Transurethral Ejaculatory Duct Resection in Infertile Patients with Aspermia/ Hypovolemic Ejaculate and Midline Prostatic Cysts: Results of a Long-Term Retrospective Study

Objective: Midline prostatic cysts are extremely rare obstructive causes of male infertility.Transurethral ejaculatory duct resection (TUR-ED) is performed as a treatment modality.This study aims to evaluate the long-term outcomes of TUR-ED. Materials and Methods:Following approval from the regional ethics committee and in compliance with the Helsinki Declaration, we retrospectively analyzed male patients who presented with infertility and underwent TUR-ED for midline prostatic cysts between January 2015 and June 2024.The patients' medical histories, semen analyses, and imaging findings were reviewed.The surgery was performed by an experienced surgeon using bipolar electrocautery.Postoperative follow-up included assessments of semen parameters, hormone levels, and complications.Statistical analyses were conducted using IBM SPSS version 2020.Results: A total of 28 patients were included in the study.Postoperatively, a statistically significant improvement was observed in semen volume, sperm concentration, and motility.The most common complications were hemospermia (25%) and epididymitis (10.7%).The mean follow-up period was 12.3 months, and pregnancy was achieved in 42.9% of patients, with 25.0% occurring spontaneously and 17.9% via assisted reproductive techniques.Conclusion: TUR-ED is an effective surgical treatment that improves semen parameters.Our long-term follow-up results demonstrate its positive impact on reproductive outcomes.However, due to potential complications, patients will be careful selection and close postoperative monitoring are essential.