巨大精囊囊肿的微创治疗

Minimally invasive treatment of large seminal vesicle cyst

目的：探讨巨大精囊囊肿的微创治疗方法。方法收集我院1995年3月至2013年3月9例巨大精囊囊肿患者，回顾性分析诊断和治疗情况。患者平均年龄32岁（21岁-47岁），未婚1例，已婚8例，不育症5例。囊肿大小4.3cm×3.7cm×5.3cm-12.3cm×9.7cm×7.3cm ，均行手术治疗，其中经腹腔途径腹腔镜下精囊囊肿切除术5例，经尿道射精管切开术2例，经尿道精囊囊肿去顶减压术2例。结果9例均治愈出院，无并发症发生。随访6个月至24个月，临床症状均消失，复查B超或CT均未见囊肿复发。5例不育症患者，4例配偶自然受孕。结论巨大精囊囊肿临床少见，应积极手术治疗，根据囊肿的病变部位及患者的生育需求决定手术方法，微创手术具有良好效果。

Objective To discuss the minimally invasive treatments of large seminal vesicle cyst. Methods Nine patients with large seminal vesicle cysts were treated in the period of March 1995-March 2013. The symptoms, diagnostic results, treatment and outcomes were analyzed retrospectively. The mean age of these patients at diagnosis was 32 year （range 21-47）. Eight patients have married, and one unmarried. Five patients were sterile. The size of masses ranged from 4.3cm× 3.7cm×5.3cm to 12.3cm×9.7cm×7.3cm. Final surgery methods for these patients consisted of laparoscopic vesiculectomy （5 patients）, transurethral electrotomy （2 patients） and transurethral unroofing in seminal vesicle cyst （2 patients）. Results All patients were free of symptoms after surgery. No one recue during the 6 months to 24 months of follow-up. Four of the five infertile patients were expecting. Conclusion Large seminal vesicle cysts are rare. Choosing the suitable surgery methods according to the diseased region and the patients＇ demands for fertility, and the minimally invasive surgery provides an effective approach to the treatment of large seminal vesicle cyst.