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    Urologists illustrate key steps in management of duct obstruction


    Transurethral resection of the ejaculatory ducts - Sharad R. Shah, MS, MCh





    This video illustrates a case of ejaculatory duct obstruction (EDO) due to congenital midline cyst. It shows the technique of utricular cannulation and Incision and utricular scopy to treat the obstruction and the postoperative result. The video also briefly discusses cystic and fibrous EDO and criteria to operate.

    Dr. Ramasamy: The prostatic utricle is a small indentation in the prostatic urethra on the verumontanum, laterally flanked by openings of the ejaculatory ducts. Prostatic utricle cysts arise from the level of the verumontanum and are always in the midline. Prostatic utricle cysts can cause ejaculatory duct obstruction resulting in infertility. Dr. Shah demonstrates incision of the prostatic utricle cyst using a Collins knife. The video also demonstrates the anatomy of ejaculatory duct openings within the prostatic utricle cyst. Incising such a cyst can help a man with low ejaculate volume and azoospermia to achieve normal ejaculate volume with sperm in ejaculate.

    Dr. Hotaling: Here Dr. Shah illustrates the diagnosis and treatment of a prostatic utricle cyst with endoscopic resection. This technique can be used to safely resect this and ensure patency.

    Sharad R. Shah, MS, MChSharad R. Shah, MS, MCh

    Dr. Shah is a consultant urologist at Lilavati Hospital and Research Centre, Mumbai, India.



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