Transrectal ultrasonography in the etiological diagnosis of male obstructive azoospermia: analysis of 695 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the role of transrectal ultrasonography (TRUS) in the etiological diagnosis of male obstructive azoospermia.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data and TRUS findings of 695 patients with obstructive azoospermia from January 2007 to May 2009.</p><p><b>RESULTS</b>Concerning the etiology of obstructive azoospermia, the main TRUS findings included ejaculatory duct abnormality (29.2%), seminal vesicle abnormality (25.4%) and prostate midline cyst (18.5%). TRUS revealed 203 cases of ejaculatory duct dilation, 177 cases of seminal vesicle abnormality (including 108 with absence or agenesis and 51 with dilation of the seminal vesicle), and 128 cases of prostate midline cyst (including 75 with ejaculatory duct cyst and 39 with Müllerian cyst). Calcification of the verumontanum or ejaculatory duct was suspected to be the causes of obstructive azoospermia in 34 cases. However, no significant etiological abnormality was found in 153 cases. Obvious etiology was shown by TRUS in 78.0% of the patients.</p><p><b>CONCLUSION</b>TRUS can clearly display the structural abnormality of the ejaculatory duct and seminal vesicle, and provide important information on the etiology of male obstructive azoospermia.</p>

Value of transrectal ultrasonography in the diagnosis of midline prostatic cysts / 中华男科学杂志

<p><b>OBJECTIVE</b>To assess the value of transrectal ultrasonography (TRUS) in the diagnosis of midline prostatic cysts.</p><p><b>METHODS</b>We retrospectively analyzed the TRUS manifestations of 87 cases of midline prostatic cysts.</p><p><b>RESULTS</b>Of the total number, 33 cases were diagnosed as Müllerian duct cysts, 21 cases ejaculatory duct cysts and the other 33 cases undifferentiated midline prostatic cysts; 19 cases had dilated seminal vesicles, 19 seminal vesicle agenesis, 9 seminal vesiculitis and 5 dilation of the ejaculatory duct.</p><p><b>CONCLUSION</b>TRUS, convenient, sensitive, safe and non-invasive, is a desirable method for the diagnosis of midline prostatic cysts.</p>

Sonographic features and clinical significance of transrectal ultrasonography in obstructive azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the ultrasonographic features of obstructive azoospermia and to evaluate transrectal ultrasonography in the diagnosis of the disease.</p><p><b>METHODS</b>We performed transrectal ultrasonography for 248 patients with obstructive azoospermia, observed the sonographic features of the prostate gland, seminal vesicle and ejaculatory duct.</p><p><b>RESULTS</b>The average volume of the prostate gland of the studied group was 13.2 ml. A total of 111 cases showed normal sonographic features, 39 cases bilateral seminal vesicle defect, 33 cases bilateral seminal vesicle aplasia, 23 cases unilateral seminal vesicle defect and contralateral seminal vesicle aplasia, 28 cases bilateral and 14 cases unilateral seminal vesicle dilatation. Of the 42 cases of seminal vesicle dilatation, 18 had ejaculatory duct dilatation and 17 had cysts in the midline of the prostate.</p><p><b>CONCLUSION</b>Obstructive azoospermia varies in kind. Transrectal ultrasonography can reveal the details of the prostate, seminal vesicle and ejaculatory duct and help to classify obstructive azoospermia and determine the location of the lesion.</p>

Surgical therapy for azoospermia with ejaculatory duct obstruction / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of transurethral resection of ejaculatory ducts (TURED) for azoospermia with ejaculatory duct obstruction (EDO).</p><p><b>METHODS</b>From June 2003 to December 2004, 20 azoospermia with EDO were diagnosed, diagnostic criteria included a history, physical examination, semen analyses, semen fructose measurement, endocrine assessment, testicular biopsy and transrectal ultrasonography (TRUS); All 20 cases were treated by TURED. Fifteen of them were followed up more than 3 months after the treatment. The semen samples of them were analysed at 3-month intervals in post-therapy.</p><p><b>RESULTS</b>Semen analyses in all 20 cases showed the typical characteristics of EDO, low semen volume (0.4-1.6 ml), azoospermia, low pH, absent or low semen fructose. TRUS showed the main etiology factor of EDO was a midline cyst in 11, lateral cystic lesions in 2, the remaining 7 cases had dilated ejaculatory duct with or without dilated seminal vesicles. Among 15 cases followed up more than 3 months after TURED, 10/15 (67%) had an improvement in semen parameters and 3/15 (20%) had pregnancies. Semen analyses had not been done in anther 5 cases.</p><p><b>CONCLUSION</b>Transurethral resection of ejaculatory ducts may be a safe and effective method for the treatment of azoospermia with EDO.</p>