精囊精道解剖学特点及在临床内镜手术中的指导意义

Anatomic characterization of the seminal vesicle and its guiding significance in seminal vesiculoscopy

目的:通过研究精囊精道解剖学,掌握局部解剖结构,指导临床精道内镜手术。方法:收集并分析临床48例精囊镜手术资料,统计进入精囊路径方式及术后临床效果;同时选取12具成人骨盆段标本进行精囊精道局部解剖研究,并模拟手术路径。结果:解剖结果与临床术中所见相互印证,52. 1%(25/48)临床病例射精管开口无法探及,但93. 8%(45/48)临床病例可经不同途径进入精囊完成手术。结论:经尿道微创精道内镜技术治疗精道、精囊疾病是完全可行的,但仍有局限性,需要结合其他治疗才能取得更好的治疗效果。

Objective： To gain a deeper insight into the local anatomic structures of the seminal vesicle and ejaculatory duct and provide some anatomic guidance in seminal vesiculoseopy. Methods： We analyzed the clinical data on 48 cases of seminal vesiculoscopy and recorded the surgical approaches to the seminal vesicle and clinical effects after operation. At the same time, we made an anatomic study of the seminal vesicle, ejaculatory duct and prostatic utricle and simulated the surgical approaches in 12 adult pelvis specimens. Results： The anatomical results accorded well with the surgical findings. The ejaculatory ducts failed to be re-vealed for 52.1% （25/48）, but 93.8% （45/48） of the operations were completed through different approaches into the seminal vesi-cle. Conclusion ： Transurethral seminal vesiculoscopy can be applied in the treatment of seminal tract and seminal vesicle diseases,but has its obvious limitations and has to be used with other strategies to achieve better results.