Ejaculatory Duct Obstruction

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Retrograde Ejaculation versus Ejaculatory Duct Obstruction

Low Viscosity

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A male may notice a significant reduction in the amount of semen or none at all during climax. People sometimes call this a dry ejaculation. The consistency can also be more liquid with less viscosity, resembling pre-ejaculatory fluid. Some patients report pain or flaccidity during ejaculation.

Typically, thick and whitish, various conditions can change the color and consistency of semen. Frequent ejaculation may lead to watery sperm. A treatable varicocele could also inflame the veins of the testicles in the scrotum. An STI such as gonorrhoea or chlamydia may inflame the epididymitis.

Tumors or hormonal imbalances, such as zinc deficiency, can degrade quality of sperm. Michael Reitano, MD says that sperm contains vitamin C, B12, ascorbic acid, calcium, citric acid, fructose, lactic acid, magnesium, zinc, potassium, sodium, fat, and hundreds of different proteins. Micronutrient lab tests can detect vitamin or mineral depletion.

The ejaculatory duct obstruction (EDO) semen does not contain enough sperm to impregnate. (Less than 15 million sperm per millilitre of semen is considered below average.) With EDO, there can also be a reduction in the amount of intercourse pleasure for both partners.

Diagnosing

As you would hope, urology professionals do specific testing prior to treatment. This can include chemical analysis of ejaculate, urine sample, and ultrasound. Such tests can reveal low fructose in the ejaculate and evidence of obstruction on transrectal ultrasonography.

Specialists will differentiate EDO from retrograde ejaculation. The latter is when semen enters the bladder instead of emerging through the penis during orgasm.

Retrograde ejaculation isn’t harmful, but it can result in male infertility. Treatment for retrograde ejaculation is generally only needed to restore fertility. Causes may be neurological, as result of surgeries—including prostatectomy—or trauma.

Ejaculatory duct obstruc­tion vs. Retrograde ejaculation comparison chart
Attri­butesEja­cu­la­tory duct ob­struc­tionRetro­grade ejacula­tion
Descrip­tionEjaculatory duct obstruction is a pathological condition which is characterized by the obstruction of one or both ejaculatory ducts. Thus, the efflux of semen is not possible. It can be congenital or acquired.Retrograde ejaculation occurs when semen which would be ejaculated via the urethra is redirected to the urinary bladder.
SymptomWatery or dry ejaculateDry ejaculate
ResultInfertilityInfertility
Spe­cial­tyUrologyUrology

Vas deferens radiography using vas deferens aspiration is an alternative effective and safe method for EDO diagnosis. The procedure involving the dilation of the ejaculatory duct using F9 seminal vesicoscopy is equally effective but has fewer postoperative complications (urine reflux into the seminal vesicle) than TURED.

Treatment

A urologist will schedule successful treatment of EDO by transurethral resection of the ejaculatory duct (TURED). During this outpatient endoscopic procedure through the penis, the doctor first injects dye into the seminal vesicle. He then resects the duct, removes the obstruction, and reconnects. Although transurethral resection is an effective method for the treatment of ejaculatory duct obstruction, the pregnancy rate is low.

Flaccidity or inability to maintain erection may require additional treatment for erectile dysfunction.

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