Department of Andrology and Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian, China.
Institution of Sexual Medicine, The Second Hospital of Dalian Medical University, Dalian, China.
Am J Mens Health. 2024 Sep-Oct;18(5):15579883241281668. doi: 10.1177/15579883241281668.
Ejaculatory duct obstruction (EDO) is a rare but treatable cause of male infertility. This case report describes a 28-year-old male with obstructive azoospermia. The patient came to our hospital after a fertility check-up revealed azoospermia. A subsequent semen analysis confirmed azoospermia. Transrectal ultrasonography (TRUS) and magnetic resonance imaging (MRI) revealed bilaterally enlarged seminal vesicles and thickened, calcified ejaculatory duct walls. The patient underwent transurethral seminal vesiculoscopy and transurethral resection of the ejaculatory ducts (TURED) for presumed partial EDO. Despite two transurethral seminal vesiculoscopy and TURED procedures, postoperative semen analysis still showed azoospermia. TRUS indicated non-contractile seminal vesicles and an unobstructed ejaculatory duct. The patient ultimately underwent percutaneous epididymal sperm aspiration for assisted reproductive technology and his spouse got pregnant. We identified a case of azoospermia caused by a rare combination of partial and functional ejaculatory duct obstruction. There are currently no reports of similar cases. This case report aims to provide valuable insights for diagnosing and treating EDO.
射精管梗阻（EDO）是一种罕见但可治疗的男性不育症病因。本病例报告描述了一位 28 岁的梗阻性无精子症男性患者。该患者在生育检查后发现无精子症，随后到我院就诊。进一步的精液分析证实了无精子症的诊断。经直肠超声（TRUS）和磁共振成像（MRI）显示双侧精囊增大，射精管壁增厚、钙化。患者接受了经尿道精囊镜检查和经尿道射精管切除术（TURED），以明确部分 EDO 的诊断。尽管进行了两次经尿道精囊镜检查和 TURED 手术，但术后精液分析仍显示无精子症。TRUS 提示精囊无收缩功能，射精管通畅。患者最终接受了经皮附睾精子抽吸术，以进行辅助生殖技术，其配偶成功怀孕。我们发现了一例由部分和功能性射精管梗阻罕见组合引起的无精子症病例，目前尚无类似病例的报道。本病例报告旨在为 EDO 的诊断和治疗提供有价值的见解。
