Transurethral Resection of Ejaculatory Ducts (TURED)
Definition - What does Transurethral Resection of Ejaculatory Ducts (TURED) mean?
Transurethral resection of ejaculatory ducts (TURED) is a procedure that involves unblocking an ejaculatory duct to allow for sperm and semen to mix. The procedure improves the sperm counts and spontaneous pregnancy rates in about 20% to 30% of men with ejaculatory duct obstruction (EDO).
FertilitySmarts explains Transurethral Resection of Ejaculatory Ducts (TURED)
TURED is performed in infertile men who display features of EDO, as suggested by the presence of:
- few or no sperm in semen
- poor ejaculatory volume
- normal hormonal profile
- midline cyst within the ejaculatory duct on transrectal ultrasonography (TRUS)
A TRUS is done to detect EDO and assess the motility of the sperms. It also aids in localizing the site of blockage and assessing the depth of resection. It is essential to diagnose EDO as it can be easily corrected with a minor procedure.
To perform TURED, the surgeon inserts an instrument called cystoscope to visualize the interior of the ducts. The entry point of the ejaculatory duct is identified and cut it to uncover the duct while taking care to avoid damaging the bladder neck on the top, the sphincter at the bottom, and the rectum at the back. Once resection is complete, the prostate is massaged to confirm the patency of the ejaculatory ducts as indicated by the dye flowing out through the ejaculatory ducts. A small plastic tube called catheter is placed for 24 hours in the bladder after the procedure.
Rare complications associated with TURED include:
- Rectal injury
- Damage to the muscle that encircles the anal canal and can be squeezed voluntarily to stop a bowel movement
- Bladder neck injury, which triggers backward ejaculation and possibly reflux of urine into the ejaculatory ducts