经尿道精囊镜摩西技术钬激光碎石治疗血精伴精囊结石

Transurethral seminal vesiculoscopy combined with moses technology holmium laser in the treatment of hemospermia with seminal vesicle stones

目的:探讨经尿道精囊镜摩西技术钬激光碎石治疗血精伴精囊结石的临床效果。方法:回顾性分析成都市第二人民医院泌尿外科2018年1月至2019年3月收治的血精伴精囊结石患者11例,6例单侧,5例双侧;11例均伴有血精;会阴部不适7例,6例伴有射精痛;术中利用4.5 F精囊镜结合摩西技术钬激光碎石。结果:本组患者手术时间27~52 min,住院时间为3~5 d。术后随访6个月,11例血精伴精囊结石患者的血精全部消失,5例射精痛缓解,6例会阴部不适缓解,11例均未出现术后附睾炎、发热及全身中毒症状。结论:经尿道精囊镜技术,能直接观察精囊内部情况,并配合摩西技术钬激光碎石,使碎石过程中结石位移更小,但结石消融量显著增加,避免结石逃逸,缩短手术时间,具有安全性高、创伤小、恢复快等优点,值得临床进一步推广使用。

Objective To evaluate the clinical effects of transurethral seminal vesiculoscopy combined with moses technology holmium laser in the treatment of hemospermia with seminal vesicle stones.MethodsThe clinical data of 1l patients with hemospermia and seminal vesicle stones treated during Jan.2018 and Mar.2019 were retrospectively analyzed,including 6 cases of unilateral and 5 cases of bilateral stones,all of them from the Second People's Hospital of Chengdu.Hematospermia was observed in 11 cases,perineal discomfort in 7 cases and painful ejaculation in 6 cases.All patients were treated with 4.5F transurethral seminal vesiculoscopy combined with moses technology holmium laser.ResultsThe operation time was 27-52 min and hospital stay was 3-5 d.During the follow-up of 6 months,hematospermia was cured in all patients,painful ejaculation disappeared in 5 cases and perineal discomfort was relieved in 6 cases.No complications such as epididymitis,fever and systemic poisoning symptoms occurred.ConclusionsTransurethral seminal vesiculoscopy can observe the seminal vesicle directly and with moses technology holmium laser in treatment of hemospermia with seminal vesicle stones,make the stone movement less but the ablation of the stone more,avoids the stone escape and shorten operation time.It is safe,effectivea and minimal invasive,which is worthy of wide clinical application.