Male Infertility is one of the most common diseases these days, and the main reason is EDO. So, how are Ejaculatory Duct Obstruction Diagnosis work? You asked well we have designed this article for you.
What is Ejaculatory Duct Obstruction?
Ejaculation occurs when two ducts transport semen from the seminal vesicles to the urethra, where it leaves the penis due to the ejaculatory reflex. There may be an obstruction or blockage in one or both of the ejaculatory ducts, which prevents sperm from entering the ejaculate.
Occasionally, the vents are clogged from birth (known as congenital obstruction), while the block is acquired in other instances.
Dr. Omar has reported several different forms of EDO. Complete or classic EDO is characterized by the occlusion of both ducts and low ejaculate volumes in the presence of no sperm or azoospermia as a presenting feature.
The blockage of one or both vents in an incomplete or partial EDO is referred to as a partial obstruction of one duct or the block of both ducts.
However, in this situation, while there is evidence of ejaculated sperm, the volume, count, and motility are all generally low. Anatomic proof of a physical blockage in the ejaculatory duct is absent in functional EDO, which manifests as typical ejaculatory duct obstruction.
Ejaculatory Duct Obstruction Diagnosis
EDO is diagnosed through a thorough sexual and medical history, a physical examination of the testicles and genitalia, and laboratory testing that examines the semen analysis and reproductive hormones, such as follicle-stimulating hormone (FSH) and testosterone levels, among other things.
When it comes to diagnosing suspected instances of EDO, transrectal ultrasonography (TRUS) is the primary diagnostic instrument to utilize. During this procedure, dilated seminal vesicles, cysts obstructing the ejaculatory ducts, and calcifications in the ducts may be discovered and treated. However, as Dr. Omar’s study has shown, TRUS alone is not always adequate to establish a diagnosis in many situations.
He has discovered that TRUS is quite effective in indicating the presence of a blockage, much like taking a snapshot photograph with a camera. However, to provide a genuinely accurate diagnosis, it should be used in conjunction with other diagnostic procedures that offer a more “dynamic” depiction of the system.
These supplementary procedures include seminal vesicle sperm aspiration, TRUS-guided seminal ventriculography, ejaculatory duct chromotubation, and ejaculatory duct manometry, to name a few examples.
Seminal vesicle sperm aspiration is a procedure that includes drawing fluid from the seminal vesicle to determine whether or not sperm is being produced.
This shows that there are impedes due to the presence of large quantities of sperm in the seminal vesicle fluid. However, this approach does not assist in identifying the location of the blockage or distinguishing between a physical backup and an obstruction that is causing a functional restriction.
Using the methods of chromotubation and ejaculatory duct pressure measurements (manometry), Dr. Omar may more reliably identify between EDO instances caused by a blockage that can be cured surgically and those that are dysfunctional and will not respond to surgery. This enables him to avoid unnecessary surgery whenever it is at all feasible.