Role of Transrectal Ultrasonography in Male Infertility

Abstract

Background: Male infertility accounts for nearly 50% of all infertility cases. The evaluation of male infertility is complex, with anatomical abnormalities playing a significant role. This study aimed to assess the role of TRUS in diagnosing anatomical abnormalities contributing to infertility in north Indian region.

Methods: This descriptive observational study was conducted over two years in the Department of Radiodiagnosis & Imaging, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), and its associated hospitals. Sixty male patients aged ≥23 years with complaints of infertility and two samples showing oligospermia/azoospermia underwent TRUS examination. TRUS was performed using a 5.5-7.5 Hz transrectal probe, evaluating the prostate, seminal vesicles, ejaculatory ducts, and vas deferens.

Results: The mean age of patients was 32.5 years, with a mean infertility duration of 6.2 years. TRUS detected abnormalities in 93% of patients, including correctable causes such as ejaculatory duct obstruction (25%), seminal vesicle cysts (40%), and prostatic cysts (30%). Irreversible conditions included congenital bilateral absence of the vas deferens (5%) and seminal vesicle hypoplasia (3%). Life-threatening conditions as prostatic abscesses were identified in 3% of cases.

Conclusions: TRUS is a valuable tool for evaluating male infertility, capable of detecting both correctable and irreversible abnormalities, as well as potentially life-threatening conditions. Its routine use in infertility workup is recommended.