Is Ejaculatory Duct Obstruction Rare?
Yes, ejaculatory duct obstruction (EDO) is rare, occurring in up to 5% of infertile men, making it an uncommon but surgically correctable cause of male infertility. 1, 2, 3
Prevalence and Clinical Context
- EDO is explicitly described as "rare in infertile males" by the American Urological Association/American Society for Reproductive Medicine guidelines 1
- The condition is diagnosed in up to 5% of men undergoing infertility evaluation, representing a small minority of male infertility cases 2, 4, 3
- Despite its rarity, EDO remains clinically significant because it is one of the few surgically correctable causes of obstructive azoospermia 2, 4
Why EDO Diagnosis Has Increased
- With the advent of high-resolution transrectal ultrasonography (TRUS) and pelvic MRI, there has been an increase in the diagnosis of this disorder over the past two decades 2, 4, 5
- Improved imaging technology has allowed better identification of anatomical abnormalities including dilated seminal vesicles, ejaculatory duct dilation, and prostatic cysts that suggest obstruction 1, 6
- Increased awareness of partial or functional EDO has led to more frequent recognition of this condition 5
Clinical Significance Despite Rarity
- EDO should be considered in the differential diagnosis for any infertile male presenting with the characteristic triad: low ejaculate volume (<1.4 mL), acidic semen (pH <7.0), and azoospermia or severe oligospermia 6
- The condition is surgically correctable through transurethral resection of ejaculatory ducts (TURED), with approximately 50% of patients showing improvement in semen parameters and 25% achieving pregnancy 6, 7
- Early endoscopic treatment can prevent progression from partial to complete bilateral obstruction 2