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Surgical Therapy in Infertile Men with Obstructive Azoospermia Due to Ejaculatory Duct Obstruction–Outcome after Transurethral Resection of Ejaculatory Duct

Sanjay Prakash Dhangar , Sanjay Prakash Dhangar* , Ibrahim H. Kothawala* , A.D. Gosavi** , Arefakothawala** , Abhay Kumar*** , Sachin Patil*

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Urology, Nephrology and Andrology International 1(1):p 27-32, January - June 2016. | DOI:

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Abstract

 Objectives: To report our experience with transurethral resection of ejaculatory ducts (TURED) in infertile men with symptomatic ejaculatory duct obstruction. Material and Method: We studied 4 cases of ejaculatory duct obstruction from January 2014 to January 2015. Investigations included a history, physical examination, semen analysis, semen culture, hormone levels and trans-rectal ultrasonography. Results were evaluated after TURED, especially the semen parameters, the patency and the pregnancy rate. Results: Causes of obstruction were previous infection with inflammation, calculus and prostatic cyst. Mean age was 34 years.Mean Duration of infertility was 3.5 years.Mean FSH value was 1.5. Mean Semen volume was 0.5 ml with SD of ± 0.10m. In all patients fructose was absent on semen analysis. On TRUS mean seminal vesicle diameter was 16.00 mm Seminal vesicle was dilated in all cases. In 3/4 patients who had patency in follow up had a mean sperm count of 14.33 million/ml.Mean time to patency was 3 months.Post TURED ejaculate volume improved in all patients with mean of 1.75ml and SD of 0.50 ml. Patients who had undergone TURED reported a patency rate of 75 %, with one patient showing absence of sperms in follow up. After TURED on follow up pregnancy was reported in one case i.e. 25 %. In our study mean follow up was 10 months. Conclusions: Men with symptomatic EDO who underwentTURED showed improvements in their ejaculation, sensation of orgasm, semenanalysis values and fertility.


Keywords: Ejaculatory Duct Obstruction; Infertility; Ejaculatory Duct/Prostatic Cyst; Transurethralresection of Ejaculatory Duct; Tured.

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