ABSTRACT
"Objective: The aim of this work is to evaluate the efficiency of transurethral resection (unroofing) of the obstructed ejaculatory ducts (TURED) as a treatment alternative for cases of obstructive ductal azoo-/ oligozoospermia Patients and Methods: Thirty-two patients; aged 26 to 45 (mean age 34 years) with varying degrees of ejaculatory duct obstruction (EDO) were selected from a large pool of infertile patients with low semen volume presenting to the outpatient clinic of the Andrology Department of Kasr el Aini Hospital; Cairo; Egypt. The patients (24 with complete and 8 with partial EDO) were then transferred to the Urology Department of the same hospital for surgical treatment performed by one surgeon. The treated patients were sent back to the Andrology Department for follow-up lasting 6 to 30 months (mean 18 months). Follow-up included history taking; physical examination and repeated semen analysis. Results: There was a statistically significant improvement in all ""mean"" semen parame-ters following TURED. Furthermore; 42of the azoospermic (bilateral complete EDO) and 63of the oligozoospermic patients (partial EDO) showed improvement in their semen parameters after TURED yielding an overall improvement rate of 47among treated patients. Pregnancy was achieved in about 17of the azoospermic and in 25of the oligozoospermic patients. The overall pregnancy rate was 19. Prolonged hematuria was the only complication; encountered in only 2 patients; and was managed conservatively. Conclusion: TURED is an effective line of treatment for cases of EDO. Used judiciously; this technique can yield satisfactory results with limited morbidity in this challenging patient population. The better response of partial EDO as compared to TURED warrants further studies involving a larger number of patients."