URINE CONTAMINATION OF SEMINAL FLUID AFTER TRANSURETHRAL RESECTION OFTHE EJACULATORY DUCTS

Transurethral resection of ejaculatory duct obstruction has assumed a significant role in the treatment of infertile men. The potential impa ct of disruption of the ejaculatory duct apparatus after transurethral resection has not been studied. The seminal plasma of patients was ev aluated after transurethral resection of the ejaculatory ducts by dete rmining creatinine levels as a measure of urine contamination of semen . Analysis of semen parameters was retrospectively performed on preope rative and postoperative samples in 8 subfertile men diagnosed with ej aculatory duct obstruction treated by transurethral resection. These w ere not 8 consecutive patients but rather individuals from a larger se ries who had seminal plasma frozen preoperatively and postoperatively. A significant increase in seminal plasma creatinine levels postoperat ively was detected in 7 of 8 patients evaluated. In patients who were requested to produce 2 specimens within 1 hour high levels of creatini ne were found in both ejaculates, although creatinine levels were lowe r in the second ejaculate. The patient who postoperatively had low lev els of creatinine in seminal plasma demonstrated an improvement in spe rm concentration and morphology, and his wife became pregnant. Transur ethral resection of the ejaculatory ducts results in marked improvemen t in some semen parameters. However, the impact of urine contamination in semen after transurethral resection of the ejaculatory ducts must be assessed in the management of patients who present with ejaculatory duct obstruction.