Ejaculatory Duct Obstruction - Symptoms & Risk Factors скачать в хорошем качестве

Ejaculatory Duct Obstruction - Symptoms & Risk Factors

Ejaculatory duct obstruction causes infertility in 5% of azoospermia cases. Duct obstruction can result from seminal vesicle calculi, mullerian duct or wolffian duct (diverticular) cysts, postsurgical or post inflammatory scar tissue, calcification near the verumontanum, or congenital atresia. Classically, this condition presents as hematospermia, painful ejaculation, or infertility with azoospermia. Associated risk factors include evidence of prior urinary tract infection or trauma and perineal pain or discomfort. It is important to discontinue medications that may impair ejaculation, like thiazides, prazosin, phentolamine and anti-psychotic medications. Anti-hypertensive agents and selective serotonin reuptake inhibitors (SSRI) are found to impair ejaculation. Ejaculatory duct obstruction is suggested by finding enlarged, palpable seminal vesicles on rectal examination. An ejaculate volume less than 1 mL and a Semen pH less than 7 that contains no sperm or fructose is suggestive of ejaculatory duct obstruction.