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[8.5/11.5F经尿道精囊镜检查在难治性血精症诊断与治疗中的应用]

[8.5/11.5F transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory hematospermia].

作者信息

Zhu Xiao-bo, Zhang Xiang-sheng, Zhang Shi-long, Shi Hong-lin, Kong Chao-hui, Ding De-gang, Liu Zhong-hua

出版信息

Zhonghua Nan Ke Xue. 2016 Mar;22(3):225-8.

Abstract

OBJECTIVE

To investigate the clinical application value of 8.5/11.5 F transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory hematospermia.

METHODS

We retrospectively analyzed 78 cases of refractory hematospermia diagnosed and treated by 8.5/11.5 F transurethral seminal vesiculoscopy from June 2012 to June 2014. The patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography, and pelvis CT or MRI before surgery, and all received transurethral seminal vesiculoscopy under the 8.5/11.5 F rigid ureteroscope.

RESULTS

Operations were all successfully accomplished, which revealed abnormal opening of the ejaculatory duct in 5 cases, mucosal inflammatory hyperemia in the prostatic utricle and seminal vesicle in 78, dark red mucilage substance in the seminal vesicle in 34, seminal vesicle stones in 19, small polyp in the seminal vesicle in 2, and ejaculatory duct or seminal vesicle cyst in 4. All the patients received symptomatic treatment during the surgery. After surgery, hematouria was found in 13 cases, which disappeared within 2 weeks, pelvic hematoma in 1 case, which was cured by conservative treatment within 3 months, and epididymitis in 2 cases, which was controlled by anti-infection treatment. Hematospermia recurred in 3 cases during the 1-year postoperative follow-up.

CONCLUSION

8.5/11.5 F transurethral seminal vesiculoscopy, with its advantages of easy operation, wide field of vision, large channel for operation, and few complications, deserves general clinical application in the diagnosis and treatment of refractory hematospermia.

摘要

目的

探讨8.5/11.5F经尿道精囊镜检查在难治性血精症诊断和治疗中的临床应用价值。

方法

回顾性分析2012年6月至2014年6月采用8.5/11.5F经尿道精囊镜检查诊断并治疗的78例难治性血精症患者。术前患者均行血清前列腺特异抗原(PSA)检查、经直肠超声检查、精囊超声检查及盆腔CT或MRI检查,均在8.5/11.5F硬性输尿管镜下行经尿道精囊镜检查。

结果

手术均顺利完成,发现射精管开口异常5例,前列腺囊及精囊黏膜炎性充血78例,精囊内暗红色胶冻样物质34例,精囊结石19例,精囊小息肉2例,射精管或精囊囊肿4例。术中所有患者均接受了对症治疗。术后出现血尿13例,2周内消失;盆腔血肿1例,3个月内保守治疗治愈;附睾炎2例,抗感染治疗后得到控制。术后1年随访,3例血精症复发。

结论

8.5/11.5F经尿道精囊镜检查操作简便、视野广、操作通道大、并发症少,在难治性血精症的诊断和治疗中值得临床推广应用。

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