Are predictive factors in sperm retrieval and pregnancy rates present in nonobstructive azoospermia patients by microdissection testicular sperm extraction on testicle with a history of orchidopexy operation?

The aim in this study is to evaluate predictive factors on sperm retrieval and pregnancy rates by microdissection testicular sperm extraction in non obstructive azoospermia patients with a history of orchidopexy operation. A total of 148 patients were included, and their medical files were evaluated. Data related to possible predictive factors on sperm retrieval and pregnancy rates such as age at orchidopexy operation, unilateral or bilateral presence of undescended testis before orchidopexy, testis volumes and hormone levels were statistically analysed. It revealed that the mean ages in patients with unilateral and bilateral orchidopexy operations were 35.37 (±4.84) and 33.94 (±5.91) respectively. Mean testis volume in the unilateral orchidopexy group was 7.59 (±3.12) ml on the right testis and 7.37 (±2.86) ml on the left testis. Mean FSH levels were detected as 22.71 (±11.86) mIU/ml in the unilateral group and 28.19 (±12.40) mIU/ml in the bilateral group. In our study, we have shown that the age at which patients undergo orchidopexy and the unilateral or bilateral presence of cryptorchidism has no correlation with sperm retrieval and pregnancy rates.

Retrograde intrarenal surgery technique without using fluoroscopy and access sheet in the treatment of kidney stones

Background/aim: In this study, we aimed to present our results on single-guidewire flexible ureteroscopy and retrograde intrarenal surgery without fluoroscopy and an access sheet, and to evaluate the efficacy and safety of this procedure retrospectively. Materials and methods: Our routine technique can be described as the evaluation of the ureter using a semirigid ureterorenoscope (URS), leading in the guidewire through the semirigid URS, pulling the semirigid URS back, inserting the flexible URS with the aid of the guidewire, inserting the laser probe through the flexible URS, and performing laser lithotripsy. Results: Our study included 400 male and 198 female patients with a mean age of 36.8 ± 16 (14­80) years. The mean stone size was 8.7 ± 4 (8­20) mm, and the mean operation time was 56 (32­106) min. Postoperative fever was observed in 24 (4%) of the patients, and 30 (5%) patients had hematuria as a minor complication. A stone-free status was observed in 466 (78%) patients, while 102 (17%) patients had clinically insignificant minor stone fragments and 30 patients had clinically significant stone residue. Conclusion: The retrograde intrarenal surgery procedure using only a guidewire without fluoroscopy and an access sheet in the treatment of kidney stones is technically safe and effective.

Evaluation of Prolidase Activity, Oxidative Stress, and Antioxidant Enzyme Levels in Testicular and Penile Tissues after Human Chorionic Gonadotropin Treatment in Rats by Predicting Infertility and Erectile Dysfunction.

OBJECTIVES: Prolidase plays a vital role in collagen turnover, matrix remodeling, and cell growth. We aimed to evaluate the association between treatment with chorionic gonadotropin and infertility and erectile dysfunction by investigating tissue prolidase activity, oxidative stress, and levels of antioxidant enzymes. MATERIALS AND METHODS: The 16 male Wistar albino rats used in this study were randomly divided into 2 groups: rats treated with human chorionic gonadotropin (hCG) and control rats (n = 8 in each group). The rats in the hCG group were subcutaneously injected with 50 IU hCG daily for 15 days, while the rats in the control group were subcutaneously injected isotonic saline. All of the rats were sacrificed by a lethal overdose of sodium pentobarbital at the first month after hCG administration. Prolidase activity and levels of malonyl aldehyde, glutathione reductase, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) were estimated in the testicular and penile tissue. The testicles and penis were transversely dissected and placed in formalin. RESULTS: Levels of prolidase and malonyl aldehyde in the testicular and penile tissues were significantly higher in the hCG group than in the control group (p < 0.001), while levels of glutathione reductase, SOD, GSH-Px, and CAT were significantly lower in the hCG group than in the control group (p < 0.001). CONCLUSIONS: In this study, we observed that treatment with hCG increased prolidase activity and oxidative stress and decreased the antioxidant capacity of penile and testicular tissues; therefore, this may affect fertility and erectile function.

The role of apoptosis and the effect of epidermal growth factor on proapoptotic BNIP 3 in an experimental rat priapism model

Background/aim: This study aimed to investigate the effects of apoptosis-inducing Bcl-2/adenovirus E1B 19 kDa-interacting protein 3 (BNIP 3) and antiapoptotic epidermal growth factor (EGF) on the pathophysiology of experimental low-flow priapism. Materials and methods: Twenty-four adult Sprague-Dawley rats were divided into four equal groups. Group I was the control group. Ischemic priapism was induced for 4 h in Group II rats. In Group III, intraperitoneal EGF at 10 µg/kg was given for 7 days before induction of ischemic priapism for 4 h. In Group IV, intraperitoneal EGF at 20 µg/kg was given for 7 days before induction of ischemic priapism for 4 h. The western blot method was used to determine BNIP 3 expression levels and the TUNEL method was used to determine the apoptotic cells in the cavernosal tissue samples. Results: Although BNIP 3 expression levels were significantly higher in all three study groups compared to the controls, BNIP 3 was significantly higher in EGF-administered groups when compared to Group II (P < 0.05). The TUNEL score of group II was significantly higher than those of the other groups. Conclusion: Decreased apoptosis in cavernosal tissues obtained by antagonizing the apoptotic effect of BNIP 3 with EGF may facilitate the development of new conservative treatment methods via those pathways.

Factors influencing young urologists' productivity and academic career choice.

OBJECTIVE: The objective of this study is to identify the variables that affect young urologists' productivity and academic career choice. PATIENTS AND METHODS: We have conducted an internet-based national survey for urologists randomly sampled from the database of Turkish Urological Association and 110 physicians completed this survey. Participants were asked to answer three-page questionnaire including 37 questions, which takes around 5 min to complete. Questionnaire was consisting of four main sections: 'demography', 'education', 'working conditions' and 'quality of life'. RESULTS: Increased dedicated research time, being interested in an academic career, being Fellow of the European Board of Urology (FEBU), having English proficiency, and greater numbers of manuscript publication during residency were associated with increased productivity after residency (p = 0.001, p = 0.028, p = 0.046, p<0.001 and p<0.001, respectively). The remaining variables including age at marriage, age at having a child, monthly salary, length of residency, having a mentor or role model during residency showed no significant relationship with manuscript publications. Twenty-nine physicians (26.4%) stated that they had once been interested in their residency but were no longer interested in academic urology. Reasons for this loss of academic interest included lack of effective mentor or role model (27.2%), bureaucracy (17%), financial issues (13.6%), mandatory rule to work in public hospitals (18.2%) or military hospitals (9%) and language problems (21.6%). CONCLUSIONS: Our data indicate that increased time spent for research, being interested in an academic career, being an FEBU, having English proficiency, and greater publication during residency were associated with increased numbers of publications and academic career choice.

Comparison of retrograde intrarenal surgery and percutaneous nephrolithotomy for the treatment of renal stones greater than 2 cm.

OBJECTIVE: To evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones greater than 2 cm and to compare its results with those of percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: We retrospectively analyzed a total of 143 patients: 86 patients (53 males and 33 females) who underwent PCNL and 57 patients (37 males and 20 females) who underwent RIRS between October 2009 and October 2013. RESULTS: The mean duration of operation was 100.26±33.26 min in the RIRS group and 75.55±21.5 min in the PCNL group (p<0.001). The hospital stay was significantly shorter in the RIRS group (1.56±0.8 vs. 4.57±2.1 days in the RIRS and PCNL groups, respectively; p<0.001). Stone-free rates after one session were 66.6% and 91.8% of the RIRS and PCNL groups, respectively. The stone-free rate of the RIRS group improved to 87.7% after the second session. Blood transfusions were required in two patients in the PCNL group. Complication rates were higher in the PCNL group. CONCLUSION: This study revealed that RIRS can be an alternative to PCNL in the treatment of kidney stones with a diameter of 2-4 cm especially in patients with comorbidities.

Second pathways in the pathophysiology of ischemic priapism and treatment alternatives.

OBJECTIVE: To evaluate the early therapeutic alternatives such as bosentan, an endothelin receptor blocker, theophylline, an adenosin receptor blocker, and a nonselective phosphodiesterase enzyme inhibitor, zinc protoporphyrin (ZnPP), a heme oxygenase 1 inhibitor, for the therapy of ischemic priapism in the rat models. METHODS: Twenty-four Sprague-Dawley rats were randomly divided into 4 equal groups: control group, ZnPP group, bosentan group, and theophylline group. Erection was provided by vacuum constriction method and maintained for 4 hours for achieving the priapism in all groups. The rats in the control group were administered 1 mL/kg saline intraperitoneally (ip). The rats in group 2 were administered 25 mg/kg ZnPP ip. The rats in group 3 were administered 0.25 mg/kg bosentan ip. The rats in group 4 were administered 100 mg/kg theophylline ip. Six rats from each group were decapitated after 6 hours of drug administration. Then endothelin 1, adenosine deaminase, heme oxygenase 1 enzymatic activity, and apoptosis index in the cavernous tissues were estimated. RESULTS: Cavernous tissue endothelin 1, adenosine deaminase, heme oxygenase 1 enzymatic activity levels, and apoptosis index were significantly decreased in bosentan, theophylline, and ZnPP-treated rats compared with the controls. CONCLUSION: Inhibition of priapism induced apoptosis with bosentan, theophylline, and ZnPP seems promising on preserving erectile function.

Potential relationship between BK virus and renal cell carcinoma.

The objective of the present study was to investigate the potential association between the presence of BK virus (BKV) DNA and mRNA and renal cell carcinoma and bladder transitional cell carcinoma. The formalin-fixed and paraffin-embedded tissue samples were obtained from 50 cancer patients with renal cell carcinoma, 40 cancer patients with bladder transitional cell carcinoma, 45 control patients with the benign renal pathology, and from another 25 control patients with benign bladder pathology. The samples were subjected to nested PCR for detection of BKV DNA and real-time reverse transcription PCR (real-time RT-PCR) for determining mRNA levels of BKV. The results of the nested PCR indicated that 23 (14.3%) of 160 samples were positive for BKV DNA. The relationship between the cancer and the presence of BKV DNA was significant (P < 0.05). The BKV DNA positivity was significantly associated with the histological diagnosis of renal cell carcinoma (P = 0.03), but not with that of bladder transitional cell carcinoma. The results of real-time RT-PCR showed that the mRNA of BKV VP1 was present in 69.5% of the BKV DNA positive samples. The levels of BKV mRNA were significantly higher in the renal cell cancer samples than in the control samples (P < 0.05). The results of the present study confirm the association between BKV and renal cell cancer. The findings also indicated that the presence of BKV DNA resulted in a fivefold increase in the risk of development of renal cell carcinoma.

In vitro examination of effects of hyperprolactinemia and hypoprolactinemia on seminal vesicle contractions.

OBJECTIVE: To investigate the contractile characteristics of the seminal vesicles in rats, in which hyperprolactinemia and hypoprolactinemia was induced by prolactin and bromocriptine administration. MATERIALS AND METHODS: A total of 24 Wistar albino rats were randomly divided into 3 groups: control group, hyperprolactinemia group, and hypoprolactinemia group. The rats in the control group were administered 0.1 mL saline subcutaneously for 21 days. The rats in group 2 received prolactin 51 µg/kg subcutaneously for 21 days. The rats in the third group received intraperitoneal bromocriptine mesylate at a dose of 66 µg/kg. All the rats were decapitated at 21 days. The seminal vesicles were removed using a microsurgical technique, and the tissue sections were prepared (0.5 × 0.2 cm). These sections were suspended in the organ bath. Subsequently, contractions were induced using 10 µmol acetylcholine or 100 mmol potassium chloride. RESULTS: The amplitude values induced by potassium chloride in the prolactin group were significantly greater than those in the bromocriptine group or control group. Similarly, the amplitude values induced by acetylcholine were also significantly greater in the prolactin group than in the other 2 groups. CONCLUSION: Experimental hyperprolactinemia results in an increase in the smooth muscle contraction and tonus of the seminal vesicles. The alterations in the smooth muscle tonus in the seminal vesicles and genitourinary tract might be involved in the etiology of infertility occurring in hyperprolactinemia.

Evaluation of sexual function in women at two stages of multiple sclerosis.

PURPOSE: In the present study, we aimed to evaluate the sexual function in patients with multiple sclerosis (MS) who were examined in two subgroups and compare the results to the control group with a validated questionnaire. METHODS: A total of 23 consecutive female MS patients divided into groups with relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) and 45 healthy control subjects were included into the study. The inclusion criteria were as follows: Definite MS, age between 18 and 60 years and an Expanded Disability Status Scale (EDSS) score of <8. The neurologic impairment, the disability and the independence of the patient, and cognitive performances were measured, and also the effect of MS is evaluated by EDSS. RESULTS: No statistically significant difference was found between two groups. FSFI scores in both groups were significantly lower than the control group. Domain scores for desire, arousal, orgasm, pain, lubrication and satisfaction measured between RRMS and SPMS patients showed no significant difference. Comparing each domain score for arousal, orgasm and satisfaction revealed significantly lower scores in RRMS and SPMS patients compared to control group. CONCLUSIONS: In this study, we detected statistically significant decrease in FSFI scores in two groups of MS compared to healthy controls. We could not define a difference in sexual function in different stages of MS in women and a statistically significant negative correlation between EDSS and FSFI scores in the two subgroups of MS.

Evaluation of left renal vein entrapment using multidetector computed tomography.

BACKGROUND: Nutcracker syndrome, also called left renal vein entrapment syndrome, is a cause of non-glomerular hematuria with difficulties in diagnosis. Multidetector computed tomography (MDCT) is a powerful tool to prevent unnecessary diagnostic procedures. PURPOSE: To retrospectively determine the prevalence of nutcracker phenomenon and nutcracker syndrome seen in MDCT in consecutive patients. MATERIAL AND METHODS: The institutional review board approved the study and waived the requirement for informed consent. Abdominal contrast-enhanced MDCT scans were reviewed from 1000 consecutive patients. MDCT scan assessment included renal vein diameter measurements and evaluation for the presence of anterior or posterior left renal vein entrapment. Electronic medical records and urine analysis reports of patients with left renal vein entrapment were reviewed. Student's t test was used to assess differences in renal vein diameter in patients with left renal vein entrapment. RESULTS: Left renal vein entrapment was observed in 10.9% (109), retro-aortic left renal vein in 6.5% (65), entrapment of left renal vein between superior mesenteric artery and aorta in 4.1% (41), and circumaortic left renal vein in 0.3% (3) of patients. Mean diameters of right (8.8 ± 1.9 mm) and unentrapped left (8.9 ± 1.8 mm) renal veins were not significantly different (P = 0.1). The mean diameter of anterior entrapped left renal veins (10.3 ± 2 mm) was significantly greater (P = 0.04) than contralateral renal veins (8.6 ± 2.1 mm) in their widest portion. In 8.8% of patients with the left renal vein entrapment, urine analysis showed isomorphic hematuria or proteinuria with no other known cause. Varicocele and pelvic congestion were seen in 5.5% of patients with the left renal vein entrapment. CONCLUSION: Left renal vein entrapment is not a rare entity and renal nutcracker phenomenon might be underdiagnosed.

Circulating soluble lectin-like oxidized low-density lipoprotein receptor-1 levels are associated with erectile dysfunction in patients without known coronary artery disease.

AIM: Endothelial dysfunction and microvascular damage are involved in the pathogenesis of erectile dysfunction (ED). Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) is identified endothelial receptor for oxidized low-density lipoprotein (ox-LDL) that plays a pivotal role in ox-LDL-induced endothelial dysfunction. The purpose of the current study was to determine the association between sLOX-1 and ED in patients without known coronary artery disease (CAD). MAIN OUTCOME MEASURES: Diagnosis of ED was based on the International Index of Erectile Function Score-5. Levels of sLOX-1 were measured in serum by enzyme-linked immunosorbent assay. METHODS: One hundred thirty-eight subjects with ED patients without known CAD (ED group) and 75 age-matched subjects without ED and known CAD (Non-ED Group) were included in this study. RESULTS: Plasma levels of sLOX-1 were significantly higher in ED than in Non-ED group (95±87 and 49±30 pg/mL, respectively, P<0.001). The levels of sLOX-1 highly negative correlated with score of ED (r=-0.618, P<0.001). The sLOX-1 levels>75 pg/mL predicts ED with 26.8% sensitivity and 96.0% specificity on receiver operator characteristic analysis. CONCLUSIONS: Our study demonstrated that serum sLOX-1 levels were associated with endothelial dysfunction that predicts ED. Moreover, the current study revealed that there was strong negative correlation between the levels of circulating sLOX-1 and score of ED. This study suggested sLOX-1 may be involved in the pathogenesis of ED in patients without known CAD.

Effect of urinary incontinence and its subtypes on quality of life of women in eastern Turkey.

OBJECTIVE: To determine the bothersomeness and effect on quality of life (QOL) of different types of urinary incontinence (UI) in married women living in eastern Turkey. MATERIALS AND METHODS: A total of 1049 married women was evaluated in the present population-based, cross-sectional study. QOL was assessed using a validated form of the Turkish version of the Incontinence Impact Questionnaire Short Form. The effects of UI subtype on the overall QOL score and on the individual domain scores were determined. The relationship between several demographic characteristics such as age, weight, education level, number of pregnancies, number of live deliveries, and presence of pelvic organ prolapse and the QOL changes was examined. RESULTS: The mean age of the women was 44.62 ± 11.01 years (range 17-80). Of the women with UI, 76.2% stated that the UI had a negative effect on their QOL. Women with mixed UI and severe UI had the worst QOL scores. The QOL changes for the different domains revealed that entertainment activities were affected least, and emotional health and feelings of frustration were the 2 domains that showed the most significant deterioration. Furthermore, older and unemployed women, housewives, women living in urban areas, and women with multiple births, difficult labor, and increased weight experienced significant negative effects on their QOL. CONCLUSION: Our results have shown that, regardless of different factors, UI has significant negative effects on QOL. The presented data emphasize the importance of the high prevalence of UI in our region and its negative effects on QOL. Thus, additional policies are needed for the prevention of the negative effects of UI.

Abdominal hypertension characterised by severe haemodynamic changes as a complication of percutanous nephrolithotomy.

Percutanous nephrolithotomy (PCNL) was performed on a patient in a prone position. During the first hour of intervention, some unwanted haemodynamic complications arose, which included a decrease in systemic blood pressure, an increase in heart rate and an increase in peak inspiratory pressures. Owing to worsening of those unexplained haemodynamic abnormalities, surgery was terminated. As the patient turned from prone to supine position, abdominal distention was noticed. Later, 3 litres of fluid were removed from the abdomen via peritoneal lavage. Upon fluid removal, a dramatic haemodynamic improvement was observed. The problem was thought to have been caused by a technical error in placing the dilator inside the abdomen, which allowed the irrigation fluid to accumulate inside the abdominal cavity. The aim of this presentation is to raise awareness of intra-abdominal hypertension when the aforementioned haemodynamic abnormalities are detected during PCNL. Early detection and treatment may prevent morbidity and mortality in similar cases.

Role of diffusion MRI and apparent diffusion coefficient measurement in the diagnosis, staging and pathological classification of bladder tumors.

OBJECTIVES: Our aim was to investigate the role of simultaneous apparent diffusion coefficient (ADC) measurement and diffusion-weighted MRI (DWMRI) in the diagnosis and differentiation of bladder masses. METHODS: We examined 45 patients presenting with hematuria by dynamic and diffusion MRI (at b100, b600, b1000 gradients) and cystoscopy. Thirty healthy volunteers without hematuria were also included in the study. Results from imaging techniques were compared to cystoscopic and histopathologic findings. The ADC values of benign and malignant bladder masses, and bladder tissue in healthy subjects were measured and compared with each other. RESULTS: The mean ADC values of benign (n = 10) and malignant lesions (n = 35) were significantly lower than the mean ADC values of adjacent bladder walls and bladder walls of healthy subjects at all 3 gradients (p < 0.05). However, no significant difference was detected between benign and malignant lesions (p > 0.05). Mean ADC values of invasive tumors were significantly lower than superficial malignancies at b600 and b1000 gradients. The mean ADC values of transitional cell tumors were significantly higher than squamous cell tumors at b100 and b600 gradients. CONCLUSION: Simultaneous measurement ofADC and DWMRI provided useful information in the diagnosis, staging and histopathological classification of bladder tumors.

Inflammatory pseudotumor of the kidney.

Inflammatory pseudotumor of the kidney is a rare benign condition with unknown etiology that can mimic malignancy. We report a case of inflammatory pseudotumor of the kidney. A 59-year-old male patient was admitted with a complaint of right flank pain and hematuria. Ultrasonography and magnetic resonance imaging of the patient revealed a 9 cm × 10 cm mass originating from the renal parenchyma with posterior extension. Operative findings revealed a mass adhering to the psoas muscle. Histopathologic examination demonstrated spindle-shaped fibroblast cells accompanying inflammatory cells. The pathological diagnosis was renal inflammatory pseudotumor. Repeated US and computed tomography revealed complete remission.

Technetium Tc 99m sulphur colloid seminal vesicle scintigraphy: a novel approach for the diagnosis of the ejaculatory duct obstruction.

OBJECTIVES: To define a novel technique in the diagnosis of partial and complete ejaculatory duct obstruction (EDO). METHODS: Twenty men with suspected EDO were initially evaluated by transrectal ultrasound (TRUS). Subsequently, all patients underwent TRUS-guided seminal vesicle (SV) scintigraphy. Technetium Tc 99m sulphur colloid solution was injected into each SV under TRUS guidance and patients were immediately evaluated by scintigraphy. After patients ejaculated scintigraphy was repeated. The difference between 2 measurements in respect to technetium Tc 99m count was used to measure the percentage of emptying. RESULTS: In the first group, TRUS revealed 11 patients with findings suggestive of EDO, whereas no abnormality was found in 9. Scintigraphic measurement in first group of patients showed a mean emptying ratio for the right and left SVs of 16.6% +/- 2.22 (2.2 to 30.6) and 17.1% +/- 2.34 (1.4 to 32.5), respectively. The mean percent of emptied technetium Tc 99m from right and left SVs in patients with no pathologic findings on TRUS was 30.9% +/- 4.3 (10.1 to 44.2) and 33.9% +/- 5.81 (13.6 to 68.1), respectively. Statistically significant difference was determined between 2 groups (P = 0.037). Initially, TRUS examination revealed no pathologic findings in 3 patients; however, SV scintigraphy showed less than 30% emptying and revealed an additional 33% of patients to be obstructed in our series. CONCLUSIONS: TRUS, the static anatomic imaging modality, may not be sufficient to distinguish functional from complete obstruction. Seminal vesicle scintigraphy is unique that incorporates physiologic aspect of ejaculation into a diagnostic intervention, of which we believe that is especially important in diagnosis of functional EDO.

Detection of bladder tumors with 3-dimensional sonography and virtual sonographic cystoscopy.

OBJECTIVE: Bladder tumors are among the most common types of malignant neoplasms of the urinary tract. The purpose of this study was to evaluate the potential value of 3-dimensional (3D) sonography and sonographic cystoscopy in detection of bladder tumors. METHODS: Thirty-one patients with suspected or known bladder tumors were included this study. All patients underwent 3D sonography and conventional cystoscopy within 15 days. The number, size, location, and morphologic features of the lesions were evaluated on gray scale, 3D virtual, and multiplanar reconstruction images obtained from the patients. The results of 3D sonographic cystoscopy were compared with the findings from conventional cystoscopy, which was considered the reference standard. RESULTS: Twenty-eight (90.3%) of 31 3D virtual sonographic cystoscopic studies had good or excellent image quality. Conventional cystoscopy revealed 47 lesions in 22 of 28 patients; 3D sonographic virtual cystoscopy showed 41 (87.2%) of 47 lesions. Three-dimensional virtual sonography alone had sensitivity of 96.2%, specificity of 70.6%, a positive predictive value of 93.9%, and a negative predictive value of 80% for tumor detection. The combination of gray scale sonography, multiplanar reconstruction, and 3D virtual sonography had sensitivity of 96.4%, specificity of 88.8%, a positive predictive value of 97.6%, and a negative predictive value of 84.2% for tumor detection. CONCLUSIONS: Three-dimensional sonography is a promising alternative noninvasive technique for use in detection of bladder tumors, their localization, and perivesical spreading. The location, size, and morphologic features of the tumors shown on 3D sonography agreed well with the findings of conventional cystoscopy.

Clinical and radiological evaluation of ejaculatory duct obstruction.

Ejaculatory duct obstruction (EDO) is a rare but surgically correctable cause of male infertility. With the advent and increased use of transrectal ultrasonography and magnetic resonance imaging, abnormalities of the ejaculatory duct (ED) related to infertility have been diagnosed more frequently. Recently, with the increased awareness of functional obstruction of ED, reports have been focusing on the diagnosis of partial or functional EDO. We present 2 review of the ED pathologies, imaging modalities and treatment options.