Transurethral resection of ejaculatory duct

Transurethral resection of ejaculatory duct

What is a TURED?

A Transurethral Resection of the Ejaculatory Ducts (TURED) is a minimally invasive endoscopic procedure performed to relieve blockage of the ejaculatory ducts. Obstruction can interfere with the normal flow of semen and may contributed to infertility, painful ejaculation, low semen volume, or recurrent infections.

The procedure is performed through the urethra (the natural urinary passage) and does not involve external incisions.

Preparation for Surgery

Before surgery, you may undergo:

  • Semen analysis and hormonal blood tests

  • Ultrasound imaging (e.g. transrectal ultrasound)

  • Possibly MRI or vasography, depending on your case

In preparation for surgery:

  • You will be given specific advice about stopping blood-thinning medications prior to surgery

  • Do not eat or drink for at least 6 hours prior to surgery

Surgical bed - Transurethral resection of ejaculatory duct

Day of Surgery

  • The procedure is performed under general anaesthesia

  • A small camera (cystoscope) is passed through the urethra

  • The opening of the ejaculatory duct is identified and carefully resected to relieve obstruction

  • The procedure typically takes 30-60min

  • a temporary urinary catheter will be placed at the end of the procedure

  • Expect to stay in hospital overnight

  • The catheter usually removed the following morning

Aftercare and Recovery

In the first few days

  • Expect mild discomfort when passing urine

  • Light bleeding in urine and semen is expected to

Activity

  • avoid heavy lifting, strenuous exercise and sexual activity for 2-4 weeks

Medications

  • You will be provided specific advice about restarting medications that were withheld for surgery

Follow up

  • Review appointment usually at 6-8 weeks

  • Repeat semen analysis may be performed several months after surgery to assess for improvement in semen parameters

Possible risks and complications

While TURED is generally safe, potential risks include:

  • Watery ejaculate (low viscosity) - usually permanent

    • importantly does not necessarily indicate infertility

  • Reflux of urine and associated epididymo-orchitis

  • Haematospermia

  • Urinary symptoms - dysuria, urinary frequency

  • Retrograde ejaculation

  • Re-obstruction/scar formation

  • No improvement in fertility/semen parameters

  • Urethral stricture

When to Seek Medical Advice

Contact your doctor or seek urgent care if you experience:

  • fever or chills

  • inability to pass urine

  • increasing pain or swelling

  • heavy or persistent bleeding

Patient recovering after surgery holding a phone and preparing to call their doctor due to concerning postoperative symptoms requiring urgent medical advice.