Perineal-guided endoscopic extraction of ejaculatory duct stones to treat obstructive azoospermia.

Objective: To report a case of transurethral endoscopic treatment of ejaculatory duct stones with transrectal ultrasound (TRUS)-guided perineal needle implant and ureteroscopic extraction of deferent duct stones in an infertile man.
Design: Case report.
Setting: Department of Urology, University of Catania, Italy.
Patient(s): A 33-year-old man with azoospermia, low ejaculate volume, perineal discomfort, and unilateral seminal tract dilatation caused by obstructing lithiasis of the ejaculatory and deferent ducts.
Intervention(s): Transurethral endoscopic treatment of ejaculatory duct stones with TRUS-guided perineal needle implant and ureteroscopic extraction of deferent duct stones.
Main Outcome Measure(s): Improvements in symptoms and seminal parameters.
Result(s): The patients had successful relief of symptoms and correction of obstructive azoospermia.
Conclusion(s): This new technique allows a more rapid and targeted identification of ejaculatory duct lithiasis, and the ureteroscope enables management of distal seminal stones through the normal anatomic tract.
(Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)