Ejaculatory Duct Research Articles

Simultaneous prostatic and right seminal vesicle abscesses: a case report

BackgroundSynchronous abscesses of the prostate and seminal vesicles represent a rare but clinically significant form of purulent retention. They pose diagnostic and therapeutic challenges and are associated with considerable morbidity and a high risk of sepsis.Case presentationWe present the case of a 60-year-old Caucasian man with a history of insulin-dependent diabetes mellitus, who had a voluminous prostatic abscess associated with a right seminal vesicle abscess due to compression of the right ejaculatory duct, and who presented to our department with sepsis. He had clinical and radiological confirmation with computed tomography scan and magnetic resonance imaging. The patient underwent percutaneous drainage of the prostatic abscess resulting in the subsidence of the seminal vesicle abscess. The treatment also consisted on prolonged antibiotic therapy. The clinical evolution was favorable.ConclusionWe conclude that prostatic abscesses can lead to synchronous seminal vesicle abscesses due to ejaculatory duct compression. Percutaneous drainage of the prostatic abscess by transrectal ultrasound-guided drainage, combined with prolonged antibiotic therapy, can effectively treat both abscesses.

Post-eclosion growth in the Drosophila Ejaculatory Duct is driven by Juvenile Hormone signaling and is essential for male fertility.

The Drosophila Ejaculatory duct (ED) is a secretory tissue of the somatic male reproductive system. The ED is involved in the secretion of seminal fluid components and ED-specific antimicrobial peptides that aid in fertility and the female post-mating response. The ED is composed of secretory epithelial cells surrounded by a layer of innervated contractile muscle. The ED grows in young adult males during the first 24h post-eclosion, but the cell cycle status of the ED secretory cells and the role of post-eclosion ED growth have been unexplored. Here, we show that secretory cells of the adult Drosophila ED undergo variant cell cycles lacking mitosis called the endocycle, that lead to an increase in the cell and organ size of the ED post eclosion. The cells largely exit the endocycle by day 3 of adulthood, when the growth of the ED ceases, resulting in a tissue containing cells of ploidies ranging from 8C-32C. The size of the ED directly correlates with the ploidy of the secretory cells, with additional ectopic endocycles increasing organ size. When endoreplication is compromised in ED secretory cells, it leads to reduced organ size, reduced protein synthesis and compromised fertility. We provide evidence that the growth and endocycling in the young adult male ED is dependent on Juvenile hormone (JH) signaling and we suggest that hormone-induced early adult endocycling is required for optimal fertility and function of the ED tissue. We propose to use the ED as a post-mitotic tissue model to study the role of polyploidy in regulating secretory tissue growth and function.

Dissection of the Male Urethra Demonstrating Its Topographical Specificity.

The urethra is a long muscular tubular organ that changes its internal configuration as it traversesdifferent regions. Therefore, the pathology of each region is distinctive, and regional characteristics may influence exploration and treatment. We set out to perform detailed dissections of the male urethra and illustrate the regional specificity for each urethral segment. Therefore, we dissected the vesical cervix, showing both the normal appearance and the appearance of prostatic middle lobe adenoma. We dissected the prostatic urethra, showing the seminal colliculus, ejaculatory ducts, and prostatic utricle. We revealed the membranous urethra surrounded by the striated sphincter. We have shown the appearance of the spongy urethral bulb with its cul-de-sac appearance, the aspect of the urethral lacunae, the navicular fossa, and the external urethral meatus. We performed cross-sections through the prostatic urethra as well as dissection of the bulbourethral glands at the level of the urogenital diaphragm. All the information obtained through dissection is illustrated in high-quality graphic form and correlated with clinical applications, making this work valuable teaching material.

Trans-rectovesical pouch urethral-sparing robotic-assisted simple prostatectomy: A case series.

To detail a novel technique of robotic-assisted simple prostatectomy that makes handling the gland protruding into the bladder neck easier and can preserve the urethra and retain ejaculation function as much as possible. This is a prospective case series. Clinical data of 17 male patients who had large volume (>80 mL) benign prostatic hyperplasia (BPH) were enrolled to undergo trans-rectovesical pouch urethral-sparing robotic-assisted simple prostatectomy (usRASP). We adopted the approach through the space between the bladder neck and seminal vesicle to perform a usRASP that can avoid the detrusor skirt and fibrous matrix area of the retropubic prostate. Between the transitional zone and the peripheral zone of the large prostate, the hyperplastic prostatic gland tissue can be enucleated under direct vision while preserving the prostatic urethra and retaining the ejaculatory duct and bladder neck intact. All preoperative, perioperative and postoperative clinical data were collected, and descriptive analysis was performed. The median intravesical prostatic protrusion was 19.3 mm (8.5-32.2). The median operative time was 100 min (75-140), and the median estimated blood loss was 100 mL (10-500). The median time to catheter removal was 7 days (5-7), with a median postoperative hospital stay of 2 days (2-4). After at least 6-month follow-up, the median maximum urine flow rate and postvoid residual volume were 40.1 mL/s (12.7-52.4) and 15 mL (5-23), respectively; the median International Prostate Symptom Score and Quality of Life score were 0 (0-6.3) and 1 (0-3), respectively; and the median total prostate-specific antigen was 0.84 ng/mL (0.15-1.01). All patients successfully underwent usRASP. Fifty-eight percent of patients with normal ejaculation function before surgery can still retain normal ejaculation function. We described a new approach to performing usRASP. This new method remarkably improved the voiding function, maintained antegrade ejaculation and did not increase the post-operative complications.

A case with an ectopic ejaculatory duct opening into the bladder trigone in Zinner syndrome, congenital unilateral renal agenesis, and an ipsilateral seminal vesicle cyst

IntroductionThis report describes a case with an ectopic ejaculatory duct opening into the bladder trigone in Zinner syndrome, congenital unilateral renal agenesis, and an ipsilateral seminal vesicle cyst.Case presentationThe patient was identified when no left kidney was detected in the fetal period. Abdominal ultrasonography and pelvic plain MRI at 6 months old revealed a 10‐mm cystic lesion on the dorsal aspect of the bladder. Cysto‐urethroscopy at 1 year old revealed a rather short posterior urethra and right and left inferior crests extending from the posterior urethra beyond the bladder neck. The ejaculatory duct opening was identified on the bladder trigone.ConclusionAnatomical abnormality of the ejaculatory duct may represent a cause of infertility and ejaculatory dysfunction in Zinner syndrome. Endoscopic evaluation should be performed for this rare anomaly, even in children.

Isolated spermatic cord metastasis of prostate cancer after radiotherapy detected with 18F-PSMA PET/CT: a case report and literature review.

We report the case of a 65year-old male with prostate cancer previously treated with external beam radiotherapy and 2years of androgen deprivation therapy. His nadir PSA reached undetectable level but gradually increased to 0.89ng/dL. 18F-PSMA PET/CT demonstrated a PSMA-avid lesion at left spermatic cord. Left groin exploration revealed an 8mm left vas deferens mass. Mass excision was performed and pathology result showed prostatic adenocarcinoma. The metastatic route is unknown but the possible routes are intraluminal route via ejaculatory duct, hematogenous route and lymphatic route. This case also highlights the role of 18F-PSMA PET/CT to detect a recurrent lesion at an atypical site in biochemical failure patients even at the low PSA level.

Zinner syndrome: a radiological journey through a little known condition.

Zinner syndrome is a rare congenital urological entity, secondary to an alteration in embryogenesis between 4th and 13th weeks of gestation, specifically because of abnormalities in the development of the distal mesonephric duct. It is characterized by the triad of unilateral renal agenesis, cystic dilatation of the ipsilateral seminal vesicle and ipsilateral ejaculatory duct obstruction. The aim of this article is to provide the reader with all the necessary information to be able to suspect the presence of this syndrome, reviewing its physiopathology, clinical manifestations and the imaging techniques that enable its diagnosis, emphasizing those radiological findings by MRI that should lead us to think about it. This work is illustrated with representative radiological images of cases belonging to our institution, including patients with different variants of Zinner syndrome. We also include an overview of the embryology of the male urogenital system, to remember the role of the mesonephric duct and the ureteral bud in the formation of the different urogenital structures, as well as a differential diagnosis that allows us to differentiate seminal vesicle cysts from other pelvic cystic lesions.

Zinner syndrome in a case of male infertility: a case report

Zinner syndrome is a rare congenital malformation formed by the developmental anomaly of distal portion of the wolffian duct. It is an unusual cause of infertility and dysuria among young males. It is associated with ipsilateral renal agenesis, seminal vesical cyst, and ejaculatory duct obstruction. We herein report a rare case of a Zinner syndrome, in a patient of primary infertility. He also presented with complaints of chronic pelvic pain and dysuria. Any young patients of male infertility or unspecified pelvic complaints should be evaluated for Zinner syndrome and surgical intervention is the mainstay treatment for symptomatic patients.

"Amyloidosis of the Prostate Gland, Seminal Vesicles and Ejaculatory Ducts: Review and Update"

"Amyloidosis of the Prostate Gland, Seminal Vesicles and Ejaculatory Ducts: Review and Update"

Systematic Review of Zinner syndrome

Zinner syndrome is characterized as a pathology of congenital origin in which there is a unilateral absence of the kidney, presence of cysts and obstruction in the ejaculatory ducts. Being diagnosed in the stage of sexual activity of patients, it can cause problems in the person's sexuality or reproduction. The objective of this work was to carry out a systematic review of clinical cases reported in the literature between 2013 and 2023. 42 reports of clinical cases with Zinner syndrome were evaluated, with a total of 49 patients with a mean age of 22.5 years, the 77.55 % of the patients presented cysts, absence of the right kidney in 44.90 % of the patients, and 91.84 % presented pain. The most common treatment for this pathology was laparoscopy (16.33 %) and in the reviewed cases there were no complications or deaths. Identifying the different presentations of this syndrome could improve the speed of diagnosis and guarantee effective management, thereby improving the quality of life of patients.

Holmium Laser Incision of Ejaculatory Duct (HoLIED): Surgical Procedure

Introduction: Ejaculatory duct obstruction is a well-known cause of infertility and many other symptoms, such as hematospermia and lower urinary tract symptoms. Diagnosis is made based on the medical history and a series of imaging tests identifying the obstructed ducts. Transurethral resection of the ejaculatory ducts is the mainstay treatment to release the obstruction. In this step-by-step surgical video, we will describe a novel technique using the holmium laser to incise the ejaculatory ducts in a patient with chronic lower urinary tract symptoms, hematospermia, and persistent urethral discharge. Materials and Methods: A pelvic MRI was obtained in workup of the above issues and identified a complex ejaculatory duct cyst. The patient consented for Holmium Laser Incision of Ejaculatory Duct. A holmium laser fiber was used through a 24F rigid cystoscope to unroof the ejaculatory duct cyst, resulting in the drainage of a dark brown fluid. Following unroofing of the cyst, the ejaculatory ducts were identified using a 17F rigid cystoscope and a 16F Foley catheter was inserted. Results: The Foley catheter was removed on POD1, and the patient was able to void. His symptoms improved progressively with time and antibiotics. A repeat MRI was obtained several months postoperatively and showed the resolution of the cystic lesion. Conclusion: Holmium Laser Incision of Ejaculatory Duct is safe and feasible procedure allowing to treat ejaculatory duct obstruction without increased risk of complications.

Anatomy and histology of the male reproductive tract of the parasitoid wasp Hymenoepimecis bicolor (Brullé, 1846) (Hymenoptera: Ichneumonidae)

AbstractHymenoepimecis wasps (Hymenoptera: Ichneumonidae) are ectoparasitoids of spiders that modify the hosts’ behaviour by inducing changes in webs. Variations in the male reproductive tract contribute to enhancing our understanding of the reproductive behaviour of these insects. This study describes the morphology of the male reproductive tract of Hymenoepimecis bicolor (Brullé, 1846) using light microscope. The male reproductive tract of H. bicolor consists of a pair of testes, each containing a single follicle, two vasa deferentia, one ejaculatory duct and two accessory glands. The testis follicle has cysts at various stages of spermatogenesis, indicating ongoing sperm cell development and maturation. The vasa deferentia are elongated, with a coiled distal portion, whereas the proximal regions are laterally associated with a pair of accessory glands. The wall of the vasa deferentia has simple cuboidal epithelium. The accessory glands had a simple columnar epithelium with the lumen filled with heterogeneous content. The seminal vesicle is absent. The similarity in the anatomy and histology of the male reproductive tract of H. bicolor with other Hymenoptera suggests that the parasitoid behaviour does not result in significant alteration to their reproductive organs, indicating that the reproductive tract is conserved in Hymenoptera, regardless of their behaviours.

Zinner syndrome: A rarer variant of a rare syndrome

Zinner syndrome, characterized by the combination of absent unilateral kidney, obstructed ejaculatory duct on the same side, and cysts in the seminal vesicle, represents a rare congenital malformation of the mesonephric duct. Its symptoms are often vague, ranging from urinary discomfort to painful ejaculation and infertility, making it difficult to diagnose without imaging. In this report, we discuss a less common form of Zinner syndrome identified through diagnostic imaging.

(073) A Novel Method——Identifying Anejaculation or Retrograde Ejaculation by Transrectal Dynamic Ultrasound (Report of 11 Cases)

Abstract Introduction Ejaculation is what we can see whereas orgasm is what we feel. Hence, the presence of ejaculate does not indicate the ability to experience orgasm. Having orgasm without ejaculate may be due to anejaculation (AE) or retrograde ejaculation (RE). Retrograde ejaculation is usually diagnosed by finding sperm in a urine sample after orgasm. However, it can be difficult to differentiate in cases of very low semen volume, previous vasectomy, ejaculatory duct obstruction, or azoospermia. Objective This study aims to explore the use of transrectal dynamic ultrasonographic (US) to observe the process of ejaculation, direction of seminal flow, and changes in seminal vesicles, ejaculatory ducts, and bladder neck during orgasm, providing visual differentiation between AE and RE. Methods US observations were conducted on 11 patients who experienced orgasm without ejaculate. Results Among the 11 patients (7 with diabetes, 1 with congenital megacolon surgery, 1 with urethral stricture), 3 patients had unsuccessful examinations due to discomfort or technical issues with the transrectal ultrasound probe. Successful observations were made in 8 patients, where 5 patients showed contraction of the seminal vesicles and incomplete closure of the bladder neck during orgasm, leading to RE. In 3 cases, no changes in the seminal vesicles or bladder neck were observed, and no seminal flow was seen, leading to AE. Conclusions Dynamic ultrasonographic allows for the observation of the ejaculation process and understanding of the changes in seminal vesicles and bladder neck during orgasm, enabling differentiation between AE and RE. Disclosure No.

(257) Prostate w-point orgasm decrypted W

Abstract Introduction Erectile dysfunction is a common disease, accounting for about 50% of adult males. No matter oral“Viagra” or surgical treatment, there are unsatisfactory, especially in the middle-aged and elderly men, there is no way, there are widowed and disabled groups. Only rely on ejaculation to get pleasure, will lose at least a third of the sex life. Prostate disease accounts for about 25 percent of the sexual dysfunction. Therefore, through the clinical observation of more than 50,000 patients, the author has improved the Prostate massage method and explored the effectiveness of diagnosis, treatment and rehabilitation not only for prostate diseases, but also for prostate diseases, a new model of male sexual pleasure-the w-spot massage technique-has also been found. 50%, 25%, 5-W. Objective To investigate a convenient and effective prostate W-spot orgasm. W. Methods 200 cases were randomly selected from prostate disease recovered patients aged 40–60 years. They were divided into two groups, an observational one and a control one with a ratio of 1:1, the experimental group used the prostate W-spot massage (massage path resembles the letter W, hence the name) method, the control used the conventional prostate P massage method (P is the initials of Prostate, no specific positioning). After 1 or 2 courses of the treatment, the efficiency was investigated by questionnaires and interviews were conducted to compare the advantages and disadvantages (W and P were substituted throughout the text).200, 40–60, W (W)P (P Prostate) 1–2 (WP). Results 91% effective rate for W and 73% effective rate for P.W 91% P 73%. Conclusions 1. W is better than P. 2. A certain duration of W-spot massage can help excrete prostate fluid, prevent or relieve prostatitis, facilitate the recovery of prostate disorders and timely detect the prostate tumors. 3. The W-spot massage path coincides with the intersection of multiple meridian paths in Chinese medicine, especially the Ren and Du meridians which intersect here. Massage can smooth and refresh Blood and Qi according to Chinese medicine theory. 4. Prostate W-spot massage is another way of sexual pleasure for non-heterosexual interpersonal sexual relations men, gay men and those who have erectile dysfunction. It may also be conducive to the rehabilitation of certain erectile dysfunction. The prostate massage path can directly stimulate the ejaculatory ducts, producing an experience similar to that of an ejaculatory orgasm. However, its pleasurable physiological mechanism is unrelated to penile erection or stimulation, thus without an “off period” for prostate orgasm. 1. WP, 2.W, 3. 4.W, 5.W. Disclosure No.

Morphology of the Male Reproductive System and Spermatozoa of Mahanarva fimbriolata (Stål, 1854) (Hemiptera: Cercopidae) with evidence of a spermatostyle in the sperm conjugation.

Changes in harvesting methods in the early 1990s led to Mahanarva fimbriolata becoming the most prevalent pest in sugarcane plantations. Encouraged by the scarcity of research on the reproductive system and spermatology of Auchenorrhyncha, we provide a detailed description of the male reproductive system and spermatozoa of this cercopid. This will not only aid in taxonomic purposes but also help in understanding the reproductive biology of the species. The male reproductive system, spermatozoa, and sperm bundles of M. fimbriolata were investigated using light microscopy. Our results reveal a reproductive system consisting of a pair of testes, each with 36 follicles, two vasa deferentia, two well-developed seminal vesicles, a single pair of accessory glands, and an ejaculatory duct. Here, we also describe and explore the particularities of the formation of secondary sperm bundles, where cells interestingly bind only to the apical region of the spermatostyle. We also propose some possible benefits of this unusual organization for the reproductive success of the species.

The Utilization of Fine-Needle Vasography to Localize Obstruction of the Male Reproductive Tract

ObjectivesTo report our experience using fine needle vasography (FNV) to identify a site of obstruction and determine candidacy for reconstructive procedures in patients presenting with suspected obstructive azoospermia or cryptozoospermia. MethodsWe report a multi-institutional case series of patients with suspected complete or partial obstructive azoospermia. Patients that were included had azoospermia or cryptozoospermia, presence of palpable vasa, testicles ≥12 ml, and FSH <7.6 IU/L. All patients underwent testicular biopsy prior to or at the time of FNV to confirm spermatogenesis. FNV was performed using a 25-gauge angiocatheter, with radio-opaque dye visualized under fluoroscopy. Descriptive statistics are reported as median and interquartile range (IQR). ResultsA total of 16 patients underwent vasography from 2014-2022 with three surgeons. Twelve patients presented with azoospermia, and four with cryptozoospermia. A total of 7 (44%) men were found to have distal obstruction on FNV. Of the eight men with prior inguinal hernia repairs, two were confirmed to have an obstruction at the level of the inguinal canal. Of the six patients with a history of genitourinary infection, four had an obstruction at the level of the epididymis (with normal FNV), while two had atresia of the vas deferens in the pelvis. ConclusionFNV is an effective, minimally-invasive way to identify the site of complete or partial obstruction in patients presenting with suspected obstructive azoospermia / cryptozoospermia. It additionally permits identification of men who are candidates for epididymovasostomy reconstruction and helps to differentiate between ejaculatory duct obstruction (EDO) and other causes of blockage.

Aquablation: An overview of a novel, minimally invasive surgical modality to treat benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) is a highly prevalent condition among aging men with significant negative impacts on quality of life. Although multiple surgical treatment modalities exist, there is an ongoing search for minimally invasive techniques to reduce hospital stays and adverse effects without compromising good functional outcomes. Aquablation is a novel minimally invasive surgical technique that combines robotic precision with heat-sparing ablation of obstructing prostate tissue. We describe the setup and mechanism of action of aquablation. A comprehensive literature search for clinical trials and recent meta-analyses was conducted and functional outcomes and adverse effects across multiple studies are summarized here. Aquablation produces comparable (if not superior) outcomes in terms of reduced International Prostate Symptom Score, improved Qmax (comparison of maximum flow velocity), and lower postvoid residuals to transurethral resection of the prostate. These findings are consistently reproduced across multiple clinical trials, including those conducted in the private sector. One major benefit of aquablation is that the risk of injury to the ejaculatory ducts appears to be significantly lower, as evident from the low percentage of cases of postoperative anejaculation issues. Adverse effects are rare, and the most significant one to mention is blood loss requiring transfusion. At present, the overall cost of aquablation is still higher than other methods of treating BPH and this is due to intraoperative and equipment costs. Postoperative care is no more expensive than other methods of BPH treatment. In conclusion, aquablation is a safe and effective surgical modality for the treatment of BPH. It can be offered as an alternative to other surgical modalities for those who wish to spare ejaculatory function. The procedure itself can be easily taught. With further development of this novel technology and increased availability, there is the potential for it to become a much more cost-effective method for surgical treatment of BPH.

Robotic excision of a giant seminal vesicle cyst

Abstract Zinner syndrome is a rare congenital condition characterized by unilateral renal agenesis, ejaculatory duct obstruction, and seminal vesicle cyst. This syndrome is caused by an embryonic malformation of the mesonephric or Wolffian duct. Seminal vesicle cysts are commonly reported, and men with these cysts often present with infertility. This report presents a case of a giant seminal vesicle cyst that was incidentally found while evaluating for bowel symptoms. The seminal vesicle cyst was successfully managed by robot-assisted excision.

Two New Species of Freshwater Planarian (Platyhelminthes, Tricladida, Dugesiidae, Dugesia) from Southern China Exhibit Unusual Karyotypes, with a Discussion on Reproduction in Aneuploid Species

Two new species of the genus Dugesia from Southern China are described by applying an integrative approach, including morphological, karyological, histological, and molecular information. In the molecular phylogenetic tree, the two new species, Dugesia pendula Chen &amp; Dong, sp. nov. and Dugesia musculosa Chen &amp; Dong, sp. nov., fall into an Eastern Palearctic/Oriental clade and an Oriental/Australasian clade, respectively, while sharing only a rather distant relationship. The separate specific status of the two new species is supported also by their genetic distances. Dugesia pendula is characterized by the following features: symmetrical openings of the oviducts into the bursal canal, a duct between seminal vesicle and diaphragm, small diaphragm, dorsally located seminal vesicle, a penis papilla suspended from the dorsal wall of the male atrium, and mixoploid karyotype with diploid complements of 2n=2x=14+0−1 B-chromosome and triploid complements of 2n=3x=21+0−1 B-chromosome, with all chromosomes being metacentric. Dugesia musculosa is characterized by the following features: asymmetrical openings of the oviducts into the bursal canal; a ventrally displaced ejaculatory duct with a terminal opening; two diaphragms; a bursal canal provided with a strong, thick layer of circular muscle, which extends from the copulatory bursa to the common atrium and gonoduct; the left vas deferens opening at the midlateral wall of the seminal vesicle, while the right sperm duct opens at the dorsolateral wall of the seminal vesicle; and karyotype consisting of complicated diploid and aneuploid mosaicism, with diploid complements of 2n=2x=16 and 2n=2x=16−17th-18th, with all chromosomes being metacentric. The uncommon karyotypes, combined with the asexual reproduction of aneuploid animals, are evaluated in the context of the relationship between ploidy levels and reproductive modalities in the genus Dugesia.