Ejaculatory duct obstruction

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

• Ejaculatory duct obstruction may be either congenital or acquired. Because the hypothalamic pituitary gonadal axis is intact, serum hormone levels are normal.

Classification

Ejaculatory duct obstruction may be complete or partial.

• Complete form: patients have a total absence of sperm in the ejaculate
• Partial form: sperm are found in the semen but exhibit reduced numbers, reduced motility, on both. Ejaculate volume is consistently decreased.

Causes

• Causes include idiopathic, transurethnal endoscopic procedures, urethral catheterization, and urethritis.

Diagnosis

Diagnosis of ejaculatory duct obstruction is suggested by the presence of a cyst posterior to the prostatic urethra, with on without dilatation of the seminal vesicles.

MR images demonstrate left ejaculatory duct obstruction

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