Transrectal US of the seminal vesicles and ejaculatory ducts: clinical correlation.

Littrup, Peter J.; Lee, F; McLeary, R D; Wu, David; Lee, A; Kumasaka, G H

doi:10.1148/radiology.168.3.3043543

Cited by 132 publications

(67 citation statements)

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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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“…Other reports confirm that ejaculatory duct obstruction may cause hematospermia [Weintraub et al 1993]. Calculi in the seminal vesicles or ejaculatory ducts were significantly associated with hematospermia and ejaculatory pain [Littrup et al 1988;Song et al 2012]. Prostatic cysts may be found in patients with hematospermia.…”

Section: Conditions Of the Prostate And Seminal Vesicles Causing Hemamentioning

confidence: 91%

A systematic review of the correlates and management of nonpremature ejaculatory dysfunction in heterosexual men

Seyam

2013

Therapeutic Advances in Urology

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BackgroundThere is an increasing interest in nonpremature ejaculatory dysfunction (non-PE EjD). The frontier of sexual medicine has shifted slowly from erectile dysfunction (ED) to premature ejaculation (PE) and now to non-PE EjD. Two factors have contributed to this shift. First is the search for new areas of research and of novel treatments and second is the better characterization of ejaculatory disorders. The development of questionnaires that better characterize the type of ejaculatory dysfunction (EjD) has helped to identify the problem with more precision in different populations.Interest in the global sexual practice patterns gave insight into the prevalence of non-PE EjD in different areas of the world. Within the non-PE EjD itself, a shift in focus occurred over the years. Early and related to prostatic surgery and retroperitoneal lymph node dissection (RPLND) retrograde ejaculation was reported. With the development of α-blockers and finasteride, retrograde ejaculation, EjD and/or orgasmic dysfunction were reported as A systematic review of the correlates and management of nonpremature ejaculatory dysfunction in heterosexual men Raouf SeyamAbstract Introduction: A better understanding of ejaculatory disorders has led to an increasing interest in nonpremature ejaculatory dysfunction (non-PE EjD). Current reviews on the subject use a symptom-based classification to describe ejaculatory dysfunction even when it is a single case report. While these reviews provide important information on the disorder, a clearer picture of the prevalence of non-PE EjD in relation to the community and various pathophysiologic states is needed. Objectives: The objective of this study was to provide a systematic review of studies of non-PE EjD excluding single case reports. Methods: A systematic review of Medline for terms including ejaculation, orgasm or hematospermia. Association with terms delay, pain or headache was made. The search was restricted to male gender and articles written in English. Abstracts were reviewed and those mainly concerned with premature ejaculation were excluded. Results: A total of 333 articles on non-PE EjD were identified. The condition was reported in community-based studies. In certain patient populations, non-PE EjD was commonly reported in association with antidepressant and antipsychotic treatments, in patients with chronic prostatitis/chronic pelvic pain syndrome, patients with lower urinary tract symptoms particularly in association with medical or surgical treatment, patients with retroperitoneal surgery and in patients with neurological diseases. Few articles were concerned with treatment options. Conclusion: There is a significant prevalence of non-PE EjD in the community and in association with particular disease states or as a side effect of medical or surgical interventions. There is a need to direct efforts to prevent and treat these conditions. Keywords: anhedonia, aspermia, ejaculation, epidemiology, headache, hemospermia, orgasm, pain, prevalence adverse events. It became clear ...

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“…In the transverse view of TRUS, the anteroposterior dimension of each seminal vesicle at its widest point was measured and seminal vesicle dilation was diagnosed when this dimension was asymmetrically or bilaterally enlarged to 15 mm or more according to the definition of Littrup et al 12 Inflammation of the seminal vesicle was arbitrarily diagnosed if one or more white blood cells per high power field (¥ 400) were present in the aspirated seminal fluid. Prostatitis was diagnosed if more than 10 white blood cells per high power field (¥ 400) were present in EPS.…”

Section: Methodsmentioning

confidence: 99%

Hematospermia: An investigation of the bleeding site and underlying lesions

Furuya

Ogura²,

Saitoh³

et al. 1999

Int J of Urology

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Background: The site of hemorrhage and causative lesions in patients with hematospermia were evaluated using the puncture technique for seminal vesicles and/or müllerian duct cysts under ultrasound guidance. Methods: Twenty-one patients aged 26-75 years (mean, 49.8 years) underwent transperineal needle aspiration of the seminal vesicles and/or müllerian duct cysts guided by transrectal ultrasonography (TRUS).Results: Dark reddish seminal vesicle fluid was aspirated and the site of bleeding was considered to be the seminal vesicles in 11 patients (52%) (group A). In group A, abnormalities of the seminal vesicles were noted in nine patients (82%). These consisted of dilated seminal vesicles in seven (bilateral in four, unilateral in three), a seminal vesicle cyst in one and seminal vesicle amyloidosis in one. A müllerian duct cyst was confirmed to be the bleeding site in two patients (10%; group B). The bleeding site was estimated to be organs rather than the seminal vesicles in four patients (group C), in all of whom ectopic prostatic tissue was observed in the prostatic urethra. In groups B and C, seminal vesicle abnormalities were not detected by TRUS. In the remaining four patients (group D), failure to aspirate seminal vesicle fluid means that it is unclear whether hemorrhage was from the seminal vesicle or from another source. In group D, ectopic prostatic tissue was demonstrated in the prostatic urethra of three patients and unilateral seminal vesicle dilation was detected by TRUS in one patient. Conclusion: Puncture of the seminal vesicles and/or müllerian duct cysts under ultrasonic guidance as well as cystourethroscopy is a useful and minimally invasive examination for determination of the bleeding site responsible for hematospermia.

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Transrectal US of the seminal vesicles and ejaculatory ducts: clinical correlation.

Cited by 132 publications

References 0 publications

Imaging in male-factor obstructive infertility

Imaging in male-factor obstructive infertility

A systematic review of the correlates and management of nonpremature ejaculatory dysfunction in heterosexual men

Hematospermia: An investigation of the bleeding site and underlying lesions

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