摘要
目的 探讨三种不同进镜途径在精囊镜手术（seminal vesicle surgery,SVS）中的成功率及并发症.方法 选取2015年10月至2017年10月在本院收治行SVS治疗患者120例的临床资料.其中血精24例,梗阻性无精子症74例（包括13例前列腺区域囊肿）,精囊炎22例.比较不同进镜途径在手术中的成功率和并发症发生情况.结果 120例患者手术时间为28～76 min,平均为（41.84 ±6.58）min,手术总成功率为96.67％ （116/120）.39例直接经射精管口,49例直接经前列腺小囊,28例经直肠实时超声（transrectal ultrasound,TRUS）引导下经前列腺小囊,4例患者手术失败.24例血精患者中,22例患者术后7d呈精液暗红色,术后30 d精液颜色恢复正常,随访3个月尚未发现复发的病例.74例梗阻性无精子症（包括13例前列腺区域囊肿）患者中,采取术中精囊冲洗液发现精子者69例,术后7d常规精液检查可见精子55例,术后6个月可见精子45例.22例精囊炎患者,术后随访3个月尚未发现复发,术后随访结果发现4例发生睾丸附睾炎,9例出现水样精液,并无尿失禁、逆行射精和直肠、前列腺损伤等并发症.结论 直接经射精管口与经前列腺小囊是采取SVS的常规进镜途径,TRUS引导下经前列腺小囊的进镜方法可有效降低手术失败率,预防术后尿失禁、逆行射精和直肠、前列腺损伤等并发症,因此具有良好的安全性.
Objective To analyze the success rate and complications of three different approaches of endoscopic approach in seminal vesiculoscopy （SVS）.Methods The clinical data of 120 patients underwent SVS in our hospital from October 2015 to October 2017 were retrospectively analyzed,including 24 cases of hemospermia,74 cases of obstructive azoospermia （including 13 cases of prostate cyst） and 22 cases of regional spermatocystitis.The success rate and complications of different approaches were compared.Results The operation time of 120 patients in the whole group was 28-76 min,with an average of （41.84 ±6.58） min,and the total success rate was 96.67％ （116/120）.Of the 120 patients,39 patients underwent direct ejaculation through the ejaculatory duct,49 patients underwent direct prostatic utricle,and 28 patients underwent transrectal ultrasound （TRUS） guided prostatic utricle,and 4 patients failed.Among of the 24 cases of hemospermia,22 cases （91.67％） after 7 days showed semen of dark red,after 30 days showed normal color of semen and after 3 months of follow-up,no recurrence was found in cases of obstructive azoospermia.Among of the 74 cases （including 13 cases of prostate cyst）,69 cases （93.24％） were found sperm lotion in the seminal vesicle,55 （74.32％） cases showed normal semen sperm after operation of 7 days,45 cases （60.81％） were found sperm at 6 months after operation.No recurrence was found in 22 cases of cystospermitis after 3 months of follow-up.The follow-up results after operation found that 4 cases of epididymitis,9 cases of watery semen,without urinary incontinence,retrograde ejaculation and rectum,prostate injury and other complications.Conclusions Directly through the ejaculatory ducts and the prostate capsule are taken into the conventional way of SVS,guided by TRUS into the prostate capsule can effectively reduce the failure rate of surgery,prevent the complications of urinary incontinence,retrograde ejaculation and rectum,prostate injury prevention after o
作者
胡月鹏
杨青松
李辰
孙青风
陶春杰
Hu Yaepeng;Yang Qingsong;Li Chen(Department of Urology,Cangzhoa People ~ Hospital,Cang-zhou 061000,China)
出处
《国际泌尿系统杂志》
2018年第6期986-989,共4页
International Journal of Urology and Nephrology
基金
沧州市科学技术研究与发展指导计划项目（162302033）
关键词
生殖器疾病
男(雄)性
精囊
外科手术
微创性
手术后并发症
Genital Diseases,Male
Seminal Vesicles
Surgical Procedures,Minimally Invasive
Postoperative Complications
