Urine Contamination of Seminal Fluid After Transurethral Resection of the Ejaculatory Ducts

Abstract

Transurethral resection of ejaculatory duct obstruction has assumed a significant role in the treatment of infertile men. The potential impact of disruption of the ejaculatory duct apparatus after transurethral resection has not been studied. The seminal plasma of patients was evaluated after transurethral resection of the ejaculatory ducts by determining creatinine levels as a measure of urine contamination of semen. Analysis of semen parameters was retrospectively performed on preoperative and postoperative samples in 8 subfertile men diagnosed with ejaculatory duct obstruction treated by transurethral resection. These were not 8 consecutive patients but rather individuals from a larger series who had seminal plasma frozen preoperatively and postoperatively. A significant increase in seminal plasma creatinine levels post-operatively was detected in 7 of 8 patients evaluated. In patients who were requested to produce 2 specimens within 1 hour high levels of creatinine were found in both ejaculates, although creatinine levels were lower in the second ejaculate. The patient who postoperatively had low levels of creatinine in seminal plasma demonstrated an improvement in sperm concentration and morphology, and his wife became pregnant. Transurethral resection of the ejaculatory ducts results in marked improvement in some semen parameters. However, the impact of urine contamination in semen after transurethral resection of the ejaculatory ducts must be assessed in the management of patients who present with ejaculatory duct obstruction.