title: Comparison of transrectal ultrasonography and transrectal ultrasonography-guided seminal vesicle aspiration in the diagnosis of the ejaculatory duct obstruction.
abstract: OBJECTIVE
  To compare transrectal ultrasonography (TRUS) and TRUS-guided seminal vesicle aspiration in the diagnosis of ejaculatory duct obstruction (EDO).
  
  
  METHODS
  A retrospective case-controlled study comparing the findings of TRUS and TRUS-guided seminal vesicle (SV) aspiration.
  
  
  METHODS
  Clinics of Urology and Radiology.
  
  
  METHODS
  Seventy patients with suspected EDO (complete in 10, partial in 60 patients) on clinical evaluation.
  
  
  METHODS
  Each SV was punctured transrectally using a 20-gauge Chiba needle within 2 hours after ejaculation.
  
  
  METHODS
  In SV aspirates, greater than three sperm per high-power microscopic field was considered a positive result for EDO.
  
  
  RESULTS
  Fifty-five (78.6%) patients had evidence of EDO on diagnostic TRUS. However, obstruction on TRUS was confirmed in 49.1% (27 of 55) of the patients with SV aspiration. Higher sperm positivity rates were achieved in patients with SV dilation (11 of 13, 84.6%) and prostatic midline/ED cyst (12 of 16, 75.0%). Stepwise logistic regression analysis revealed that the incidence of SV dilation was significantly higher, whereas that of chronic inflammatory findings in the prostate was significantly lower in the positive SV aspirate group.
  
  
  CONCLUSIONS
  TRUS alone is not a reliable tool for the diagnosis of EDO. For this reason, SV aspiration should be used as an adjunctive technique in patients with SV dilation or a prostatic midline/ED cyst to confirm the diagnosis before surgery.
authors.affiliation: Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. Electronic address: gengin@Istanbul.edu.tr.
authors.forename: Gulgun
authors.initials: G
authors.lastname: Engin
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Celtik
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Oner
authors.initials: O
authors.lastname: Sanli
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Aytac
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Zarifcan
authors.initials: Z
authors.lastname: Muradov
authors.affiliation: Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Ates
authors.initials: A
authors.lastname: Kadioglu
mesh_terms: D000293:Adolescent; D000328:Adult; D044963:Biopsy, Fine-Needle / Q000379:methods; D016022:Case-Control Studies; D004543:Ejaculatory Ducts / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007248:Infertility, Male / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D052801:Male Urogenital Diseases / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D008875:Middle Aged; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013076:Sperm Count; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult