The Ejaculatory Duct Obstruction

사정관 폐쇄

We found reports of only about 20 cases of well documented ejaculatory duct obstruction presenting with infertility and treated by TUR. While infertility caused by ejaculatory duct obstruction is rare accurate diagnosis by vasoseminal vesiculography is important, since these obstructions may be treatable. In our 29 patients undergoing vasoseminal vesiculography for 1 year to demonstrate obstruction site in seminal tract the ejaculatory duct obstruction was found in 6 patients. The intial methods of treament were TUR of the ejaculatory duct in 2 patients, forceful lavage of ejaculatory duct through the vas deferens in 4 patients. One patient's wife who had undergone TUR of the ejaculatory duct delivered a normal female baby 15 months postoperatively. In one patient who had undergone forceful lavage of ejaculatory duct semen analysis returns to normal level except the motility. When initial methods of treatment fail to get the normal semen we have the plan to perform TUR of the ejaculatory duct or aspiration of seminal fluid in the seminal vesicle under the control of the ultrasonography for AIH according to the level of ejaculatory duct obstruction. Our report suggests that ejaculatory obstruction has been underdiagnosed and should receive more attention by urologist.