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Transurethral resection of the colliculus seminalis offers a method of removing obstructions in the region of the ductus ejaculatorii. Treatment of post-gonadal azoospermia is problematic since, even if the seminal duct is made passable, the sperm quality remains unsatisfactory. Impairment of sperm motility and spermiogenesis itself is suspected as the expression of an auto-immune reaction to distal obstruction.

Although most cases of male infertility are the result of primary testicular abnormalities (either maturation arrest, decreased spermatogenesis, or germinal hypoplasia), obstruction of the genital tract is a well recognized and potentially correctable cause of infertility. Seminal vesiculography is an excellent method of evaluating the male genital tract not only for obstruction but also for other structural lesions that may cause infertility. In 27 patients undergoing vesiculography as part of an evaluation of infertility, obstruction was found in 25%. Three patients (11%) were found to have nonobstructing structural lesions as a possible cause of infertility. Patients with obstructive lesions were found to have significantly lower semen volumes than those with patent outflow tracts. The continued role of seminal vesiculography in the evaluation of male infertility is discussed.

A case is reported of fluid leakage per rectum after ejaculation. The patient was infertile and did not have antegrade or retrograde ejaculation. The cause of this problem is presented.

There are 29 cases of vesiculodeferentography (VDG) (1962-1975) presented. The very indication of VDG was the evaluation of azoospermia due to occlusion of the vas deferens, in addition to other urologic diseases. Especially from the andrologic point of view the various forms of occlusion-azoospermia are classified and analyzed. It is pointed out, that the rete testis region is not to be elucidated by VDG.

The diagnosis, long-range pathophysiology and surgical approach to ejaculatory duct obstruction are presented. Of 5 cases 3 had epididymal extravasation from long-term pressure buildup and secondary epididymal obstruction. This is similar to the epididymal findings after long-term vasectomy.

We report a case of a midline cyst involving both ejaculatory ducts and seminal vesicles. There have been only 3 previous reports in the literature of ejaculatory duct cysts, 1 of which was iatrogenic, and all have been unilateral. However, several cases have been reported of cysts arising from the müllerian duct or seminal vesicle, in which the described anatomy is essentially identical to our case. It is proposed that midline retroprostatic/retrovesical cysts that communicate with both wolffian systems be classified as urogenital sinus cysts.

The clinical condition of obstruction of the ejaculatory ducts and seminal vesicles is described; it may be suspected from the symptoms, and the diagnosis subsequently confirmed by radiology. The method of treatment by transurethral incision or resection is described; the results were encouraging and it is suggested that this neglected clinical problem should receive more attention by urologists.