely müllerian cysts may be associated with renal agenesis but usually they are considered as an isolated entity. During an investigation most of them are diagnosed in the third or fourth decade due to infection, urinary retention [9], hemospermia [10], constipation [9], hematuria [11], infertility or azospermia [12].…”

Section: Discussionmentioning

confidence: 99%

A Müllerian Prostatic Cyst Protruding into the Base of the Urinary Bladder

Barzilai

Ginesin

1998

Urol Int

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The unique appearance of a midline prostatic cyst is reported. The cyst presented as a round-shaped filling defect at the base of the urinary bladder during an intravenous pyelography study. Transabdominal sonography showed the mass to be a midline prostatic cyst. The sonographic features of the mass and its location are the hallmark of a müllerian duct prostatic cyst. Midline prostatic cysts are discussed and the features differentiating müllerian duct cysts from utricle cysts are emphasized.

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“…Calcifications within the substance of the prostate can be associated with prior inflammation. How inflammation can lead to EDO has not been fully characterized; proposed mechanisms include inflammation involving the ducts, changes in compliance, or adjacent tissue impinging upon on the duct [11,21]. Calcifications have also been described at the junction of the urethra and ejaculatory duct in normal individuals [13].…”

Section: Signs and Symptoms Of Copmentioning

confidence: 99%

Ejaculatory Duct Dysfunction and Lower Urinary Tract Symptoms: Chronic Prostatitis

McIntyre

Fisch

2010

Curr Urol Rep

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Chronic pelvic pain syndrome (CPPS) is the most prevalent form of prostatitis. It is characterized by pelvic pain, voiding symptoms, and ejaculatory symptoms in the absence of bacterial infection. This can be a difficult condition to treat. Many etiologies for CPPS have been proposed including immunologic, neurologic, endocrine, and psychological factors. This article examines a potentially correctable condition that may lead to CPPS, ejaculatory duct obstruction (EDO). EDO is easily correctable with minor surgery. In patients with symptoms of CPPS with associated ejaculatory pain, the diagnosis of EDO should strongly be considered.

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Transrectal Ultrasound in the Evaluation of Men with Low Volume Azoospermia

Cited by 42 publications

References 16 publications

Imaging in male-factor obstructive infertility

Imaging in male-factor obstructive infertility

A Müllerian Prostatic Cyst Protruding into the Base of the Urinary Bladder

Ejaculatory Duct Dysfunction and Lower Urinary Tract Symptoms: Chronic Prostatitis

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