Treating Ejaculatory Duct Obstruction

  There are several options for treating ejaculatory duct obstruction. We list four treatment methods from least harmful to most invasive.

1. Repetitive prostatic massage, with or without antibiotics
2. Washout of the ejaculatory ducts
3. Dilation of the ejaculatory ducts
4. Resection of the ejaculatory ducts

Resection of the ejaculatory ducts

  If there is an obstruction to the ejaculatory duct, and other methods do not clear it, transurethral resection of the ejaculatory ducts can be performed, if the obstruction is distal enough to be reached.

  This is completed in the operating room with the use of anesthesia. The operation can be performed on an outpatient basis, or with one night’s hospitalization, through a small telescope placed into the urethra. No skin cutting is needed. The incision is made inside the prostate. A urinary catheter that passes through the urethra into the bladder may be required for a day or two post-operatively.

   Blood may be present or noted in the urine post-operatively in the ejaculation. The patient should refrain and avoid from sexual action for one week or more. One month after the procedure a semen analysis is usually performed.

   One can expect a 50 to 80 percent chance of improvement in semen quality, and if semen quality is improved, approximately 50 percent probability of pregnancy is expected. As in any type of surgery there is a risk of bleeding and infection. In this procedure the risk is about 1 percent. Complications of the procedure are rare. Scarring may re-block the ejaculatory ducts, necessitating a repeat resection.