What is Sperm duct blockage?

Sperm duct blockage is also known as Ejaculatory duct obstruction(EDO) which is an obstruction of one or both ejaculatory ducts, which prevents you from expelling sperm into semen while ejaculating. The ejaculatory ducts are paired structures in male anatomy. When the ejaculatory ducts are blocked in some way, this can result in low semen volume, low sperm count, and a much lower likelihood of conceiving a child through natural means(Infertility). EDO can be a congenital or acquired condition.

It’s estimated that ejaculatory duct obstructions make up about 1 percent to 5 percent of all cases of male infertility.

Ejaculatory duct obstruction must not be confused with an obstruction of the vas deferens.

Symptoms of Ejaculatory duct obstruction

Symptoms of Ejaculatory duct obstruction include 

• Hematospermia ( presence of blood in ejaculation )

• Painful ejaculation
• Infertility. 
• Pelvic pain.
• In some cases, men may notice pain while having intercourse. 

When patients notice pain associated with ejaculation, this is a good indication that medical help is necessary. 

Cause of Ejaculatory duct obstruction

There are two ejaculatory ducts, left and right side, that are formed by the union of the duct from the seminal vesicle and the vas deferens. If both ejaculatory ducts are completely obstructed, affected men will demonstrate male infertility due to Ejaculatory duct obstruction.

How to diagnose Ejaculatory duct obstruction?

When your doctor suspects that you have an EDO, he may order an ultrasound to determine its location.

If you have an ejaculatory duct obstruction, your ejaculate will be low in fructose and pH level, which your Urologists can detect with a chemical analysis.

Types of Ejaculatory duct obstruction 

There are different forms of ejaculatory duct obstruction. They are as follows:

• Complete/Classic EDO – Complete obstruction of the ejaculatory ducts resulting in low sperm or semen volume.
• Incomplete/Partial EDO – Blockage of just one of the ejaculatory ducts resulting in lower ejaculate volume and lower semen volume.
• Functional EDO – Similar to classic EDO, but there is no evidence of a physical blockage present.

Treatment of Ejaculatory duct obstruction

The medicines used to treat EDO can cause certain side effects like erectile dysfunction. So, Transurethral resection of the ejaculatory duct(TURED) is considered a more definitive treatment of EDO.

In terms of addressing the blockage directly the same transurethral resection of the ejaculatory ducts (TURED) is considered. This procedure is effective in about 20% of men who are affected by ejaculatory duct obstruction.

Transurethral resection of ejaculatory ducts (TURED). 

Transurethral resection of ejaculatory duct or TURED is an effective surgical treatment for unblocking the ejaculatory duct obstruction. This is an outpatient procedure performed endoscopically, with instruments inserted into the patient’s penis. Ejaculatory duct obstructions (EDO)can be congenital, (due to abnormal development as a fetus) or acquired. Acquired obstructions may be secondary to trauma or infection/inflammation. Obstructed ejaculatory ducts are usually diagnosed by transrectal ultrasound imaging or by special radiographic tests called vasograms.

Transurethral resection of the ejaculatory duct results in the appearance of sperm in the ejaculate in 50-75% of cases. The pregnancy rate achieved by this surgery is about 25%.

Is TURED treatment Effective?

Men after TURED treatment have shown great improvements in their semen quality and were also successful in impregnating their partner.

Hematospermia and Ejaculatory obstruction have been effectively treated after TURED surgery.

In some rare cases, the complications in TURED is blood in the urine and watery ejaculate.

Conclusion 

 Partial EDO, whatever the etiology, has an excellent outcome after TURED treatment. One need not panic as curable and it’s very uncommon and might not be the reason for not conceiving.