title: Transurethral resection of ejaculatory ducts in the treatment of complete ejaculatory duct obstruction.
abstract: OBJECTIVE
  To evaluate the value of transurethral resection of the ejaculatory duct (TURED) in the treatment of complete ejaculatory duct obstruction (EDO) as a treatable cause of male factor infertility.
  
  
  METHODS
  We retrospectively evaluated 12 azoospermic infertile men who were diagnosed as having complete EDO. The mean age of the patients was 32 years (range 24-40). Inclusion criteria were EDO in patients with azoospermia, normal serum levels of gonadotropins and testosterone and evidence of obstruction on transrectal ultrasonographic (TRUS) images. The definitive diagnosis was based on the absence of an efflux of methylene blue injected through the seminal vesicles during cystoscopy. All patients were treated by TURED.
  
  
  RESULTS
  Before TURED, all patients were azoospermic and had been considered as candidates for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI). Following the operation, sperms were seen in the ejaculates of 11/12 patients. After a mean follow-up period of 12 (range 4-36) months, five (41.6%) pregnancies were noted (three spontaneous, one with intrauterine insemination and one with IVF/ICSI).
  
  
  CONCLUSIONS
  Transurethral resection was found to be a safe and somewhat effective approach for the treatment of EDO. After TURED, a significant improvement was achieved in semen parameters, and spontaneous pregnancy resulted in three cases. In addition, TURED can reduce the need for expensive procedures such as IVF/ICSI as this modality allows IVF/ICSI to be performed with ejaculated instead of surgically retrieved sperm.
authors: Meram Medical Faculty, Department of Urology, Selcuk University, Meram, Konya 42080, Turkey.
authors: Talat
authors: T
authors: Yurdakul
authors: Gurhan
authors: G
authors: Gokce
authors: Ozcan
authors: O
authors: Kilic
authors: M M
authors: MM
authors: Piskin
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000209:etiology / Q000628:therapy; D004543:Ejaculatory Ducts / Q000601:surgery*; D005832:Genital Diseases, Male / Q000601:surgery; D006801:Humans; D008297:Male; D008751:Methylene Blue; D012189:Retrospective Studies
chemical_list: D008751:Methylene Blue