J Korean Androl Soc.  1994 Dec;12(2):101-107.

Role of Transrectal Ultrasonography in Management of Ejaculatory Duct Obstruction

• Paick JS
• Kim HG
• Lee JH
• Jeon SS

Abstract

Transrectal ultrasonography(TRUS) has been used recently to establish the diagnosis of ejaculatory duct obstruction(EDO). We analyzed the findings in 39 patients we examined by TRUS during the last 6 years. In 19 patients, no or severely atrophic seminal vesicles were found. The initial 4 patients were found to have bilateral vasa deferential obstuction in multiple sites at follow-up vasoseminal vesiculography. Interestingly, 15 patients in this group had a history of treated pulmonary tuberculosis. The findings of TRUS in the other 20 patients were a midline cyst in 8 patients, dilation of the seminal vesicles in 11 patients, and no abnormalities in 1 patient. The findings of vasoseminal vesiculography were identical to those of TRUS exceptin 1 patient, who had EDO on vasoseminal vesiculography but normal findings on TRUS. Regarding the treatment, TRUS was a valuable aid for preoperative surgical planning. With TRUS-guided injection of contrast material and methylene blue into the dilated system, a clear picture of the anatomy could be provided by vasoseminal vesiculography, and the efflux of methylene blue during transurethral resection indicated relief of the obstruction. Based on our experiences, in patients showing atrophic seminal vesicles by TRUS and having a history of pulmonary tuberculosis, further testing is not necessary. In other patients, TRUS not only establishes the diagnosis of EDO in most cases but also enables precise transurethral resection into the obstructed system.

MeSH Terms

Diagnosis
Ejaculatory Ducts*
Follow-Up Studies
Humans
Infertility
Male
Methylene Blue
Seminal Vesicles
Tuberculosis, Pulmonary
Ultrasonography*
Methylene Blue