The absence of sperm from the ejaculate (azoospermia) is found in 15% of infertile men and obstruction of the ductal system is responsible for approximately 40% of cases. Obstructive azoospermia may result from epididymal, vasal, or ejaculatory duct pathology. Vasectomy is the most common cause of vasal obstruction. Severe genitourinary infections, injury during scrotal or inguinal surgery such as hernia repairs are other common causes of obstructive azoospermia. Patients with low volume of ejaculate (1.0 cc or less) and acidic semen that have been found to have an obstruction of the ejaculatory ducts confirmed with a transrectal US or seminal vesiculography and candidates for TUREDs.
The patient is given a general anesthetic. Endoscopy is performed where a scope is passed through the natural opening in the urinary tract. There are no incisions. A small instrument is used to open up the blocked ducts.
Patients may experience some mild blood in the urine or burning with urination that should resolve over the next week or two. They may also feel like they have to urinate more frequency during the healing phase.
Frequently Asked Questions
How do you detect ejaculatory duct obstruction?
If you have an ejaculatory duct obstruction, your ejaculate will be low in fructose and pH level, which your Urologist can detect with a chemical analysis.
When your doctor suspects that you have an EDO, he may order an ultrasound to determine its location.