Ejaculatory ductal obstruction can be treated surgically with transurethral resection of the prostatic verumontanum until patency of the ejaculatory duct openings is achieved. This should be done in conjunction with intraoperative vasography. Injection of indigo carmine intravasally facilitates determination of the adequacy of resection. Transurethral resection improves semen parameters in about 50% to 70% of cases. Complications of such treatment include urinary reflux to ejaculatory ducts, epididymitis, retrograde ejaculation and urinary incontinence. buy ortho tri-cyclen online
In addition to obstruction, ejaculatory disorders may also lead to azoospermia. Anejaculatory and retrograde ejaculation are seen in men with neurological disorders or injuries to the lower urinary tract that involve the bladder neck, seminal vesicles, prostate and urethra. While medical treatment with sympathomimetics and electroejaculation may induce antegrade ejaculation in some cases to allow pregnancy through natural intercourse or intrauterine insemination, surgical sperm retrieval may be required in many of these patients seeking assisted reproduction.