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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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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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Huang ZM, Li YF, Wang Q, Zhang Y, Luo Y, Nie ZL, Li K, Feng QX, Liu XD. Clinical characteristics and endoscopic treatment of hematospermia with postcoital hematuria. BMC Urol 2020; 20:78. [PMID: 32600309 PMCID: PMC7325095 DOI: 10.1186/s12894-020-00646-x] [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] [Received: 02/08/2020] [Accepted: 06/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recurrent hematospermia accompanied by postejaculatory hematuria is a very rare phenomenon, has not been well understood in the clinical setting, and usually leads to misdiagnosis and mistreatment. The aim of this study was to summarize the clinical characteristics, etiologic diagnosis, and endoscopic treatment of hematospermia with postcoital hematuria. METHODS We collected the clinical data from 39 patients of hematospermia with postcoital hematuria, who were admitted to our hospital from May 2014 to October 2019. The etiologic diagnostic process and endoscopic surgery were analyzed retrospectively, and we observed and evaluated the efficacy and any complications during follow-up. RESULTS The average age of the 39 patients was 44.1 years (range, 18-61 years), and the disease history ranged from 1 month to 20 years, with a median duration of 24 months. All of the patients were observed by urethrocystoscopy, which showed 38 cases of posterior urethral hemangioma (PUH) or abnormal varicose vessels, and 1 case of anterior urethral hemangioma. Of these, 18 patients underwent transurethral resection of urethral hemangioma, and 21 patients underwent transurethral electrocauterization. Postoperative follow-up ranged from 1 to 56 months, with a median of 16 months. The symptoms disappeared in 37 patients and recurred in 2 patients two to 3 months after the operation. The two recurrent patients were treated again by transurethral electrocauterization, and their symptoms then disappeared. CONCLUSIONS PUH is the most common cause of hematospermia with postejaculatory hematuria. Herein, we demonstrated that transurethral resection or electrocauterization provides a safe, effective, and minimally invasive method for the treatment of PUH.
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Affiliation(s)
- Zao-Ming Huang
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China
| | - Yan-Feng Li
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China.
| | - Qi Wang
- Department of Urology, Chongqing Renji Hospital, University of Chinese Academy of Sciences, Chongqing, 400062, China
| | - Yong Zhang
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China
| | - Yong Luo
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China
| | - Zhi-Lin Nie
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China
| | - Ke Li
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China
| | - Qing-Xing Feng
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China
| | - Xu-Dong Liu
- Department of Urology, Daping Hospital, Army Medical University, No.10, Daping Changjiangzhilu, Yuzhong District, Chongqing, 400042, China
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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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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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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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