Ejaculatory Duct Obstruction Diagnosis and Management
Summary
Ejaculatory duct obstruction is an uncommon cause of male infertility and lower urinary tract symptoms, arising from congenital anomalies, midline prostatic cysts, inflammation or iatrogenic injury. Clinically, it presents with low-volume ejaculate, acidic seminal pH and either azoospermia or severe oligozoospermia despite normal hormonal profiles and secondary sexual characteristics. Diagnosis relies on detailed history, physical examination and semen analysis, followed by imaging modalities such as transrectal ultrasound and magnetic resonance imaging to visualise ductal patency and identify obstructive lesions. Management strategies range from minimally invasive endoscopic techniques—especially transurethral resection of the ejaculatory ducts—to microsurgical reconstruction and robotic approaches. Successful intervention restores antegrade ejaculation, improves semen parameters and may permit natural conception or more effective use of assisted reproductive technologies. Emerging evidence highlights the importance of precise imaging guidance and the potential for novel ablation or stenting methods to reduce restenosis and improve long-term fertility outcomes.
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Ejaculatory Duct Obstruction Diagnosis and Management publication trend
The graph below shows the total number of articles in ejaculatory duct obstruction diagnosis and management across all publications each year (not limited to Nature Index journals).
Technical terms
Ejaculatory duct: Paired conduits carrying sperm and seminal fluid from the seminal vesicles and vas deferens into the prostatic urethra.
Obstructive azoospermia: Absence of spermatozoa in the ejaculate due to a physical blockage in the male reproductive tract.
Transrectal ultrasound (TRUS): High-frequency ultrasound probe introduced into the rectum to visualise the prostate, seminal vesicles and ejaculatory ducts.
Transurethral resection of ejaculatory ducts (TURED): Endoscopic surgical technique to remove obstructive tissue at the ejaculatory duct orifices via the urethra.
Ejaculatory duct cyst: Fluid-filled dilation arising within or adjacent to the ducts, potentially causing bilateral obstruction and infertility.
References
- Transurethral Resection of the Ejaculatory Ducts in Treatment of Male Infertility: The Surgical Technique and the Role of Transrectal Ultrasound. Videourology (2020).
- Инструментальные методы визуализации при обструкции семенных путей. Andrology and Genital Surgery (2022).
- Ejaculatory duct cyst causing bilateral obstruction and subsequent infertility: A rare case report from Indonesia. Radiology Case Reports (2022).
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