摘要
目的分享精囊镜经自然腔道进镜方法的手术经验及技术体会。方法回顾性分析我院2018年1月至2021年3月采用精囊镜手术诊治的20例顽固性血精患者的临床资料。结果20例患者手术中精囊镜均成功进入精囊,其中经自然腔道38侧,2例患者各1侧无法寻及射精管开口采取破壁法进入,经自然腔道进镜成功率95%,平均手术时间(58.1±25.4)min,术中发现精囊黏膜充血、精囊内血块8例,精囊内黄色或白色絮状物16例,精囊结石5例,精囊疑似肿物2例,取活检病理证实均为炎性病变。1例患者术后出现急性附睾炎,给予对症治疗后痊愈,其他患者均未出现逆行射精、尿失禁、直肠损伤等并发症。20例患者术后中位随访时间19个月,15例血精消失或明显改善。结论应用无导丝引导经自然腔道的精囊镜视野好、操作通道大、安全性高、并发症少,值得临床推广。
Objective To discuss the techniques of natural orifice transurethral seminal vesiculoscopy.Methods Clinical data of 20 patients with intractable hematospermia treated with transurethral seminal vesiculoscopy in our institution during Jan.2018 to Mar.2021 were retrospectively analyzed.Results All operations were successful,and 38 seminal vesicle glands were entered through the natural cavity;however,the opening of the ejaculatory duct was unable to be found on one side in 2 patients.The success rate of natural orifice transurethral seminal vesiculoscopy was 95%.The average operation time was(58.1±25.4)minutes.During the operation,blood clots in the seminal vesicles were found in 8 cases,large amount of turbid flocs in the seminal vesicles was found in 16 cases,and seminal vesicle stones were found in 5 cases.Suspected masses of seminal vesicles were found in 2 cases,which were confirmed by biopsy as inflammatory lesions.Acute epididymitis was observed in 1 patient,who was cured after symptomatic treatment.No other complications such as retrograde ejaculation,urinary incontinence,or rectal injury were observed.During the median follow-up of 19 months.the hematospermia symptoms in 15 patients disappeared or improved significantly.Conclusion The application of seminal vesiculoscopy with non-wire guidance through the natural orifice has advantages of good visual field,large operating channel,high safety,and few complications.
作者
刘铭
杨庆亚
王东
袁会阳
焦方东
陈军
孙辉
LIU Ming;YANG Qingya;WANG Dong;YUAN Huiyang;JIAO Fangdong;CHEN Jun;SUN Hui(Department of Urology,Qilu Hospital(Qingdao),Cheeloo College of Medicine,Shandong University,Qingdao 266035,China)
出处
《现代泌尿外科杂志》
CAS
2021年第12期1023-1025,1081,共4页
Journal of Modern Urology
关键词
精囊镜
经自然腔道
进镜技巧
seminal vesiculoscopy
natural orifice
surgical technique
