Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention
Uni- or bilateral ejaculatory duct obstruction (EDO) is a rare but correctable cause of infertility, chronic pelvic pain and postejaculatory pain. EDO is a congenital or acquired condition, it is the underlying cause of infertility in approximately 5% of infertile men. If acquired, the etiology ofte...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | deu |
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German Medical Science GMS Publishing House
2012-03-01
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| Series: | GMS German Medical Science |
| Subjects: | |
| Online Access: | http://www.egms.de/static/en/journals/gms/2012-10/000157.shtml |
| _version_ | 1818208407527620608 |
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| author | Ole Kayser Daniar Osmonov Jonas Harde Guido Girolami Thilo Wedel Philipp Schäfer |
| author_facet | Ole Kayser Daniar Osmonov Jonas Harde Guido Girolami Thilo Wedel Philipp Schäfer |
| author_sort | Ole Kayser |
| collection | DOAJ |
| description | Uni- or bilateral ejaculatory duct obstruction (EDO) is a rare but correctable cause of infertility, chronic pelvic pain and postejaculatory pain. EDO is a congenital or acquired condition, it is the underlying cause of infertility in approximately 5% of infertile men. If acquired, the etiology often remains unresolved, but prostatitis or urethritis with post-inflammatory adhesion of the duct walls seems to be a common underlying pathomechanism. Although a certain constellation of physicochemical semen parameters may lead to correct diagnosis, EDO often resembles a diagnosis by exclusion. Imaging of acquired EDO remains a challenge and the established surgical therapy, transurethral resection of the ejaculatory ducts (TURED), leads to a low rate of natural conception and a high rate of complications such as reflux of urine and epididymitis. We present a case of a male with suspected EDO who underwent a combined approach to both, semi-invasive diagnosis and therapy by transrectal puncture of the seminal vesicles and antegrade balloon-dilation of the ejaculatory ducts. Possibilities and pitfalls of this procedure are described and the literature is reviewed. Furthermore, we suggest a CT- or MRI-guided, percutaneous intervention for treatment of ejaculatory duct obstruction by balloon dilation and demonstrate initial steps of this procedure with a body donor. We call this new procedure PTED (percutaneous transgluteal ejaculatory ductoplasty). |
| first_indexed | 2024-12-12T04:44:20Z |
| format | Article |
| id | doaj.art-d4a52ced15434377b6c5b4db589083c8 |
| institution | Directory Open Access Journal |
| issn | 1612-3174 |
| language | deu |
| last_indexed | 2024-12-12T04:44:20Z |
| publishDate | 2012-03-01 |
| publisher | German Medical Science GMS Publishing House |
| record_format | Article |
| series | GMS German Medical Science |
| spelling | doaj.art-d4a52ced15434377b6c5b4db589083c82022-12-22T00:37:42ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742012-03-0110Doc06Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided interventionOle KayserDaniar OsmonovJonas HardeGuido GirolamiThilo WedelPhilipp SchäferUni- or bilateral ejaculatory duct obstruction (EDO) is a rare but correctable cause of infertility, chronic pelvic pain and postejaculatory pain. EDO is a congenital or acquired condition, it is the underlying cause of infertility in approximately 5% of infertile men. If acquired, the etiology often remains unresolved, but prostatitis or urethritis with post-inflammatory adhesion of the duct walls seems to be a common underlying pathomechanism. Although a certain constellation of physicochemical semen parameters may lead to correct diagnosis, EDO often resembles a diagnosis by exclusion. Imaging of acquired EDO remains a challenge and the established surgical therapy, transurethral resection of the ejaculatory ducts (TURED), leads to a low rate of natural conception and a high rate of complications such as reflux of urine and epididymitis. We present a case of a male with suspected EDO who underwent a combined approach to both, semi-invasive diagnosis and therapy by transrectal puncture of the seminal vesicles and antegrade balloon-dilation of the ejaculatory ducts. Possibilities and pitfalls of this procedure are described and the literature is reviewed. Furthermore, we suggest a CT- or MRI-guided, percutaneous intervention for treatment of ejaculatory duct obstruction by balloon dilation and demonstrate initial steps of this procedure with a body donor. We call this new procedure PTED (percutaneous transgluteal ejaculatory ductoplasty).http://www.egms.de/static/en/journals/gms/2012-10/000157.shtmlejaculatory ductEDOejaculatory duct obstructionTUREDresection of the ejaculatory ductballoon dilationCTtransgluteal |
| spellingShingle | Ole Kayser Daniar Osmonov Jonas Harde Guido Girolami Thilo Wedel Philipp Schäfer Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention GMS German Medical Science ejaculatory duct EDO ejaculatory duct obstruction TURED resection of the ejaculatory duct balloon dilation CT transgluteal |
| title | Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention |
| title_full | Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention |
| title_fullStr | Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention |
| title_full_unstemmed | Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention |
| title_short | Less invasive causal treatment of ejaculatory duct obstruction by balloon dilation: a case report, literature review and suggestion of a CT- or MRI-guided intervention |
| title_sort | less invasive causal treatment of ejaculatory duct obstruction by balloon dilation a case report literature review and suggestion of a ct or mri guided intervention |
| topic | ejaculatory duct EDO ejaculatory duct obstruction TURED resection of the ejaculatory duct balloon dilation CT transgluteal |
| url | http://www.egms.de/static/en/journals/gms/2012-10/000157.shtml |
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