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Posterior urethral valve: an unusual cause of primary male infertility.

Agbugui JO, Omokhudu O - J Reprod Infertil (2015 Apr-Jun)

Bottom Line: This can be an unusual cause of primary male infertility as a result of abnormalities in sexual function.His spouse achieved pregnancy thereafter.Restoration of fertility potential can be achieved following valve ablation.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria.

ABSTRACT

Background: Posterior urethral valve presenting in adulthood is uncommon. This can be an unusual cause of primary male infertility as a result of abnormalities in sexual function.

Case presentation: This report describes a 40 year old man who presented to us on account of inability to impregnate his wife after 2 years of marriage. History revealed poor stream of urine since childhood and passage of scanty ejaculate during intercourse. A micturating cystourethrogram revealed dilated posterior urethra in keeping with posterior urethral valves. Endoscopic valve ablation was done with subsequent improvement in ejaculate volume and urine stream. His spouse achieved pregnancy thereafter.

Conclusion: In this report, it was found that adult posterior urethral valve though uncommon may be a cause of male infertility. Restoration of fertility potential can be achieved following valve ablation.

No MeSH data available.


Related in: MedlinePlus

Micturating cystourethrogram of the patient showing dilated posterior urethra
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Figure 0001: Micturating cystourethrogram of the patient showing dilated posterior urethra

Mentions: Examination findings were essentially normal except for mild left hydocele. The peak flow rate was 8 ml/s. An assessment of urethral stricture leading to primary male infertility was initially entertained. However, contrast studies by means of a retrograde urethrogram and a micturating cystourethrogram showed a dilated posterior urethra suggestive of PUV with associated bladder trabeculations (Figure 1). Abdominal ultrasonography revealed mild bilateral hydronephrosis. The patient was not able to produce sufficient semen for proper seminal fluid analysis (SFA), on the two occasions the test was requested. Urine culture did not yield any growth of organisms while serum urea, electrolytes and creatinine values were within normal limits (Na+ 138 mEq/l, K+ 4.2 mEq/l, Urea 30 mg/dl and Creatinine 1.1 mg/dl). He subsequently had urethrocystoscopy which confirmed type 1 of PUV that was ablated during the procedure using a diathermy bugbee electrode. After removal of catheter the next day, there was significant improvement of the urine stream with a peak flow rate of 15 ml/s.


Posterior urethral valve: an unusual cause of primary male infertility.

Agbugui JO, Omokhudu O - J Reprod Infertil (2015 Apr-Jun)

Micturating cystourethrogram of the patient showing dilated posterior urethra
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4386085&req=5

Figure 0001: Micturating cystourethrogram of the patient showing dilated posterior urethra
Mentions: Examination findings were essentially normal except for mild left hydocele. The peak flow rate was 8 ml/s. An assessment of urethral stricture leading to primary male infertility was initially entertained. However, contrast studies by means of a retrograde urethrogram and a micturating cystourethrogram showed a dilated posterior urethra suggestive of PUV with associated bladder trabeculations (Figure 1). Abdominal ultrasonography revealed mild bilateral hydronephrosis. The patient was not able to produce sufficient semen for proper seminal fluid analysis (SFA), on the two occasions the test was requested. Urine culture did not yield any growth of organisms while serum urea, electrolytes and creatinine values were within normal limits (Na+ 138 mEq/l, K+ 4.2 mEq/l, Urea 30 mg/dl and Creatinine 1.1 mg/dl). He subsequently had urethrocystoscopy which confirmed type 1 of PUV that was ablated during the procedure using a diathermy bugbee electrode. After removal of catheter the next day, there was significant improvement of the urine stream with a peak flow rate of 15 ml/s.

Bottom Line: This can be an unusual cause of primary male infertility as a result of abnormalities in sexual function.His spouse achieved pregnancy thereafter.Restoration of fertility potential can be achieved following valve ablation.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Benin Teaching Hospital, Benin City, Nigeria.

ABSTRACT

Background: Posterior urethral valve presenting in adulthood is uncommon. This can be an unusual cause of primary male infertility as a result of abnormalities in sexual function.

Case presentation: This report describes a 40 year old man who presented to us on account of inability to impregnate his wife after 2 years of marriage. History revealed poor stream of urine since childhood and passage of scanty ejaculate during intercourse. A micturating cystourethrogram revealed dilated posterior urethra in keeping with posterior urethral valves. Endoscopic valve ablation was done with subsequent improvement in ejaculate volume and urine stream. His spouse achieved pregnancy thereafter.

Conclusion: In this report, it was found that adult posterior urethral valve though uncommon may be a cause of male infertility. Restoration of fertility potential can be achieved following valve ablation.

No MeSH data available.


Related in: MedlinePlus