Perineal-guided endoscopic extraction of ejaculatory duct stones to treat obstructive azoospermia

Fertil Steril. 2011 Jun;95(7):2430.e11-4. doi: 10.1016/j.fertnstert.2011.01.146. Epub 2011 Feb 21.

Abstract

Objective: To report a case of transurethral endoscopic treatment of ejaculatory duct stones with transrectal ultrasound (TRUS)-guided perineal needle implant and ureteroscopic extraction of deferent duct stones in an infertile man.

Design: Case report.

Setting: Department of Urology, University of Catania, Italy.

Patient(s): A 33-year-old man with azoospermia, low ejaculate volume, perineal discomfort, and unilateral seminal tract dilatation caused by obstructing lithiasis of the ejaculatory and deferent ducts.

Intervention(s): Transurethral endoscopic treatment of ejaculatory duct stones with TRUS-guided perineal needle implant and ureteroscopic extraction of deferent duct stones.

Main outcome measure(s): Improvements in symptoms and seminal parameters.

Result(s): The patients had successful relief of symptoms and correction of obstructive azoospermia.

Conclusion(s): This new technique allows a more rapid and targeted identification of ejaculatory duct lithiasis, and the ureteroscope enables management of distal seminal stones through the normal anatomic tract.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Azoospermia / diagnosis
  • Azoospermia / etiology
  • Azoospermia / surgery*
  • Calculi / complications
  • Calculi / diagnosis
  • Calculi / surgery*
  • Ejaculatory Ducts / diagnostic imaging
  • Ejaculatory Ducts / pathology
  • Ejaculatory Ducts / surgery*
  • Genital Diseases, Male / complications
  • Genital Diseases, Male / diagnosis
  • Genital Diseases, Male / surgery*
  • Humans
  • Lithiasis / diagnosis
  • Lithiasis / etiology
  • Lithiasis / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Perineum
  • Semen Analysis
  • Treatment Outcome
  • Ultrasonography, Interventional
  • Ureteroscopy*
  • Urologic Surgical Procedures, Male*