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An update on the diagnosis and management of ejaculatory duct obstruction.
Nat Rev Urol. 2016 Jan; 13(1):13-20.NR

Abstract

Ejaculatory duct obstruction (EDO) remains a rare but surgically correctable cause of male sexual dysfunction and male infertility due to obstructive azoospermia, diagnosed in up to 5% of infertile men. EDO should, therefore, be considered within the list of differential diagnoses for men undergoing infertility investigations, with work up including clinical examination, transurethral ultrasonography, semen analysis, chromotubation, seminal vesiculography and seminal vesicle aspiration. Obstruction can be limited to the distal ends of the ducts or it can extend proximally to include the terminal portions of the vasa deferentia, with the site and length of the obstruction having implications for surgical intervention. Early endoscopic treatment can reverse symptoms and prevent the progression of partial obstruction to bilateral, complete obstruction, and transurethral resection of the ejaculatory duct remains the main treatment option for EDO. Alternative treatment options include endoscopic laser-assisted resection of the ducts, antegrade seminal-vesicle lavage to relieve EDO secondary to inspissated material or calculi, or dilatation of the ejaculatory ducts using 9F seminal vesicoscopy or balloon.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Modgil V
Department of Urology, Worcestershire Acute Hospitals NHS Trust, Alexandra Hospital, Woodrow Drive, Redditch B98 7UB, UK.
Rai S
Department of Urology, Harrogate District Hospital, Lancaster Park Road, Harrogate HG2 7SX, UK.
Ralph DJ
Department of Andrology, University College London Hospital, 250 Euston Road, London NW1 2PG, UK.
Muneer A
Department of Andrology, University College London Hospital, 250 Euston Road, London NW1 2PG, UK.

MeSH

AnimalsDisease ManagementEjaculatory DuctsHumansInfertility, MaleMaleSemen Analysis

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

26620608

Citation

Modgil, Vaibhav, et al. "An Update On the Diagnosis and Management of Ejaculatory Duct Obstruction." Nature Reviews. Urology, vol. 13, no. 1, 2016, pp. 13-20.
Modgil V, Rai S, Ralph DJ, et al. An update on the diagnosis and management of ejaculatory duct obstruction. Nat Rev Urol. 2016;13(1):13-20.
Modgil, V., Rai, S., Ralph, D. J., & Muneer, A. (2016). An update on the diagnosis and management of ejaculatory duct obstruction. Nature Reviews. Urology, 13(1), 13-20. https://doi.org/10.1038/nrurol.2015.276
Modgil V, et al. An Update On the Diagnosis and Management of Ejaculatory Duct Obstruction. Nat Rev Urol. 2016;13(1):13-20. PubMed PMID: 26620608.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An update on the diagnosis and management of ejaculatory duct obstruction. AU - Modgil,Vaibhav, AU - Rai,Sonpreet, AU - Ralph,David J, AU - Muneer,Asif, Y1 - 2015/12/01/ PY - 2015/12/2/entrez PY - 2015/12/2/pubmed PY - 2016/5/7/medline SP - 13 EP - 20 JF - Nature reviews. Urology JO - Nat Rev Urol VL - 13 IS - 1 N2 - Ejaculatory duct obstruction (EDO) remains a rare but surgically correctable cause of male sexual dysfunction and male infertility due to obstructive azoospermia, diagnosed in up to 5% of infertile men. EDO should, therefore, be considered within the list of differential diagnoses for men undergoing infertility investigations, with work up including clinical examination, transurethral ultrasonography, semen analysis, chromotubation, seminal vesiculography and seminal vesicle aspiration. Obstruction can be limited to the distal ends of the ducts or it can extend proximally to include the terminal portions of the vasa deferentia, with the site and length of the obstruction having implications for surgical intervention. Early endoscopic treatment can reverse symptoms and prevent the progression of partial obstruction to bilateral, complete obstruction, and transurethral resection of the ejaculatory duct remains the main treatment option for EDO. Alternative treatment options include endoscopic laser-assisted resection of the ducts, antegrade seminal-vesicle lavage to relieve EDO secondary to inspissated material or calculi, or dilatation of the ejaculatory ducts using 9F seminal vesicoscopy or balloon. SN - 1759-4820 UR - https://www.unboundmedicine.com/medline/citation/26620608/An_update_on_the_diagnosis_and_management_of_ejaculatory_duct_obstruction_ DB - PRIME DP - Unbound Medicine ER -