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Transurethral resection of ejaculatory ducts in the treatment of complete ejaculatory duct obstruction.
Int Urol Nephrol. 2008; 40(2):369-72.IU

Abstract

OBJECTIVES

To evaluate the value of transurethral resection of the ejaculatory duct (TURED) in the treatment of complete ejaculatory duct obstruction (EDO) as a treatable cause of male factor infertility.

MATERIALS AND METHODS

We retrospectively evaluated 12 azoospermic infertile men who were diagnosed as having complete EDO. The mean age of the patients was 32 years (range 24-40). Inclusion criteria were EDO in patients with azoospermia, normal serum levels of gonadotropins and testosterone and evidence of obstruction on transrectal ultrasonographic (TRUS) images. The definitive diagnosis was based on the absence of an efflux of methylene blue injected through the seminal vesicles during cystoscopy. All patients were treated by TURED.

RESULTS

Before TURED, all patients were azoospermic and had been considered as candidates for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Following the operation, sperms were seen in the ejaculates of 11/12 patients. After a mean follow-up period of 12 (range 4-36) months, five (41.6%) pregnancies were noted (three spontaneous, one with intrauterine insemination and one with IVF/ICSI).

CONCLUSION

Transurethral resection was found to be a safe and somewhat effective approach for the treatment of EDO. After TURED, a significant improvement was achieved in semen parameters, and spontaneous pregnancy resulted in three cases. In addition, TURED can reduce the need for expensive procedures such as IVF/ICSI as this modality allows IVF/ICSI to be performed with ejaculated instead of surgically retrieved sperm.

Authors+Show Affiliations

Yurdakul T
Meram Medical Faculty, Department of Urology, Selcuk University, Meram, Konya 42080, Turkey.
Gokce G
No affiliation info available
Kilic O
No affiliation info available
Piskin MM
No affiliation info available

MeSH

AdultAzoospermiaEjaculatory DuctsGenital Diseases, MaleHumansMaleMethylene BlueRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17899434

Citation

Yurdakul, Talat, et al. "Transurethral Resection of Ejaculatory Ducts in the Treatment of Complete Ejaculatory Duct Obstruction." International Urology and Nephrology, vol. 40, no. 2, 2008, pp. 369-72.
Yurdakul T, Gokce G, Kilic O, et al. Transurethral resection of ejaculatory ducts in the treatment of complete ejaculatory duct obstruction. Int Urol Nephrol. 2008;40(2):369-72.
Yurdakul, T., Gokce, G., Kilic, O., & Piskin, M. M. (2008). Transurethral resection of ejaculatory ducts in the treatment of complete ejaculatory duct obstruction. International Urology and Nephrology, 40(2), 369-72.
Yurdakul T, et al. Transurethral Resection of Ejaculatory Ducts in the Treatment of Complete Ejaculatory Duct Obstruction. Int Urol Nephrol. 2008;40(2):369-72. PubMed PMID: 17899434.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transurethral resection of ejaculatory ducts in the treatment of complete ejaculatory duct obstruction. AU - Yurdakul,Talat, AU - Gokce,Gurhan, AU - Kilic,Ozcan, AU - Piskin,M M, PY - 2007/06/04/received PY - 2007/08/08/accepted PY - 2007/9/28/pubmed PY - 2008/10/1/medline PY - 2007/9/28/entrez SP - 369 EP - 72 JF - International urology and nephrology JO - Int Urol Nephrol VL - 40 IS - 2 N2 - OBJECTIVES: To evaluate the value of transurethral resection of the ejaculatory duct (TURED) in the treatment of complete ejaculatory duct obstruction (EDO) as a treatable cause of male factor infertility. MATERIALS AND METHODS: We retrospectively evaluated 12 azoospermic infertile men who were diagnosed as having complete EDO. The mean age of the patients was 32 years (range 24-40). Inclusion criteria were EDO in patients with azoospermia, normal serum levels of gonadotropins and testosterone and evidence of obstruction on transrectal ultrasonographic (TRUS) images. The definitive diagnosis was based on the absence of an efflux of methylene blue injected through the seminal vesicles during cystoscopy. All patients were treated by TURED. RESULTS: Before TURED, all patients were azoospermic and had been considered as candidates for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Following the operation, sperms were seen in the ejaculates of 11/12 patients. After a mean follow-up period of 12 (range 4-36) months, five (41.6%) pregnancies were noted (three spontaneous, one with intrauterine insemination and one with IVF/ICSI). CONCLUSION: Transurethral resection was found to be a safe and somewhat effective approach for the treatment of EDO. After TURED, a significant improvement was achieved in semen parameters, and spontaneous pregnancy resulted in three cases. In addition, TURED can reduce the need for expensive procedures such as IVF/ICSI as this modality allows IVF/ICSI to be performed with ejaculated instead of surgically retrieved sperm. SN - 0301-1623 UR - https://www.unboundmedicine.com/medline/citation/17899434/Transurethral_resection_of_ejaculatory_ducts_in_the_treatment_of_complete_ejaculatory_duct_obstruction_ L2 - https://doi.org/10.1007/s11255-007-9273-z DB - PRIME DP - Unbound Medicine ER -