Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology

Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology

Abstract To investigate the surgical outcomes of vesiculoscopy on refractory hematospermia and ejaculatory duct obstruction (EDO), the clinical data (including pelvic magnetic resonance imaging (MRI) examinations and the long-term effects of endoscopic treatment) from 305 patients were analyzed. Fou...

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Autores principales: Liang-Gong Liao, Yan-Feng Li, Yong Zhang, Ke Li, Tong Zhu, Bo-Jun Li, Qi Wang, Xu-Dong Liu, Yong Luo, Bo Zhou, Jun Jiang
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Publicado: Nature Portfolio 2019
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Acceso en línea:https://doaj.org/article/4902596cbdf04b02b3d4903ec4c61cab
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spelling oai:doaj.org-article:4902596cbdf04b02b3d4903ec4c61cab2021-12-02T15:09:21ZEtiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology10.1038/s41598-019-41123-22045-2322https://doaj.org/article/4902596cbdf04b02b3d4903ec4c61cab2019-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-019-41123-2https://doaj.org/toc/2045-2322Abstract To investigate the surgical outcomes of vesiculoscopy on refractory hematospermia and ejaculatory duct obstruction (EDO), the clinical data (including pelvic magnetic resonance imaging (MRI) examinations and the long-term effects of endoscopic treatment) from 305 patients were analyzed. Four main etiologic groups were found on MRI. We found that 62.0% (189/305) of patients showed abnormal signal intensity in MRI investigations in the seminal vesicle (SV) area. Cystic lesions were observed in 36.7% (112/305) of the patients. The third sign was dilatation or enlargement of unilateral or bilateral SV, which were observed in 32.1% (98/305) of the patients. The fourth sign was stone formation in SV or in an adjacent cyst, which was present in 8.5% (26/305) of the patients. The transurethral endoscopy or seminal vesiculoscopy and the related procedures, including fenestration in prostatic utricle (PU), irrigation, lithotripsy, stone removal, biopsy, electroexcision, fulguration, or transurethral resection/incision of the ejaculatory duct (TURED/TUIED), chosen according to the different situations of individual patients were successfully performed in 296 patients. Fenestrations in PU+ seminal vesiculoscopy were performed in 66.6% (197/296) of cases. Seminal vesiculoscopy via the pathological opening in PU was performed in 10.8% (32/296) of cases. TURED/TUIED + seminal vesiculoscopy was performed in 12.8% (38/296) of cases, and seminal vesiculoscopy by the natural orifices of the ejaculatory duct (ED) was performed in 2.4% (7/296) of cases. Electroexcision and fulguration to the abnormal blood vessels or cavernous hemangioma at posterior urethra were performed in 7.4% (22/296) of cases. Two hundred and seventy-one patients were followed up for 6–72 months. The hematospermia of all the patients disappeared within 2–6 weeks, and 93.0% of the patients showed no further hematospermia during follow-up. No obvious postoperative complications were observed. The transurethral seminal vesiculoscopy technique and related procedures are safe and effective approaches for refractory hematospermia and EDO.Liang-Gong LiaoYan-Feng LiYong ZhangKe LiTong ZhuBo-Jun LiQi WangXu-Dong LiuYong LuoBo ZhouJun JiangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 9, Iss 1, Pp 1-11 (2019)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Liang-Gong Liao
Yan-Feng Li
Yong Zhang
Ke Li
Tong Zhu
Bo-Jun Li
Qi Wang
Xu-Dong Liu
Yong Luo
Bo Zhou
Jun Jiang
Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology
description Abstract To investigate the surgical outcomes of vesiculoscopy on refractory hematospermia and ejaculatory duct obstruction (EDO), the clinical data (including pelvic magnetic resonance imaging (MRI) examinations and the long-term effects of endoscopic treatment) from 305 patients were analyzed. Four main etiologic groups were found on MRI. We found that 62.0% (189/305) of patients showed abnormal signal intensity in MRI investigations in the seminal vesicle (SV) area. Cystic lesions were observed in 36.7% (112/305) of the patients. The third sign was dilatation or enlargement of unilateral or bilateral SV, which were observed in 32.1% (98/305) of the patients. The fourth sign was stone formation in SV or in an adjacent cyst, which was present in 8.5% (26/305) of the patients. The transurethral endoscopy or seminal vesiculoscopy and the related procedures, including fenestration in prostatic utricle (PU), irrigation, lithotripsy, stone removal, biopsy, electroexcision, fulguration, or transurethral resection/incision of the ejaculatory duct (TURED/TUIED), chosen according to the different situations of individual patients were successfully performed in 296 patients. Fenestrations in PU+ seminal vesiculoscopy were performed in 66.6% (197/296) of cases. Seminal vesiculoscopy via the pathological opening in PU was performed in 10.8% (32/296) of cases. TURED/TUIED + seminal vesiculoscopy was performed in 12.8% (38/296) of cases, and seminal vesiculoscopy by the natural orifices of the ejaculatory duct (ED) was performed in 2.4% (7/296) of cases. Electroexcision and fulguration to the abnormal blood vessels or cavernous hemangioma at posterior urethra were performed in 7.4% (22/296) of cases. Two hundred and seventy-one patients were followed up for 6–72 months. The hematospermia of all the patients disappeared within 2–6 weeks, and 93.0% of the patients showed no further hematospermia during follow-up. No obvious postoperative complications were observed. The transurethral seminal vesiculoscopy technique and related procedures are safe and effective approaches for refractory hematospermia and EDO.
format article
author Liang-Gong Liao
Yan-Feng Li
Yong Zhang
Ke Li
Tong Zhu
Bo-Jun Li
Qi Wang
Xu-Dong Liu
Yong Luo
Bo Zhou
Jun Jiang
author_facet Liang-Gong Liao
Yan-Feng Li
Yong Zhang
Ke Li
Tong Zhu
Bo-Jun Li
Qi Wang
Xu-Dong Liu
Yong Luo
Bo Zhou
Jun Jiang
author_sort Liang-Gong Liao
title Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology
title_short Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology
title_full Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology
title_fullStr Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology
title_full_unstemmed Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology
title_sort etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology
publisher Nature Portfolio
publishDate 2019
url https://doaj.org/article/4902596cbdf04b02b3d4903ec4c61cab
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