To explore the treatment of a case of functional obstructive azoospermia with autosomal dominant polycystic kidney disease.

29-year-old azoospermia male with sperm volumn was 0.2 ml, ultrasound showed seminal and vas megavesicles. The primary diagnosis was ejaculatory duct obstruction and the surgery of bilateral vas exploration and transurethral resection of ejaculatory ducts (TURED) were performed.

Instillation of methylene blue dye can be seen from the bilateral ejaculatory ducts at the time of cystoscopy although the stream of left side was less than the right side. The verumontanum was deeply resected down to the ejaculatory ducts. The patient got fever after surgery and underwent cystoscopy to clear the infection. The postoperative semen analysis revealed that the semen contained no spermatozoa although with increasing of the sperm volume (4.2 ml).

Seminal megavesicles with autosomal dominant polycystic kidney disease may lead to obstructive azoospermia. It looked like "functional obstruction" but not only "mechanical obstruction" . The obstruction was probably due to partial through compression of the ductal system but mainly because of the failure of the vas deferens and seminal vesicles to contract effectively, which called dyskinesia. TURED was less effective in the treatment of this situation.