title: Perineal-guided endoscopic extraction of ejaculatory duct stones to treat obstructive azoospermia.
abstract: OBJECTIVE
  To report a case of transurethral endoscopic treatment of ejaculatory duct stones with transrectal ultrasound (TRUS)-guided perineal needle implant and ureteroscopic extraction of deferent duct stones in an infertile man.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Department of Urology, University of Catania, Italy.
  
  
  METHODS
  A 33-year-old man with azoospermia, low ejaculate volume, perineal discomfort, and unilateral seminal tract dilatation caused by obstructing lithiasis of the ejaculatory and deferent ducts.
  
  
  METHODS
  Transurethral endoscopic treatment of ejaculatory duct stones with TRUS-guided perineal needle implant and ureteroscopic extraction of deferent duct stones.
  
  
  METHODS
  Improvements in symptoms and seminal parameters.
  
  
  RESULTS
  The patients had successful relief of symptoms and correction of obstructive azoospermia.
  
  
  CONCLUSIONS
  This new technique allows a more rapid and targeted identification of ejaculatory duct lithiasis, and the ureteroscope enables management of distal seminal stones through the normal anatomic tract.
authors.affiliation: Department of Urology, Univeristy of Catania, Catania, Italy. vincenzo.favilla@libero.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Favilla
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cimino
authors.forename: Massimo
authors.initials: M
authors.lastname: Madonia
authors.forename: Tommaso
authors.initials: T
authors.lastname: Castelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sortino
authors.forename: Marco
authors.initials: M
authors.lastname: Russo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morgia
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002137:Calculi / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004543:Ejaculatory Ducts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005832:Genital Diseases, Male / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D020347:Lithiasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D010502:Perineum; D055101:Semen Analysis; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D018666:Ureteroscopy; D013521:Urologic Surgical Procedures, Male