Ejaculatory duct obstruction is a rare condition that may cause male infertility. It presents with a low ejaculate volume and semen analysis affirms no sperm count or very low sperm count, abnormal semen quality with normal male hormones (FSH and testosterone) as well as normal testis size.
Ejaculatory duct obstruction can be either congenital or acquired. Congenital causes include congenital atresia or stenosis of the ejaculatory ducts.
Acquired causes may be secondary to trauma, either infectious or inflammatory etiologies. Calculus formation secondary to infection may also cause obstruction. Cyst formation from prior treatment or infection may also occur.
The diagnosis of obstruction can be confirmed by transurethral ultrasound (TRUS) showing large seminal vesicles or dilated ejaculatory ducts in association with a cyst, calcification or stones along the ducts.
Symptoms associated with ejaculatory duct obstruction can be quite variable but include infertility, decreased force of ejaculation, pain on or after ejaculation, decreased ejaculate volume, hematospermia, perineal or testicular pain, low back pain, urinary obstruction, dysuria or no symptoms.
Transurethral resection of the ejaculatory ducts is the most recommended form of treatment for Ejaculatory Duct Obstruction. The ejaculatory ducts are surgically opened up allowing for the normal flow of ejaculate and improvement of various parameters linked to semen quality.
This procedure has helped couples to be able to conceive naturally, without the need for Assisted Reproductive Technologies such as IVF/ICSI.
Alternatively, a microsurgical re-anastomosis of the duct can be done, which can be discussed with our specialists.
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