| Ejaculatory duct manometry in normal men and in patients with ejaculatory duct obstruction. | |
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MedLine Citation:
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PMID: 18499178 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Michael L Eisenberg; Thomas J Walsh; Maurice M Garcia; Katsuto Shinohara; Paul J Turek |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2008-05-21 |
Journal Detail:
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Title: The Journal of urology Volume: 180 ISSN: 1527-3792 ISO Abbreviation: J. Urol. Publication Date: 2008 Jul |
Date Detail:
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Created Date: 2008-06-12 Completed Date: 2008-08-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 255-60; discussion 260 Citation Subset: AIM; IM |
Affiliation:
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Department of Urology, University of California-San Francisco, San Francisco, California 94143-1695, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Ejaculatory Ducts* Genital Diseases, Male / diagnosis* Humans Male Manometry / methods Middle Aged Prospective Studies |
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