Ejaculatory Duct Obstruction: Causes, Symptoms & Treatments

Man talking to doctor about ejaculatory duct obstruction

What is Ejaculatory Duct Obstruction?

Ejaculatory duct obstruction (or EDO), is a blockage of one or both of the ejaculatory ducts, the tubules which transport a mixture of sperm and seminal vesicle fluid into the prostate gland in order to produce semen. An obstructed ejaculatory duct can cause reduced sperm production, low sperm count, infertility and pain after ejaculation.

EDO is the source of infertility in up to 5% of infertile men. However, it is usually treatable.

What Are The Ejaculatory Ducts?

The ejaculatory ducts are a pair of hollow tubules in the male anatomy that are situated on either side of the prostate gland. Each duct is approximately two centimeters long and is formed when the duct of a seminal vesicle merges with the vas deferens.

Sperm is transported to the ejaculatory ducts during sexual arousal and is combined with seminal vesicle fluid to nourish the sperm and keep them active and motile. This mixture then moves into the prostate gland (where it is combined with prostatic fluid) and then enters the bulbourethral glands as semen where it is ready to be ejaculated from the penis via the urethra.

Types of Ejaculatory Duct Obstruction

There are types of ejaculatory duct obstruction (EDO), including:

  • Complete obstruction: Where both of the ejaculatory ducts are blocked.
  • Incomplete obstruction: A complete blockage of one duct, or a partial blockage of both ducts.
  • Functional obstruction: Like a complete obstruction, but not caused by a physical blockage.

Symptoms of Ejaculatory Tube Obstruction

You may also have ejaculatory obstruction (EDO)

  • Pain that occurs during or after sex
  • Low sperm production and/or sperm count
  • Infertility
  • Volume of ejaculate is low (less than 1.5 ml)
  • Blood in the semen
  • Blood in the urine
  • Prostate pain

What Causes Ejaculatory Duct Obstruction?

EDO can be caused by:

    • Cysts
    • Genetic abnormalities
    • Calculi (hard deposits made of minerals and salts)
    • Prostatitis
    • Having had frequent UTIs (urinary tract infections)
    • Epididymitis (inflammation of the epididymis)
    • Scar tissue due to previous pelvic surgery
    • Damage or injury to the urethra

Treatment

The most frequent type of treatment for ejaculatory duct obstruction is a procedure called transurethral resection of the ejaculatory ducts (TURED).  This operation involves inserting a small telescope through the urethra. Then, if possible, any obstructions are removed.

This procedure takes about an hour and is performed under general anesthesia. It is typically conducted on an outpatient basis, meaning you will be able to go home the same day.

A similar procedure that may be used is known as a seminal vesiculoscopy. This involves inserting a telescopic device into the prostate gland in order to remove any duct obstructions.

In some cases, doctors may use both procedures. Because these treatments aren’t always successful, your doctor may recommend that you have your semen frozen before you undergo these procedures.

Recovery After Treatment

You may have a catheter placed in your penis for you to use to urinate for a couple of days or so. After the procedure, you may experience blood in your urine or semen.

You should refrain from engaging in sexual activity until you’ve had a follow-up appointment with your doctor. The catheter will be removed by your provider at that time.

Avoid lifting anything heavier than 10 pounds for the next couple of weeks. You will be prescribed medication to take, such as pain relievers and antibiotics. Your provider will let you know when it is OK to return to work.

Side effects and complications

Some possible side effects or complications of a TURED procedure can include:

  • It is possible that the blockage could return.
  • Epididymitis
  • During ejaculation, you may release watery fluid.
  • Rectal injury
  • It is possible to develop urinary incontinence.

There have been very few side effects associated with the vesiculoscopy procedure. The majority of side effects have been temporary, such as pain.

Even so, some men have reported experiencing a sensation of ejaculating less semen, and/or changes in sexual performance or function.

Contact your healthcare provider promptly if you experience any concerning issues following your surgery, such as:

  • Prolonged or heavy bleeding
  • Intense or new pain
  • Fever and/or chills
  • Swelling
  • Allergic reaction to medication

Can Ejaculatory Duct Obstruction Be Prevented?

Currently, there is no known way to prevent ejaculatory duct obstructions. You can consult with a genetic specialist about specific genetic concerns that you may have.

Conclusion

If you are having trouble starting a family, it is possible that you’ll learn that the problem is due to ejaculatory duct obstruction. The condition may also be diagnosed if you have recurring pain because of EDO.

Although ejaculatory duct obstruction may cause discomfort, it is not dangerous or life-threatening. Very often, your doctor will be able to successfully treat the condition and restore fertility.

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