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Wednesday, November 12, 2014

Ejaculatory Duct Obstruction: A Challenge to Diagnose

EDO, or blockage of the ejaculatory duct, is a rare but treatable cause of severe male factor infertility. Men have severe oligopermia with low volume ejaculate, low to no seminal fructose, and no sperm on post ejaculate UA.   TRUST may show dilated seminal vesicles, a dilated ejaculatory duct, and on occasion a midline prostate cyst.   Often all findings are not present and a certainly of diagnosis remains elusive. In these cases MRI may help verses the more traditional approach of vasography followed by TUR-ED--resection of the ejaculatory ducts.  When the diagnosis is correct, outcome of treatment is dramatic and full fertility can be restored immediately following the procedure.