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

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.