Document Detail

Ejaculatory duct manometry in normal men and in patients with ejaculatory duct obstruction.
MedLine Citation:
PMID:  18499178     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Ejaculatory duct obstruction is a treatable cause of male infertility but the diagnosis can be difficult to make. Transrectal ultrasound is valuable but not specific for ejaculatory duct obstruction. Adjunctive procedures, such as chromotubation and seminal vesicle aspiration, are more sensitive but not definitive, especially for partial obstruction. We describe what is to our knowledge a new hydraulic test and report its ability to identify physical and functional ejaculatory duct obstruction. MATERIALS AND METHODS: Two groups of men were studied, including patients with infertility or ejaculatory pain in whom ejaculatory duct obstruction was suspected and fertile men undergoing vasectomy reversal (controls). In each cohort ejaculatory duct injection and manometry were performed. Patients with ejaculatory duct obstruction underwent transurethral ejaculatory duct resection based on routine criteria. Pressure was reassessed after resection. Manometry pressures were compared between controls and patients with ejaculatory duct obstruction, and correlated with the response to transurethral ejaculatory duct resection. RESULTS: In the 7 controls (14 sides) mean ejaculatory duct opening pressure was 33.2 cm H(2)O. In the 9 patients (17 sides) with suspected ejaculatory duct obstruction mean ejaculatory duct opening pressure before transurethral ejaculatory duct resection was 116 cm H(2)O. In the 6 patients who underwent resection, which was unilateral and bilateral in 3 each, mean ejaculatory duct opening pressure decreased from 118 to 53 cm H(2)O. Of the 5 patients who underwent semen analyses before and after resection 80% showed an increase in ejaculate volume and/or at least 100% improvement in TMC (volume x concentration x motile fraction). CONCLUSIONS: Ejaculatory duct manometry with baseline values defined in fertile men demonstrates that men with clinically suspected ejaculatory duct obstruction have higher ejaculatory duct opening pressure than fertile men and ejaculatory duct pressure decreases after transurethral ejaculatory duct resection.
Michael L Eisenberg; Thomas J Walsh; Maurice M Garcia; Katsuto Shinohara; Paul J Turek
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-05-21
Journal Detail:
Title:  The Journal of urology     Volume:  180     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-12     Completed Date:  2008-08-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  255-60; discussion 260     Citation Subset:  AIM; IM    
Department of Urology, University of California-San Francisco, San Francisco, California 94143-1695, USA.
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MeSH Terms
Ejaculatory Ducts*
Genital Diseases, Male / diagnosis*
Manometry / methods
Middle Aged
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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