Wang Ming-Song, Li Bo-Jun, Huang Zao-Ming, Luo Yong, Zhang Yong, Li Ke, Zhang Ke-Qin, Jin Feng-Shuo, Li Yan-Feng
Department of Urology, Daping Hospital, Institute of Surgery Research, Third Military Medical University, Chongqing, 400042, China.
Int Urol Nephrol. 2015 May;47(5):717-21. doi: 10.1007/s11255-015-0944-x. Epub 2015 Mar 21.
Seminal vesicle cysts are a rare disorder of the male reproductive system. The goal of this report was to summarize the radiological manifestations and transurethral endoscopic treatment of large seminal vesicle cysts.
The clinical data of seven cases of giant seminal vesicle cysts, including their symptoms, radiological images, transurethral endoscopic treatment, and postoperative follow-up, were retrospectively reviewed.
Computerized tomography and magnetic resonance imaging (MRI) demonstrated the cysts behind the bladder, above the prostate, and away from the midline. The lesions ranged in size from 8.26 cm × 7.98 cm × 4.85 cm to 9.27 cm × 8.95 cm × 8.15 cm. Two cases were associated with ipsilateral renal and ureteral agenesis and were classified as congenital malformations. The other five cases were simple seminal vesicle cysts thought to be secondary to acquired ejaculatory duct obstruction. All seven cases were successfully treated using transurethral endoscopic unroofing with cautery of the mucosa. All the seminal vesicle cysts were confirmed by pathologic examination. No malignant disease was found. All preoperative symptoms resolved after surgery. No complications were observed. No patient developed abnormalities of erection, ejaculation, or orgasm. No bladder or rectal injuries were noted. The seminal vesicle cysts were significantly decreased in size or absent 3-6 months after treatment.
MRI best characterized seminal vesical cysts and their cause. Transurethral unroofing with cautery of the mucosa is an extension of well-accepted cystoscopic techniques. It is safe, easy to perform, and effective. It is the preferred method for the treatment of large seminal vesicle cysts.
精囊囊肿是男性生殖系统的一种罕见疾病。本报告的目的是总结大型精囊囊肿的影像学表现及经尿道内镜治疗。
回顾性分析7例巨大精囊囊肿患者的临床资料，包括症状、影像学图像、经尿道内镜治疗及术后随访情况。
计算机断层扫描和磁共振成像（MRI）显示囊肿位于膀胱后方、前列腺上方且远离中线。病变大小范围为8.26 cm×7.98 cm×4.85 cm至9.27 cm×8.95 cm×8.15 cm。2例合并同侧肾及输尿管缺如，归类为先天性畸形。另外5例为单纯精囊囊肿，认为继发于后天性射精管梗阻。所有7例均采用经尿道内镜囊肿去顶并黏膜烧灼术成功治疗。所有精囊囊肿均经病理检查证实。未发现恶性病变。所有术前症状术后均缓解。未观察到并发症。无患者出现勃起、射精或性高潮异常。未发现膀胱或直肠损伤。治疗后3 - 6个月精囊囊肿大小显著减小或消失。
MRI能最佳地显示精囊囊肿及其病因。经尿道黏膜烧灼囊肿去顶术是公认的膀胱镜技术的扩展。该方法安全、操作简便且有效。是治疗大型精囊囊肿的首选方法。
