精囊镜微创技术在顽固性血精诊疗中的临床应用

Transurethral seminal vesiculoscopy in diagnosis and treatment of persistent hemospermia

目的:探讨经尿道精囊镜微创技术在顽固性血精疾病诊治中的临床应用价值。方法:经尿道逆行插入精囊镜,逆行进入射精管及精囊,对43例顽固性血精患者进行检查和治疗。结果:43例患者中,39例均成功进入精囊,手术时间40~94(51.0±9.3)min。术中见单纯精囊壁黏膜炎症性充血、淤血块25例,精囊黏膜炎症合并精囊结石9例,射精管囊肿3例,精囊囊肿2例,行相应处理。术后随访至少3个月,34例血精消失,3例血精症复发,再次治疗后好转,余2例无效。结论:经尿道精囊镜技术是有效可行的诊断和治疗顽固性血精的新方法,并发症少,有较好的临床应用价值。

Objective：To explore the clinical application value of transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory hemospermia.Method：Totally 43 cases with seminal vesicles disorder were diagnosed and treated with transurethral seminal vesiculoscopy through the distal seminal tracts and seminal vesicles.Result：Thirty-nine cases were successfully entered the seminal vesicles,and the average operative time was（51.0±9.3）（range,40-94）minutes.Among them,simple mucosal inflammatory hyperemia and hemorrhage was found in the seminal vesicles in 25 patients,tunica mucosa vesicular seminal inflammation combined with intracavitary calculi in 9patients.Three cases were diagnosed as ejaculation pipe cyst,and cyst of seminal vesicles was found in two cases.All of them were treated properly.They were followed up for at least three months.Thirty-four cases were cured.Three cases were found recurrence of hemospermia,and they recovered again after proper treatment.However,there were still two patients who failed to improve.Conclusions：Transurethral seminal vesiculoscopy is an effective and feasible new method for clinical diagnosis and treatment of refractory hemospermia,it deserves to be popularized.