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Yao RJ, Xiao H, Chen SS, Feng ZH, Ding YL, Chen X, Tang SX, Zhou HL. Efficacy of various surgical approaches in treating hematospermia using transurethral seminal vesiculoscopy. BMC Surg 2023; 23:385. [PMID: 38129847 PMCID: PMC10740288 DOI: 10.1186/s12893-023-02290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To explore the efficacy of different approaches of seminal vesiculoscopy surgery and the predictive factors of good treatment outcome. MATERIALS AND METHODS A retrospective analysis of 68 patients who underwent seminal vesiculoscopy for hematospermia in our hospital from January 2015 to January 2021. According to different surgical approaches, they were divided into three groups: natural ejaculatory ducts (method A, 45 cases), assisted transurethral resection/incision of ejaculatory ducts (method B, 14 cases), fenestration in prostatic utricle (method C, 9 cases). We analyzed the recurrence rate of the three surgical approaches and the predictive factors of treatment efficacy. RESULTS The total recurrence rate after the seminal vesiculoscopy for hematospermia in this group was 32.35%. The postoperative recurrence rates of the three methods were 24.44% for method A, 50.00% for method B and 44.44% for method C, and there was no significant difference among the three methods (P > 0.05). The data of five predictors of 45 cases in method A group were included in the Univariate Logistic analysis, the results suggest that whether complicated with seminal tract stones/cysts was an effective predictor (OR 0.250, P = 0.022), which was still an effective predictor in the Multivariate Logistic analysis model (OR 0.244, P = 0.010). CONCLUSIONS The Transurethral seminal vesiculoscopy technique demonstrates a low postoperative recurrence rate in treating hematospermia. Among the various approaches, the intraoperative use of natural orifices through the ejaculatory duct exhibits the lowest recurrence rate. Additionally, seminal tract stones/cysts effectively predict favorable postoperative outcomes.
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Affiliation(s)
- Rui-Jie Yao
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Hong Xiao
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Shu-Shen Chen
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Zhi-Hao Feng
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Yi-Lang Ding
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Xi Chen
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Song-Xi Tang
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.
| | - Hui-Liang Zhou
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.
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Andrade V, Pina J, Calais F, Campos Pinheiro L. Seminal Vesicle Calculi as a Cause of Hematospermia and Ejaculatory Pain: A Case Report. Cureus 2023; 15:e42547. [PMID: 37637661 PMCID: PMC10460135 DOI: 10.7759/cureus.42547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Seminal vesicle calculi are a rare entity that may present with hematospermia, painful ejaculation, or urinary complaints. We present a case of a 40-year-oldmale with complaints of hematospermia, ejaculatory pain, and perineal discomfort in the last five years. A 7 mm left seminal vesicle calculi were diagnosed by magnetic resonance imaging (MRI), and a laparoscopic robot-assisted vesiculectomy was performed. All the complaints improved completely after treatment. Seminal vesicle lithiasis should be kept in mind when evaluating patients with hematospermia and ejaculatory pain. Transrectal ultrasound (TRUS) and magnetic resonance imaging are the best radiology techniques to diagnose this kind of lithiasis. Different surgical treatments can be used to treat these calculi, depending on the size and location of the calculi and the surgical experience of the surgeon.
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Affiliation(s)
- Vanessa Andrade
- Urology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, PRT
| | - João Pina
- Urology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, PRT
| | - Fernando Calais
- Urology, Centro Hospitalar Universitário de Lisboa Central, Lisboa, PRT
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3
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Han H, Lei HE, Zhang XD, Tian L. Magnetic resonance imaging compared to ultrasound as the preferred method for diagnosing intractable haematospermia. Andrologia 2021; 53:e14054. [PMID: 33955038 PMCID: PMC8244118 DOI: 10.1111/and.14054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 01/12/2023] Open
Abstract
We aimed to evaluate and compare the clinical diagnostic values of magnetic resonance imaging (MRI) and ultrasound in patients with intractable haematospermia. We performed a retrospective review of 23 patients with intractable haematospermia who were diagnosed with seminal vesicle haematocele and/or calculi by transurethral seminal vesiculoscopy (TSV). Patients’ demographics, disease durations, operative times, and MRI and transrectal ultrasound (TRUS) results were recorded. McNemar's test was used to compare the positive diagnostic rates of MRI and TRUS. All patients had undergone preoperative seminal vesicle MRI and TRUS to identify the aetiology of the haematospermia. The average age and disease duration were 39.3 years and 24.1 months, respectively. The mean operative time was 81.1 min. The positive result rates for MRI and TRUS were 95.7% (22/23) and 39.1% (9/23), respectively. Compared with TRUS, MRI had a significantly higher preoperative positive diagnostic rate (p < 0.01). These results suggest that MRI should be considered as a method for diagnosing intractable haematospermia in patients when TRUS findings are negative or inconclusive.
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Affiliation(s)
- Hu Han
- Department of Urology, Institute of Urology, Capital Medical University, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hong-En Lei
- Department of Urology, Institute of Urology, Capital Medical University, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiao-Dong Zhang
- Department of Urology, Institute of Urology, Capital Medical University, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Long Tian
- Department of Urology, Institute of Urology, Capital Medical University, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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4
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Wiesmayr M, Meyer D, König F, Engeler D, Schmid HP, Müllhaupt G. First Report of a Symptomatic Calculus of the Ampulla of the Ductus Deferens. J Endourol Case Rep 2021; 6:253-255. [PMID: 33457647 DOI: 10.1089/cren.2020.0024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Similar to other secretory organs, the male spermatic ducts may develop calculi. However, this condition is described as rare in literature and usually affects the seminal vesicles. As far as we know, no cases of calculi in the ampulla of the ductus deferens have been published so far. Patients with seminal vesicle calculi usually complain of hematospermia, painful ejaculation, perineal or testicular discomfort or pain, and often experience significant impairment of quality of life. Case Presentation: We present a case of a 39-year-old patient who presented himself in an external urologic practice with recurrent hematospermia and painful ejaculation. According to the diagnosis of a seminal vesicle calculus of 1 cm in length on the right side, the patient underwent a transurethral vesiculo- and ampulloscopy with a semirigid ureteroscope whereby the stone could be located in the ampulla of the ductus deferens and removed in toto. Conclusion: Lithiasis should be kept in mind when examining patients with hematospermia and ejaculation pain. Transurethral ampulloscopy is an efficient, safe, and minimally invasive method for stone removal from the ampulla of the ductus deferens.
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Affiliation(s)
- Magdalena Wiesmayr
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Daniel Meyer
- Doctor's Office for Urology, Urologie Appenzellerland, Herisau, Switzerland
| | - Frederik König
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Daniel Engeler
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Hans-Peter Schmid
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Gautier Müllhaupt
- Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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5
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Cui B, Wu JT, Xu JJ, Ou TW. Efficacy and feasibility of day surgery using transurethral seminal vesiculoscopy under caudal block anesthesia for intractable hemospermia. Transl Androl Urol 2020; 9:2493-2499. [PMID: 33457223 PMCID: PMC7807306 DOI: 10.21037/tau-20-870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Transurethral seminal vesiculoscopy (TSV) is a safe and effective method for intractable hemospermia. It uses a natural cavity, is fast, involves little trauma, and boasts a low incidence of complications. Because uncontrollable penile erection during general anesthesia will severely influence the surgical operation or even damage the endoscope, spinal anesthesia was applied more on TSV. But spinal anesthesia extends the length of stay in the hospital and brings patients unnecessary discomfort. As the TSV is a quick recovery operation, we should think about a more suitable mode for these patients. Methods A total of 141 patients received TSV between January 2015 and July 2019: 81 patients received day surgery under caudal block (group A), and 60 received inpatient surgery under spinal anesthesia (group B). Operative time, postoperative hospital stay, hemospermia remission rate, magnetic resonance imaging (MRI) remission rate are compared. Visual analog scale (VAS) scores of groups were taken and compared at 2 time points: when there was pain during surgery (T1) and at the end of surgery (T2). Surgical methods of two groups are the same. Results The mean operative time of two groups are 34 min (group A) and 32 min (group B), and there was no statistical difference. Postoperative hemospermia remission rates are both 100% at 3 months, which at 6 months are 60% and 48%, and there was no statistical difference. MRI remission at 3 months are 72% and 57%, which has no statistical difference. Postoperative complications were mild in two groups like hematuria and dysuria which can relieve within one day, and there were no severe complications. Intraoperative pain was present in 18.5% (15/81) of group A. Their highest VAS score was 3 points, indicating mild pain, which did not influence the surgical process or postoperative recovery. The postoperative VAS scores were similar between the 2 groups. Group A did not require postoperative hospitalization, whereas the average postoperative hospitalization in group B was 2 days. Conclusions Seminal vesiculoscopy can be performed as a day surgery under caudal block, which has obvious advantages in accelerating postoperative recovery and shortening the hospital stay.
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Affiliation(s)
- Bo Cui
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiang-Tao Wu
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jian-Jun Xu
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tong-Wen Ou
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing, China
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6
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Pang K, Lou K, Huang Y, Wang H, Hao L, Shi Z, Zang G, Wei C, Chen B, Han C. Application of ultrasound-guided seminal vesicle radiography combining CT three-dimensional reconstruction technique in transurethral seminal vesiculoscopy. Andrologia 2020; 52:e13845. [PMID: 33053609 DOI: 10.1111/and.13845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 08/26/2020] [Accepted: 08/30/2020] [Indexed: 02/03/2023] Open
Abstract
For the treatment of ejaculatory duct obstruction, transurethral seminal vesiculoscopy (TSV) is the most common method, but the success rate is much lower than studies that have reported. So we developed a new ultrasound-guided seminal vesicle radiography (UGSVR) combining CT three-dimensional reconstruction (CT-TR) technique to improve the success rate of TSV. Between June 2018 and November 2019, 32 patients were enrolled and randomly assigned to two groups: experimental group (UGSvR combining CT-TR) and control group (standard evaluation). Baseline information, including age, smoking history and body mass index (BMI), was compared preoperatively. Surgical parameters included success rates (SR), surgical time (ST), catheter days (CD), length of hospital stays (HS) and complications were compared between groups. There were no statistically significant differences in baseline data between the two groups (all p > .05). There were no significant differences in the CD, HS and complications between the two groups (all p > .05), but the differences in ST and SR were statistically significant (p < .05). In conclusion, this new technique of UGSvR combining CT-TR was achieving a satisfactory increase in the success rate of TSV, while not increasing the incidence of complications, compared to normal evaluation before TSV operation.
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Affiliation(s)
- Kun Pang
- Department of Urology, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China.,Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou City, China.,College of Life Sciences, Jiangsu Normal University, Xuzhou City, China
| | - Kexin Lou
- Department of Ultrasound, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Yayong Huang
- Department of Computed Tomography, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Hao Wang
- Department of Urology, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Lin Hao
- Department of Urology, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Zhenduo Shi
- Department of Urology, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Guanghui Zang
- Department of Urology, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Cui Wei
- Department of Pediatrics, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Bo Chen
- Department of Urology, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China
| | - Conghui Han
- Department of Urology, Xuzhou Clinical School of Xuzhou Medical College, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, Xuzhou Central Hospital, Xuzhou, China.,Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou City, China.,College of Life Sciences, Jiangsu Normal University, Xuzhou City, China
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7
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Song L, Han H, Lei H, Cui Y, Feng S, Zhang X, Tian L. Successful treatment of seminal vesicle calculi and prostatic utricle calculi by transurethral seminal vesiculoscopy. Andrologia 2020; 52:e13804. [PMID: 32851699 PMCID: PMC7757201 DOI: 10.1111/and.13804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 01/27/2023] Open
Abstract
To investigate the outcomes of transurethral seminal vesiculoscopy (TSV) for the treatment of seminal vesicle calculi (SVC), prostatic utricle calculi (PUC) and combination of them, a retrospective review on 27 patients with SVC and/or PUC who complained of intractable haematospermia was conducted. Patient demographics, disease duration, operation time, stone location and complications were recorded. The calculi in the seminal vesicle and/or prostatic utricle were removed by holmium laser lithotripsy and/or basket extraction. The stone composition was determined in 19 of 27 patients using Infrared spectroscopy. The average age and disease duration of patients were 39.4 years and 23.1 months respectively. The mean operative time was 78.5 min. We detected SVC, SVC and PUC, and PUC in 59.3% (16/27), 33.3% (9/27) and 7.4% (2/27) patients respectively. The stones were mainly composed of calcium oxalate dehydrate (COD), carbonate apatite (CA), COD and calcium oxalate monohydrate (COM), CA and magnesium ammonium phosphate, CA and COM, and COD and uric acid in 42.1% (8/19), 21.1% (4/19), 15.8% (3/19), 15.8% (3/19), 5.3% (1/19) and 5.3% (1/19) cases respectively. No intraoperative and post‐operative complications were noted. These results suggested that SVC and PUC can be diagnosed and treated using TSVs.
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Affiliation(s)
- Liming Song
- Department of Urology, Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hu Han
- Department of Urology, Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hongen Lei
- Department of Urology, Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yun Cui
- Department of Urology, Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Sujuan Feng
- Department of Urology, Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaodong Zhang
- Department of Urology, Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Long Tian
- Department of Urology, Institute of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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8
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Guiding role of seminal tract anatomical study in transurethral seminal vesiculoscopy. Wideochir Inne Tech Maloinwazyjne 2020; 15:176-184. [PMID: 32117502 PMCID: PMC7020709 DOI: 10.5114/wiitm.2019.86774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 05/29/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction There have been problems with low qualification operator-related complications and failures of transurethral seminal vesiculoscopy (TSV) in China. Aim To study the guiding role of seminal tract anatomical study (STAS) in TSV. Material and methods We performed STAS to study the structure, morphology, duct trajectory, and anatomical relationships between the seminal vesicles and the adjacent tissue in pelvic specimens from 12 adult cadavers. Then the surgical effects and complications of 82 cases of TSV performed by 3 doctors were retrospectively studied to compare the difference between the two groups of before and after the anatomical study. Results The anatomical studies of the 12 adult cadaveric pelvis specimens identified the lengths and widths of the right- and left-side seminal vesicles and tracts. The TSV can treat lesions located in the distal seminal tract and vesicle, but proximal lesions cannot be reached, which is an anatomical limitation of this technique. There were significant differences in the surgical times and the surgical validity rates between the 2 groups. Conclusions Our anatomical study of the seminal tract and seminal vesicles is valuable for guiding TSV in clinical practice.
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Pang K, Dong BZ, Han CH. Commentary on "Transurethral seminal vesiculoscopy for recurrent hemospermia: experience from 419 cases". Asian J Androl 2020; 22:227-228. [PMID: 31187781 PMCID: PMC7155798 DOI: 10.4103/aja.aja_56_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kun Pang
- Department of Urology, Xuzhou Central Hospital, Xuzhou Clinical College Affiliated to Xuzhou Medical University, Xuzhou 221009, China
| | - Bing-Zheng Dong
- Department of Urology, Xuzhou Central Hospital, Xuzhou Clinical College Affiliated to Xuzhou Medical University, Xuzhou 221009, China
| | - Cong-Hui Han
- Department of Urology, Xuzhou Central Hospital, Xuzhou Clinical College Affiliated to Xuzhou Medical University, Xuzhou 221009, China
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10
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Zaidi S, Gandhi J, Seyam O, Joshi G, Waltzer WC, Smith NL, Khan SA. Etiology, Diagnosis, and Management of Seminal Vesicle Stones. Curr Urol 2019; 12:113-120. [PMID: 31316318 DOI: 10.1159/000489429] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/13/2018] [Indexed: 01/05/2023] Open
Abstract
Background/Aims Seminal vesicle (SV) stones are a rare, and thus readily misdiagnosed condition in practice. Understanding the etiology, diagnosis, and management are crucial to guide a urologist's care, and are provided in this literature review. Methods The inclusion criteria for the literature search, using the search engines MEDLINE® and PubMed was conducted using a combined query of "seminal vesicle stone" and the following keywords: calculi, hematospermia, calcification, and transrectal ultrasound (TRUS). Results The etiology of SV stones is currently unknown where majority of the patients present with having painful ejaculation and hematospermia. However, clinicians have reported potential etiologies by categorization as an inflammatory or non-in-flammatory. A majority of the previous cases had shown multiple stones being present in the SV duct system that are typically diagnosed through radiological examination such as TRUS, MRI, or plain radiographs. Amongst the many imaging approaches, TRUS remains the primary imaging diagnoses of SV calculi. Transurethral seminal vesiculoscopy has shown to be used in an abundant of the case reports to be an ideal surgical approach for managing small SV stones. In regard to larger stones, a transperitoneal laparoscopic protocol is proper. Conclusion The current imaging techniques have increased the case reports and diagnosis of SV calculi; however, more research is warranted for understanding the pathogenesis of the formation of SV stones. An optimal management of the extraction of SV stones depends on a number of factors such as size and location.
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Affiliation(s)
- Saher Zaidi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Jason Gandhi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Department of Urology, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Omar Seyam
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Gunjan Joshi
- Medical Student Research Institute, St. George's University School of Medicine, Grenada, West Indies
| | | | - Noel L Smith
- Department of Internal Medicine, Stony Brook Southampton Hospital, Southampton, NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Foley Plaza Medical, New York, NY, USA
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11
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Li ZY, Xu Y, Liu C, Xiao ZM, Luo BH, Xu GW, Wu KC, Zhong SZ, Ouyang J. Anatomical study of the seminal vesicle system for transurethral seminal vesiculoscopy. Clin Anat 2018; 32:244-252. [PMID: 30281853 DOI: 10.1002/ca.23293] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/07/2018] [Accepted: 09/28/2018] [Indexed: 01/23/2023]
Abstract
Because of a general lack of knowledge regarding the precise anatomy of the seminal vesicle system, efforts to use transurethral seminal vesiculoscopy (TSV) are currently constrained. We investigated 26 normal adult male specimens. Contrast medium was injected into the seminal vesicle system in 18 specimens and the openings of the ejaculatory ducts were examined with an operating microscope. India ink was injected into the urethra in four specimens to investigate the function of the ejaculatory duct valve. Another four specimens were examined histologically to identify the anatomical relationships of the seminal vesicle system. We found that the openings of the ejaculatory ducts were covered by the ejaculatory duct valve, which could be classified into two types and acted as a one-way valve. The apex of the seminal colliculus together with the right and left openings of the ejaculatory ducts formed a shape resembling an isosceles triangle. This could be used to locate the openings of the ejaculatory ducts during TSV. The ejaculatory ducts can be classified into two types according to their course. During surgery, efforts must be made to protect the ejaculatory duct valve. During inspection or surgery, the second segment and the angles of the ejaculatory ducts, particularly in Type Ib and Type II cases, require particular attention. Clin. Anat. 32:244-252, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Ze Y Li
- Department of Anatomy, Southern Medical University, Guangzhou, China
| | - Yu Xu
- Department of Orthopedic Surgery, Nan fang Hospital, Southern Medical University, Guangzhou, China
| | - Chang Liu
- Department of Anatomy, Southern Medical University, Guangzhou, China
| | - Zhao M Xiao
- Department of Anatomy, Southern Medical University, Guangzhou, China
| | - Bao H Luo
- Department of Anatomy, Southern Medical University, Guangzhou, China
| | - Guang W Xu
- Department of Anatomy, Southern Medical University, Guangzhou, China
| | - Kun C Wu
- Department of Anatomy, Southern Medical University, Guangzhou, China
| | - Shi Z Zhong
- Department of Anatomy, Southern Medical University, Guangzhou, China
| | - Jun Ouyang
- Department of Anatomy, Southern Medical University, Guangzhou, China
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12
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Tian L, Han H, Lei HE, Zhang XD. Clinical features of haematospermia associated with seminal vesicle calculi versus posterior urethral haemangioma. Andrologia 2018; 50:e13072. [PMID: 29938822 DOI: 10.1111/and.13072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/15/2018] [Accepted: 05/21/2018] [Indexed: 01/30/2023] Open
Abstract
To compare the clinical features of seminal vesicle calculi(SVC) versus posterior urethral haemangioma(PUH) to assist urologists in differentiating and diagnosing the causes of haematospermia. Patients with SVC or PUH were included. Patient age, disease duration, hospital stay, operation time, symptoms, surgical approach, pathological results and postoperative complications were recorded. A total of seven patients with SVC and 15 patients with PUH involved have an average age of 34.1 and 44.5 years separately. Patients with SVC complained of recurrent haematospermia; patients with PUH complained of recurrent haematospermia and urethral opening bleeding after sexual arousal. SVC manifested as a dark red blood-semen mixture with ejaculation pain and no blood clots; the condition could improve after anti-infective treatment. PUH manifested as no visible blood-semen mixture, bright red semen with blood clots and no ejaculation pain; the condition did not respond to anti-infective treatment. SVC was treated with holmium laser lithotripsy under a transurethral seminal vesiculoscopy. PUH was treated with transurethral resection and fulguration. Postoperative follow-up showed that the clinical symptoms gradually disappeared, with no postoperative complications. Both SVC and PUH can result in recurrent haematospermia. Therefore, urologists should treat haematospermia differently according to the cause.
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Affiliation(s)
- Long Tian
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hu Han
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hong-En Lei
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiao-Dong Zhang
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Williams SA, Christodoulidou M, Nigam R. Large bilateral seminal vesicle calculi presenting with spermolithiasis. BMJ Case Rep 2017; 2017:bcr-2017-219630. [PMID: 28576910 DOI: 10.1136/bcr-2017-219630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 34-year-old male presented with an 8-month history of passing increasingly painful 'grit' in his ejaculate. Semen analysis was normal as were urinary and blood tests. T1-weighted MRI revealed several bilateral high-signal areas measuring up to 1 cm in diameter, located in the seminal vesicles. These were confirmed as calculi on T2-weighted imaging and a seminal vesiculogram, with no drainage from the left ejaculatory duct and only minimal from the right duct. He is currently awaiting a robot-assisted laparoscopic vesiculotomy after completion of family.
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Affiliation(s)
| | | | - Raj Nigam
- Urology, The Royal Surrey County Hospital, Surrey, UK
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