TRANSURETHRAL RESECTION OF PARTIALLY OBSTRUCTED EJACULATORY DUCTS - SEMINAL PARAMETERS AND PREGNANCY OUTCOMES ACCORDING TO THE ETIOLOGY OF OBSTRUCTION

Purpose: We determine how transurethral resection of the ejaculatory d ucts performed for infertility affects seminal parameters and pregnanc y outcomes in patients with partial ejaculatory duct obstruction due t o a congenital or acquired etiological factor. Materials and Methods: Based on history and physical examination, hormonal profiles, semen an alyses, transrectal ultrasonography and vasography findings partial ej aculatory duct obstruction was diagnosed in 14 men a mean of 30 years old who presented for infertility evaluation. Patients were grouped ac cording to congenital or acquired cause of obstruction. Transurethral resection of the ejaculatory ducts was performed using the standard re sectoscope loop technique. Clinical outcome was assessed by postoperat ive analyses of seminal parameters and pregnancy reports. Results: Tra nsurethral resection of the ejaculatory ducts significantly improved s emen quality (ejaculate volume and percentage of sperm motility) in al l patients in the congenital group, while all but 1 (83%) had an impro ved sperm count. Pregnancy was achieved via sexual intercourse by 66% of the patients an average of 5.7 months postoperatively. Of the acqui red etiological factor group 37.5% had improved semen quality after tr ansurethral resection of ejaculatory duct and 12.5% achieved pregnancy via sexual intercourse. Postoperative complications occurred at a sim ilar rate in each group (33%). However, complications in the congenita l etiology group were minor, while 25% of the men in the acquired grou p had significant impairment of seminal parameters after transurethral resection of the ejaculatory ducts. Conclusions: Semen quality improv ement and pregnancy outcome after transurethral resection of the ejacu latory ducts for partial ejaculatory duct obstruction differ significa ntly according to the main etiological cause of obstruction. An equivo cal diagnosis of partial obstruction and technical problems during tra nsurethral resection of the ejaculatory ducts may contribute to failur e. However, in some cases the reason for failure remains unclear.