MR 19. Effect of transurethral resection of ejaculatory duct for treatment of ejaculatory duct obstruction

Purpose: To evaluate the effect of transurethral resection of ejaculatory duct (TURED) for treatment of ejaculatory duct obstruction (EDO).

Materials and Methods: The clinical information of 60 cases of EDO were analyzed from Oct 2004 to Oct 2010. The diagnostic criteria included semen analyses, fructose in seminal plasma, transrectal ultrasonography (TRUS), and vasography necessarily. All patients were treated by TURED. Postoperative semen assay, postoperative patency rate and postoperative impregnation rate were followed.

Results: Semen analyses in the majority of cases showed the typical characteristics of EDO, azoospermia, low semen volume (average 1.10 mL), low PH (average 6.5), absent or low semen fructose (average 5.86 μmol/ one ejaculation). TRUS showed pure dilation of both ejaculatory duct in 15 cases, prostatic cyst in 6, pure dilated seminal vesicles on both sides in 10, unilateral dilated seminal vesicle in 4, dilation of both ejaculatory duct and seminal vesicles in 10, dilated seminal vesicles with prostatic cyst in 5, unilateral dilated seminal vesicle and contralateral aplasia of seminal vesicle in 2, dilated seminal vesicles with dilation and calcifications of both ejaculatory duct in 3, the remaining 5 had unilateral dilated ejaculatory duct and seminal vesicle with contralateral aplasia of seminal vesicle. Among all cases followed up more than 6-78 months after TURED, 51 patients (85.0%) had improved semen parameters and 16 patient's wife (26.7%) pregnancies.

Conclusions: TURED may be the simple, minimally invasive and effective method for the treatment of EDO.