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Ejaculatory duct obstruction in subfertile males: analysis of 87 patients.
Fertil Steril. 1991 Oct; 56(4):725-30.FS

Abstract

OBJECTIVE

To study the causes, presentation, and treatment of ejaculatory duct obstruction in subfertile males.

DESIGN

Collaborative retrospective study of clinical experience collected by two urologists over a 15-year period.

SETTING

National Health Service and Private Care Hospitals.

PATIENTS, PARTICIPANTS

Subfertile males with azoospermia (n = 67), very severe oligozoospermia (n = 17), oligozoospermia (n = 1), or normal sperm concentration (n = 2) in small volume ejaculates with acid pH and little or no fructose.

INTERVENTIONS

Exploration of scrotum with vasogram and testicular biopsy, plus reconstruction if possible.

MAIN OUTCOME MEASURES

Follow-up seminal analysis and occurrence of pregnancy in female partners.

RESULTS

The causes were: müllerian duct cyst (n = 17); wolffian duct malformation (n = 19); previous surgical trauma (e.g., imperforate anus) (n = 15); previous genital infection (n = 19); tuberculosis (n = 8); megavesicles (pathological dilatation of vesicles and ampullae of unknown cause) (n = 8); and carcinoma of prostate (n = 1). After incision of Mullerian duct cysts, five pregnancies were produced. Five pregnancies occurred in the other groups using a variety of surgical techniques.

CONCLUSIONS

Routine vasography has shown that ejaculatory duct obstruction is not as rare as previously thought. The diagnosis should not be missed because the condition is simple to correct surgically in certain cases.

Authors+Show Affiliations

Institute of Urology, London, United Kingdom.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1915949

Citation

Pryor, J P., and W F. Hendry. "Ejaculatory Duct Obstruction in Subfertile Males: Analysis of 87 Patients." Fertility and Sterility, vol. 56, no. 4, 1991, pp. 725-30.
Pryor JP, Hendry WF. Ejaculatory duct obstruction in subfertile males: analysis of 87 patients. Fertil Steril. 1991;56(4):725-30.
Pryor, J. P., & Hendry, W. F. (1991). Ejaculatory duct obstruction in subfertile males: analysis of 87 patients. Fertility and Sterility, 56(4), 725-30.
Pryor JP, Hendry WF. Ejaculatory Duct Obstruction in Subfertile Males: Analysis of 87 Patients. Fertil Steril. 1991;56(4):725-30. PubMed PMID: 1915949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ejaculatory duct obstruction in subfertile males: analysis of 87 patients. AU - Pryor,J P, AU - Hendry,W F, PY - 1991/10/1/pubmed PY - 1991/10/1/medline PY - 1991/10/1/entrez SP - 725 EP - 30 JF - Fertility and sterility JO - Fertil Steril VL - 56 IS - 4 N2 - OBJECTIVE: To study the causes, presentation, and treatment of ejaculatory duct obstruction in subfertile males. DESIGN: Collaborative retrospective study of clinical experience collected by two urologists over a 15-year period. SETTING: National Health Service and Private Care Hospitals. PATIENTS, PARTICIPANTS: Subfertile males with azoospermia (n = 67), very severe oligozoospermia (n = 17), oligozoospermia (n = 1), or normal sperm concentration (n = 2) in small volume ejaculates with acid pH and little or no fructose. INTERVENTIONS: Exploration of scrotum with vasogram and testicular biopsy, plus reconstruction if possible. MAIN OUTCOME MEASURES: Follow-up seminal analysis and occurrence of pregnancy in female partners. RESULTS: The causes were: müllerian duct cyst (n = 17); wolffian duct malformation (n = 19); previous surgical trauma (e.g., imperforate anus) (n = 15); previous genital infection (n = 19); tuberculosis (n = 8); megavesicles (pathological dilatation of vesicles and ampullae of unknown cause) (n = 8); and carcinoma of prostate (n = 1). After incision of Mullerian duct cysts, five pregnancies were produced. Five pregnancies occurred in the other groups using a variety of surgical techniques. CONCLUSIONS: Routine vasography has shown that ejaculatory duct obstruction is not as rare as previously thought. The diagnosis should not be missed because the condition is simple to correct surgically in certain cases. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/1915949/Ejaculatory_duct_obstruction_in_subfertile_males:_analysis_of_87_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(16)54606-8 DB - PRIME DP - Unbound Medicine ER -