Does response to treatment of ejaculatory duct obstruction in infertile men vary with pathology?

被引:45
作者
Kadioglu, A [1 ]
Cayan, S
Tefekli, A
Orhan, I
Engin, G
Turek, PJ
机构
[1] Istanbul Univ, Istanbul Fac Med, Dept Urol, TR-34390 Istanbul, Turkey
[2] Mersin Univ, Sch Med, Dept Urol, Mersin, Turkey
[3] Istanbul Univ, Istanbul Fac Med, Dept Radiol, Istanbul, Turkey
[4] Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA
关键词
infertility; ejaculatory duct; obstruction; pathology; transurethral resection; ICSI;
D O I
10.1016/S0015-0282(01)01817-9
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To describe the pathology-specific response to transurethral resection of ejaculatory ducts (TURED) in patients with complete or partial ejaculatory duct obstruction and to evaluate the role of TURED in light of powerful assisted reproductive technologies. Design: Retrospective clinical study. Setting: University hospital. Patient(s): Thirty-eight infertile men with obstruction of the ejaculatory ducts. Intervention(s): Diagnosis by transrectal ultrasonography or magnetic resonance imaging, and treatment with TURED. Main Outcome Measure(s): Changes in semen variables, pregnancy outcomes, and complication rates were analyzed before and after surgery. Result(s): Improvement in semen variables was significantly better in patients with partial obstruction (94%) of ducts than in those with complete obstruction (59%) CP=.04). Cystic obstruction, especially midline and eccentric cysts, responded best to TURED. Before surgery, all patients were candidates for IVF/ICSI; after surgery, 32% of azoospermic men and 81% of oligospermic men conceived spontaneously or were referred for IUI instead of IVF/ICSI. Conclusion(s): Ejaculatory duct obstruction due to cysts appears to respond best to TURED. In addition, TURED may decrease the need for IVF/ICSI as primary treatment in many cases. Finally, TURED may allow IVF/ICSI to be performed with ejaculated rather than surgically retrieved sperm. (C) 2001 by American Society for Reproductive Medicine.
引用
收藏
页码:138 / 142
页数:5
相关论文
共 17 条
[1]   STENOSIS OF EJACULATORY DUCTS TREATED BY ENDOSCOPIC RESECTION [J].
EARLEY, S ;
BARNES, R .
JOURNAL OF UROLOGY, 1973, 109 (04) :664-666
[2]  
Engin G, 2000, ACTA RADIOL, V41, P288, DOI 10.1080/028418500127345271
[3]  
Fisch H., 1992, CURR SURG TECHN UROL, V5, P2
[4]   EJACULATORY DUCT OBSTRUCTION IN THE INFERTILE MALE [J].
GOLUBOFF, ET ;
STIFELMAN, MD ;
FISCH, H .
UROLOGY, 1995, 45 (06) :925-931
[5]   TRANSRECTAL ULTRASOUND AND PARTIAL EJACULATORY DUCT OBSTRUCTION IN MALE-INFERTILITY [J].
HELLERSTEIN, DK ;
MEACHAM, RB ;
LIPSHULTZ, LI .
UROLOGY, 1992, 39 (05) :449-452
[6]  
JAROW JP, 1993, FERTIL STERIL, V60, P1035
[7]   SEMINAL-VESICLE ASPIRATION IN THE MANAGEMENT OF PATIENTS WITH EJACULATORY DUCT OBSTRUCTION [J].
JAROW, JP .
JOURNAL OF UROLOGY, 1994, 152 (03) :899-901
[8]  
MEACHAM RB, 1993, FERTIL STERIL, V59, P393
[9]  
Netto NR, 1998, J UROLOGY, V159, P2048
[10]  
Nguyen Hiep T., 1996, Journal of Urology, V155, p367A