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Wang XS, Li M, Shao GF, Sun WD, Zhang XL, Xiao ZY, Ma Z, Yuan MZ, Guo LQ. Real-time transrectal ultrasound-guided seminal vesiculoscopy for the treatment of patients with persistent hematospermia: A single-center, prospective, observational study. Asian J Androl 2021; 22:507-512. [PMID: 31898586 PMCID: PMC7523612 DOI: 10.4103/aja.aja_134_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
This study aimed to describe endoscopic anatomy of the seminal tract and summarize our experience of transutricular seminal vesiculoscopy (TSV) guided by real-time transrectal ultrasonography (TRUS) in managing persistent hematospermia. A total of 281 consecutive patients with persistent hematospermia who underwent TSV with or without real-time TRUS were enrolled in this single-center, prospective, observational study. The median follow-up period was 36.5 (range: 8.0–97.5) months. TSV was successfully performed in 272 (96.8%) patients. The approach of a 4.5/6 F rigid vesiculoscope entering the seminal tract was categorized into four types on the basis of endoscopic presentation of the ejaculatory duct orifice and verumontanum. Seven (2.6%), 74 (27.2%), 64 (23.5%), and 127 (46.7%) patients had Types I (through the ejaculatory duct in the urethra), II (through the ejaculatory duct in the prostatic utricle), III (transutricular fenestration through a thin membrane), and IV (real-time transrectal ultrasound-guided transutricular fenestration) approach, respectively. In patients who successfully underwent surgery, bleeding occurred in the seminal vesicle in 249 (91.5%) patients. Seminal vesiculitis, calculus in the prostatic utricle, calculus in the ejaculatory duct, calculus in the seminal vesicle, prostatic utricle cysts, and seminal vesicle cysts were observed in 213 (78.3%), 96 (35.3%), 22 (8.1%), 81 (29.8%), 25 (9.2%), and 11 (4.0%) patients, respectively. Hematospermia was alleviated or disappeared in 244 (89.7%) patients 12 months after surgery. Fifteen patients had recurrent hematospermia, and the median time to recurrence was 7.5 (range: 2.0–18.5) months. TSV guided by TRUS may contribute to successful postoperative outcomes in managing persistent hematospermia.
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Affiliation(s)
- Xue-Sheng Wang
- Department of Urology, Center for Reproductive Medicine, Shandong University, Jinan 250001, China.,Department of Urology, The Second Hospital of Shandong University, Jinan 250033, China
| | - Ming Li
- Department of Urology, The Second Hospital of Shandong University, Jinan 250033, China
| | - Guang-Feng Shao
- Department of Urology, The Second Hospital of Shandong University, Jinan 250033, China
| | - Wen-Dong Sun
- Department of Urology, The Second Hospital of Shandong University, Jinan 250033, China
| | - Xiu-Lin Zhang
- Institute of Urology, Shandong University, Jinan 250033, China
| | - Zhi-Ying Xiao
- Department of Urology, The Second Hospital of Shandong University, Jinan 250033, China.,Institute of Urology, Shandong University, Jinan 250033, China
| | - Zhen Ma
- Department of Urology, The Second Hospital of Shandong University, Jinan 250033, China
| | - Ming-Zhen Yuan
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
| | - Li-Qiang Guo
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
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Miao C, Liang C, Wang Y, Song Z, Xu A, Liu B, Li J, Song N, Wang Z. The management and composition of symptomatic seminal vesicle calculi: aetiological analysis and current research. BJU Int 2019; 125:314-321. [PMID: 30924591 DOI: 10.1111/bju.14758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report our experience in the diagnosis, minimally invasive treatment, and composition of seminal vesicle calculi (SVC). PATIENTS AND METHODS In the present study, we evaluated 20 patients who were admitted to our hospital from January 2013 to January 2018. All the patients were diagnosed with intractable haematospermia and SVC. The diagnosis was further confirmed by seminal vesiculoscopy. SVC were removed by basket extraction; with larger SVC fragmented by holmium laser before extraction. Scanning electron microscopy, X-ray diffraction, and infrared spectroscopy were used to determine the SVC composition. RESULTS All operations were completed successfully without surgical complications. SVC were mostly composed of hydroxyapatite and protein, suggesting that they were produced by infections. CONCLUSIONS Seminal vesiculoscopy is a simple, minimally invasive technique that can be used for diagnostic confirmation and treatment of seminal vesiculitis with SVC. This study improves our understanding of SVC and provides a theoretical basis for the prevention of postoperative recurrence of SVC.
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Affiliation(s)
- Chenkui Miao
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chao Liang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yamin Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen Song
- Department of Urology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, China
| | - Aiming Xu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Bianjiang Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Li
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zengjun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Hu JC, Chen CS. Transurethral seminal vesiculoscopy acts as a therapeutic investigation for intractable hemospermia: Step-by-step illustrations and single-surgeon experience. Int J Urol 2018; 25:589-595. [PMID: 29664136 DOI: 10.1111/iju.13569] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/22/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the methodology of transurethral seminal vesiculoscopy and the anatomy of the seminal tract, and to report a single-surgeon experience with this procedure. METHODS A total of 38 consecutive patients with intractable macroscopic hemospermia were enrolled from January 2010 to July 2016. A 6/7.5-Fr semirigid ureteroscope was used to enter the seminal tract by one of these two approaches: through either a trans-ejaculatory duct opening or a trans-utricle fenestration. Patient characteristics and their preoperative and postoperative measurements were analyzed retrospectively. RESULTS The success rate of transurethral seminal vesiculoscopy was 92.1%, whereas the approaching method in most patients was the trans-utricle fenestration (88.89%). A total of 34 (94.4%) transurethral seminal vesiculoscopy inspections ended with complete remission, even though nearly half of them (47.2%) only disclosed negative perioperative findings. The median period to complete remission was 4 weeks (interquartile range 4-6 weeks) after the procedure. Four patients had recurrent hemospermia, and the median time to recurrence was 21.5 (range 13-48.5) months. CONCLUSIONS Transurethral seminal vesiculoscopy is a valuable diagnostic tool for intractable hemospermia, and also plays a therapeutic role by blocking the vicious cycle of stasis, calculi and seminal vesiculitis. More familiarity of the anatomy and enough practice would make the learning curve less steep.
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Affiliation(s)
- Ju-Chuan Hu
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chuan-Shu Chen
- Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
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Ardiaca M, Bonvehi C, Cuesta M, Gomez A, Montesinos A. Seminal Vesiculitis in Three Pet Rabbits ( Oryctolagus cuniculus ). J Am Anim Hosp Assoc 2016; 52:335-40. [PMID: 27487350 DOI: 10.5326/jaaha-ms-6368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
To date, descriptions of pathologic conditions of the seminal vesicle in rabbits are scarce and limited to the laboratory animals in experimental conditions. The present article describes three cases of strangury, abdominal pain, and anorexia associated with seminal vesiculitis in pet rabbits. Three non-neutered male pet rabbits aged 3.6, 1.5, and 2.1 yrs were presented with strangury, abdominal pain, and anorexia. Seminal vesiculitis was diagnosed based on clinical signs and ultrasonography findings. Vesiculectomy was performed in two cases that presented strangury refractory to medical treatment, and diagnosis was confirmed by histopathology. In the third case, the patient received medical treatment, and a sequela in the form of lithiasis of the seminal vesicle was detected 3 yrs later. Plain radiographs were nearly unremarkable, and results from complete blood analysis and urinalysis were not specific in all three cases. Contrast radiography was performed in one case, showing a dilated seminal vesicle. Ultrasound and surgical biopsy seem to be the most sensitive techniques in the diagnosis of this pathology. Seminal vesiculitis must be included in the differential diagnosis of acute or chronic strangury in male pet rabbits.
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Affiliation(s)
| | | | | | - Alicia Gomez
- From Centro Veterinario Los Sauces, Madrid, Spain
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Dagur G, Warren K, Singh N, Khan SA. Detecting diseases of neglected seminal vesicles using imaging modalities: A review of current literature. Int J Reprod Biomed 2016. [DOI: 10.29252/ijrm.14.5.293] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Dell'Atti L. Importance of an Early Diagnosis in Primary Adenocarcinoma of the Seminal Vesicle. Rare Tumors 2016; 8:6187. [PMID: 27134716 PMCID: PMC4827653 DOI: 10.4081/rt.2016.6187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/15/2015] [Accepted: 12/20/2015] [Indexed: 11/23/2022] Open
Abstract
The prognosis of seminal vesicle (SV) adenocarcinoma is often poor due to delayed diagnosis. About 95% of the patients die in less than 3 years. Diagnosis is difficult due to the absence of early clinical signs as hematuria, hematospermia and/or dysuria. We present the case of a 61-year-old Caucasian man with a left SV mass detected by transrectal ultrasound. SV ultrasound-guided biopsy showed an adenocarcinoma. The tumor was uniformly strongly immunoreactive for cytokeratin-7 and carcinoembryonic antigen. There was no immunoreactivity for prostate-specific acid phosphatase (PSAP) and CK-20. These tumors have been reported to be also positive for CA-125. Therefore a combination of positive staining for CK-7, CEA and CA-125; with negative staining for CK-20, PSA and PSAP is the pattern of immunohistochemical findings noted for this rare tumor. The computed tomography of the abdomen-pelvis and chest X-ray was negative for metastases. The patient underwent a radical prostatectomy and lymphadenectomy. The prostate, rectum, bladder and lymph nodes were free from tumor involvement. The patient did not receive any adjuvant chemotherapy or radiation; and remains free of disease 3 years post-surgery.
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Affiliation(s)
- Lucio Dell'Atti
- Department of Urology, St. Anna University Hospital , Ferrara, Italy
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Abnormal Expression of Sg I is Closely Related to Seminal Vesiculitis. Urology 2016; 88:227.e9-227.e14. [DOI: 10.1016/j.urology.2015.08.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/04/2015] [Accepted: 08/31/2015] [Indexed: 02/01/2023]
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Reddy MN, Verma S. Lesions of the Seminal Vesicles and their MRI Characteristics. J Clin Imaging Sci 2014; 4:61. [PMID: 25396077 PMCID: PMC4229784 DOI: 10.4103/2156-7514.143734] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 09/12/2014] [Indexed: 11/04/2022] Open
Abstract
Over the past few decades, MRI of the prostate has made great strides in improving cancer detection and is being embraced by more clinicians each day. This article aims to review the imaging characteristics of common and uncommon, but consequential lesions involving the seminal vesicles (SV), as seen predominantly on MRI. Many of these findings are seen incidentally during imaging of the prostate. Anatomy and embryology of the SV will be described which will help illustrate the associations of abnormalities seen. Congenital, infectious, neoplastic, and tumor mimics will be explored in detail, with discussion on clinical presentation and treatment strategies.
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Affiliation(s)
- Mahati N Reddy
- Department of Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Sadhna Verma
- Department of Abdominal Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
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Liu B, Song Z, Xu A, Su S, Wang Z, Yin C. Is abnormal expression of semenogelin I involved with seminal vesiculitis? Med Hypotheses 2014; 82:338-40. [DOI: 10.1016/j.mehy.2013.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 12/28/2013] [Indexed: 10/25/2022]
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Liu B, Li J, Li P, Zhang J, Song N, Wang Z, Yin C. Transurethral seminal vesiculoscopy in the diagnosis and treatment of intractable seminal vesiculitis. J Int Med Res 2014; 42:236-42. [PMID: 24391141 DOI: 10.1177/0300060513509472] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the efficacy and safety of transurethral seminal vesiculoscopy in the diagnosis and treatment of intractable seminal vesiculitis. METHODS This prospective observational study enrolled patients with intractable seminal vesiculitis. The transurethral seminal vesiculoscope was inserted into the bilateral ejaculatory ducts and seminal vesicles, via the urethra. The ejaculatory ducts and seminal vesicles were visualized to confirm the diagnosis of seminal vesiculitis and to determine the cause of the disease. The seminal vesicles were washed repeatedly using 0.90% (w/v) sodium chloride before a 0.50% (w/v) levofloxacin solution was injected into the seminal vesicles. RESULTS A total of 114 patients participated in the study and 106 patients underwent bilateral seminal vesiculoscopy. Six patients with postoperative painful ejaculation were treated successfully with oral antibiotics and α-blockers. Two patients with postoperative epididymitis were treated successfully with a 1-week course of antibiotics. Haematospermia was alleviated in 94 of 106 patients (89%), and their pain and discomfort had either disappeared or had been obviously relieved, following treatment. CONCLUSION Transurethral seminal vesiculoscopy is effective for diagnosing and treating intractable seminal vesiculitis.
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Affiliation(s)
- Bianjiang Liu
- State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
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