Ejaculatory duct obstruction

Ejaculatory Duct Obstruction (EDO) is a medical condition affecting the male reproductive system, specifically the ejaculatory ducts. These ducts are responsible for transporting sperm from the vas deferens to the urethra, the final pathway through which sperm exits the body during ejaculation. Obstruction of these ducts can lead to significant reproductive and urinary symptoms, impacting an individual's fertility and overall quality of life.

Causes

Ejaculatory duct obstruction can be caused by several factors, including:

• Congenital abnormalities: Some men are born with structural anomalies in their ejaculatory ducts.
• Infections: Infections, particularly sexually transmitted infections (STIs), can lead to scarring and blockage.
• Cysts: Cysts, such as Müllerian duct cysts or Wolffian duct cysts, can form in the area of the ejaculatory ducts, leading to obstruction.
• Trauma: Injury to the pelvic area can cause scarring or damage to the ejaculatory ducts.
• Prostate surgery: Surgical procedures on the prostate, such as transurethral resection of the prostate (TURP), can sometimes lead to EDO.

Symptoms

Symptoms of ejaculatory duct obstruction can vary but often include:

• Hemospermia (blood in the semen)
• Oligospermia (low sperm count) or azoospermia (absence of sperm in the semen)
• Painful ejaculation
• Pelvic pain
• Reduced ejaculate volume

Diagnosis

Diagnosis of ejaculatory duct obstruction involves a combination of medical history, physical examination, and diagnostic tests, including:

• Semen analysis: To evaluate sperm count and quality.
• Transrectal ultrasound (TRUS): An imaging test that provides detailed pictures of the prostate and ejaculatory ducts.
• MRI: Magnetic resonance imaging can be used for a more detailed view of the pelvic structures.
• Vasography: A specialized X-ray procedure that involves injecting dye into the vas deferens to visualize the ejaculatory ducts.

Treatment

Treatment options for ejaculatory duct obstruction depend on the cause and severity of the obstruction. They may include:

• Antibiotics: If an infection is causing the obstruction, antibiotics may be prescribed.
• Surgical intervention: Procedures such as transurethral resection of the ejaculatory ducts (TURED) can be performed to remove the obstruction.
• Assisted reproductive technologies (ART): In cases where fertility is affected, techniques such as in vitro fertilization (IVF) may be recommended.

Prognosis

The prognosis for ejaculatory duct obstruction varies depending on the underlying cause and the success of treatment. Surgical intervention can be effective in relieving symptoms and improving fertility in many cases. However, some individuals may continue to experience fertility issues and may require further treatment or assisted reproductive technologies to achieve pregnancy.

See Also

• Male infertility
• Vas deferens
• Urethra
• Prostate