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Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention.
Ger Med Sci. 2012; 10:Doc06.GM

Abstract

Uni- or bilateral ejaculatory duct obstruction (EDO) is a rare but correctable cause of infertility, chronic pelvic pain and postejaculatory pain. EDO is a congenital or acquired condition, it is the underlying cause of infertility in approximately 5% of infertile men. If acquired, the etiology often remains unresolved, but prostatitis or urethritis with post-inflammatory adhesion of the duct walls seems to be a common underlying pathomechanism.Although a certain constellation of physicochemical semen parameters may lead to correct diagnosis, EDO often resembles a diagnosis by exclusion. Imaging of acquired EDO remains a challenge and the established surgical therapy, transurethral resection of the ejaculatory ducts (TURED), leads to a low rate of natural conception and a high rate of complications such as reflux of urine and epididymitis. We present a case of a male with suspected EDO who underwent a combined approach to both, semi-invasive diagnosis and therapy by transrectal puncture of the seminal vesicles and antegrade balloon-dilation of the ejaculatory ducts. Possibilities and pitfalls of this procedure are described and the literature is reviewed.Furthermore, we suggest a CT- or MRI-guided, percutaneous intervention for treatment of ejaculatory duct obstruction by balloon dilation and demonstrate initial steps of this procedure with a body donor. We call this new procedure PTED (percutaneous transgluteal ejaculatory ductoplasty).

Authors+Show Affiliations

Department of Radiology, University Hospital Schleswig-Holstein, Kiel, Germany. o.kayser@rad.uni-kiel.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

22557939

Citation

Kayser, Ole, et al. "Less Invasive Causal Treatment of Ejaculatory Duct Obstruction By Balloon Dilation: a Case Report, Literature Review and Suggestion of a CT- or MRI-guided Intervention." German Medical Science : GMS E-journal, vol. 10, 2012, pp. Doc06.
Kayser O, Osmonov D, Harde J, et al. Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention. Ger Med Sci. 2012;10:Doc06.
Kayser, O., Osmonov, D., Harde, J., Girolami, G., Wedel, T., & Schäfer, P. (2012). Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention. German Medical Science : GMS E-journal, 10, Doc06. https://doi.org/10.3205/000157
Kayser O, et al. Less Invasive Causal Treatment of Ejaculatory Duct Obstruction By Balloon Dilation: a Case Report, Literature Review and Suggestion of a CT- or MRI-guided Intervention. Ger Med Sci. 2012;10:Doc06. PubMed PMID: 22557939.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention. AU - Kayser,Ole, AU - Osmonov,Daniar, AU - Harde,Jonas, AU - Girolami,Guido, AU - Wedel,Thilo, AU - Schäfer,Philipp, Y1 - 2012/03/14/ PY - 2011/11/24/received PY - 2012/02/22/revised PY - 2012/5/5/entrez PY - 2012/5/5/pubmed PY - 2012/10/2/medline KW - CT KW - EDO KW - TURED KW - balloon dilation KW - ejaculatory duct KW - ejaculatory duct obstruction KW - resection of the ejaculatory duct KW - transgluteal SP - Doc06 EP - Doc06 JF - German medical science : GMS e-journal JO - Ger Med Sci VL - 10 N2 - Uni- or bilateral ejaculatory duct obstruction (EDO) is a rare but correctable cause of infertility, chronic pelvic pain and postejaculatory pain. EDO is a congenital or acquired condition, it is the underlying cause of infertility in approximately 5% of infertile men. If acquired, the etiology often remains unresolved, but prostatitis or urethritis with post-inflammatory adhesion of the duct walls seems to be a common underlying pathomechanism.Although a certain constellation of physicochemical semen parameters may lead to correct diagnosis, EDO often resembles a diagnosis by exclusion. Imaging of acquired EDO remains a challenge and the established surgical therapy, transurethral resection of the ejaculatory ducts (TURED), leads to a low rate of natural conception and a high rate of complications such as reflux of urine and epididymitis. We present a case of a male with suspected EDO who underwent a combined approach to both, semi-invasive diagnosis and therapy by transrectal puncture of the seminal vesicles and antegrade balloon-dilation of the ejaculatory ducts. Possibilities and pitfalls of this procedure are described and the literature is reviewed.Furthermore, we suggest a CT- or MRI-guided, percutaneous intervention for treatment of ejaculatory duct obstruction by balloon dilation and demonstrate initial steps of this procedure with a body donor. We call this new procedure PTED (percutaneous transgluteal ejaculatory ductoplasty). SN - 1612-3174 UR - https://www.unboundmedicine.com/medline/citation/22557939/Less_invasive_causal_treatment_of_ejaculatory_duct_obstruction_by_balloon_dilation:_a_case_report_literature_review_and_suggestion_of_a_CT__or_MRI_guided_intervention_ L2 - https://doi.org/10.3205/000157 DB - PRIME DP - Unbound Medicine ER -