An update on the diagnosis and management of ejaculatory duct obstruction
| Autor: | Sonpreet Rai, Vaibhav Modgil, Asif Muneer, David Ralph |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Infertility
Male medicine.medical_specialty Urology 030232 urology & nephrology Obstructive azoospermia Physical examination urologic and male genital diseases Ejaculatory duct Male infertility 03 medical and health sciences 0302 clinical medicine Seminal vesicle medicine Animals Humans Ejaculatory duct obstruction Infertility Male 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Disease Management medicine.disease Surgery Ejaculatory Ducts Semen Analysis medicine.anatomical_structure Urethra business |
| Zdroj: | Nature reviews. Urology. 13(1) |
| ISSN: | 1759-4820 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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