Transurethral resection of ejaculatory duct in infertile men: outcome and predictors of success

El‐Assmy, Ahmed; El-Tholoth, Hossam S.; Abouelkheir, Rasha T.; El-Ghar, Mohamed Abou

doi:10.1007/s11255-012-0253-6

Cited by 34 publications

(27 citation statements)

References 23 publications

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“…ducts and utricular, müllerian, and wolffian duct cysts. It has been well established in clinical practice [6][7][8], but there are very few large series of patients reported and variable surgical outcomes [9][10][11][12][13]. However, the pathogenesis of ejaculatory duct obstruction has not been well understood.…”

Section: Introductionmentioning

confidence: 99%

Transurethral bipolar plasma kinetic resection of ejaculatory duct for treatment of ejaculatory duct obstruction

Liu

Zhao

et al. 2013

Journal of X-Ray Science and Technology: Clinical Applications

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To evaluate the efficacy of transurethral bipolar plasma kinetic resection of ejaculatory duct for ejaculatory duct obstruction. The clinical information of 42 cases of ejaculatory duct obstruction was analyzed between July 2008 and June 2012. The diagnostic criteria included semen analysis, fructose and neutral α-glucosidase measurement in seminal plasma, transrectal ultrasonography, magnetic resonance imaging and vasography necessarily. Endoscopic procedure with bipolar plasma kinetic resection of ejaculatory duct was performed in all patients. Among these cases followed up 6∼24 months after operation, 38 patients (90.5%) had improved semen parameters, 23 azoospermic patients (60.5%) had sperm in the semen and 13 patients' wife (31%) achieved pregnancies in 42 cases of bipolar plasma kinetic resection of ejaculatory duct. Postoperative complications ensued as epididymitis in 1 case, watery ejaculate in 1, but no serious complication was observed. Bipolar plasma kinetic resection of ejaculatory duct appears to represent a promising endoscopic treatment alternative for ejaculatory duct obstruction patients, with high efficacy, less complications, quicker recovery and satisfactory follow-up parameters.

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Section: Introductionmentioning

confidence: 99%

Transurethral bipolar plasma kinetic resection of ejaculatory duct for treatment of ejaculatory duct obstruction

Liu

Zhao

et al. 2013

Journal of X-Ray Science and Technology: Clinical Applications

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“…Other authors found similar outcomes, with higher patency rates with resulting improvement in sperm counts and increased number of spontaneous pregnancies for patients with m€ ullerian duct cysts after TURED compared with men with EDO secondary to other causes (10). Regardless of complete or incomplete EDO, El-Assmy et al showed improved sperm count in 72% of patients with midline cysts after TURED and improvement in only 31% of patients with noncystic causes of EDO (31). Not all researchers have as dismal an opinion about treating acquired causes of EDO.…”

Section: Transurethral Resection Of Ejaculatory Ductmentioning

confidence: 78%

“…Although 74% of all the men benefited from TURED with improved semen parameters, significantly fewer men with complete EDO had improvement compared with men with incomplete EDO (27). Similarly, El-Assmy et al found that 23.5% of men with complete EDO had improvement in their semen parameters compared with 100% men with partial EDO (31).…”

Section: Transurethral Resection Of Ejaculatory Ductmentioning

confidence: 97%

“…Larger studies with TURED. Based on larger studies, TURED appears to lead to a 12.5%-31% spontaneous pregnancy rate depending on the etiology of EDO (2,10,(27)(28)(29)(30)(31)(32). In general, outcomes include improved semen parameters in 63%-83% of patients in general, or in 59% of patients with complete EDO and in 94% with partial EDO (2,11,(27)(28)(29).…”

Section: Transurethral Resection Of Ejaculatory Ductmentioning

confidence: 99%

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Transurethral resection of the ejaculatory ducts: etiology of obstruction and surgical treatment options

Avellino

Lipshultz

Sigman

et al. 2019

Fertility and Sterility

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“…We hypothesize these LSV patients to have a factor affecting both semen volume and spermatogenesis that could be hormonal; we were not able to assess this possibility as only oligozoospermic patients have had reproductive hormones check-up. However, some patients may have exclusion of both sperm and seminal liquid secondary to a unilateral congenital absence of vas deferens–as observed in up-to 3% of azoospermic patients [27]–or acquired obstruction of one ejaculatory duct [28]. This indicates both systematic reproductive hormonal check-up and transrectal ultrasonography (TRUS) -independently of the value of sperm count- in further prospective studies to validate these hypotheses or not.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume

et al. 2017

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In non-azoospermic patients with low semen volume (LSV), looking for partial retrograde ejaculation (PRE) by searching sperm in the postejaculatory urine (PEU) is required. The use of a retro-ejaculatory index (R-ratio) was suggested to define PRE, but none of the studies indicated a specific threshold above which PRE must be considered. Our objective was to propose a threshold value for the R-ratio as indicative of PRE in patients with LSV selected to be devoid of any known causes or risk factors for retrograde ejaculation or LSV. Among our data base (2000–2009) including 632 patients with PEU, 245 male patients from infertile couples who had had a first semen analysis with LSV (< 2mL) and a second semen analysis associated with PEU, were selected on the previous criteria. A prospective control group was randomly constituted (2007–2008) of 162 first consulting male patients from infertile couples, with a normal semen volume (≥ 2mL) on a first semen analysis and who accepted to collect PEU with their usual second semen analysis, selected on the previous criteria. To define an R-ratio threshold indicative of PRE, we used a ROC curve analysis and a regression tree based on a classification and regression tree (CART) algorithm. Of the 245 LSV patients, 146 still presented low semen volume (< 2 mL) on the second semen analysis. From the use of the CART algorithm, two low (1.5% and 2.8%) and two high R-values (7.1% and 8.3%) were defined, according to the lower reference limit for semen volume of 2.0 mL (WHO 1999) or 1.5 mL (WHO 2010) respectively. As only one or no patient with normal semen volume was observed above the two high R-values, we suggest an R-value higher than the range of [7.1–8.3]% as indicative of PRE until confirmation by a prospective multicenter study.

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Transurethral resection of ejaculatory duct in infertile men: outcome and predictors of success

Abstract: Partial EDO, whatever the etiology, has an excellent outcome after TURED. Complete EDO due to cysts appears to respond better than postinflammatory obstruction to TURED.

Cited by 34 publications

References 23 publications

Transurethral bipolar plasma kinetic resection of ejaculatory duct for treatment of ejaculatory duct obstruction

Transurethral bipolar plasma kinetic resection of ejaculatory duct for treatment of ejaculatory duct obstruction

Transurethral resection of the ejaculatory ducts: etiology of obstruction and surgical treatment options

Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume

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