Answer- D. Transrectal ultrasound to detect duct obstructionAbsent fructose with no sperms in ejaculate is suggestive of obstruction of vas deferens with seminal vesicle agenesis or obstruction. Next line of management in this patient would be transrectal ultrasound to detect duct obstruction.Transrectal Ultrasound-High-frequency (5-7) mHz transrectal ultrasound (TRUS) offers superb imaging of the prostate, seminal vesicles, and ejaculatory ducts.Due to both accuracy and convenience, TRUS has replaced surgical vasography in the diagnosis of obstructive lesions that cause infeility.
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