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Transutricular seminal vesiculoscopy in the management of symptomatic midline cyst of the prostate.
World J Urol. 2016 Jul; 34(7):985-92.WJ

Abstract

PURPOSE

To evaluate the utility of transutricular seminal vesiculoscopy as a diagnostic and therapeutic option for symptomatic midline cyst of the prostate in patients with hematospermia and symptoms associated with prostatitis.

MATERIALS AND METHODS

From January 2005 to July 2013, 61 patients with symptomatic (hematospermia, pain on ejaculation, scrotal discomfort) midline cyst of the prostate, who did not improve with medication within a 4-week period, were included. Diagnosis of a midline cyst of the prostate was based on an anechoic round or spheroid-shaped lesion in the median, above the level of the verumontanum, extending into the prostatic base on transrectal ultrasonography (TRUS). All patients underwent transutricular seminal vesiculoscopy using a 9.0 Fr rigid ureteroscope and Bugbee electrode. Medical records, the Chronic Prostatitis Symptom Index (NIH-CPSI), and TRUS were used for assessment for more than 3 months after the procedure.

RESULTS

Of the 61 patients, 32 (52.4 %) had hematospermia, 20 (32.7 %) had symptoms associated with chronic pelvic pain syndrome, such as perineal pain, scrotal discomfort, and testicular pain, and nine (14.7 %) patients had ejaculatory disturbances, such as painful or uncomfortable ejaculation and anejaculation as major complaints/symptoms. In endoscopic findings, hemorrhage was present in the dilation of the prostatic utricle and in the seminal vesicle in 11 (18.0 %) and 21 (34.4 %) of the patients, respectively. Calculi were found in the dilation of the prostatic utricle and in the seminal vesicle in 12 (19.7 %) and six (9.8 %), respectively. Hematospermia resolved in 29 of 32 (90.6 %) patients after transutricular seminal vesiculoscopy. In 29 patients with chronic pelvic pain syndrome and ejaculatory disturbances, NIH-CPSI scores improved, from 19.0 ± 3.8 to 11.8 ± 3.6 (p < 0.001), after treatment. The pain domain and quality-of-life domain scores of the NIH-CPSI were better postsurgery than presurgery (p < 0.001). Acute epididymitis, as a postoperative complication, was observed in two patients (3.3 %).

CONCLUSIONS

There are various endoscopic findings in the dilation of prostatic utricle and seminal vesicle such as hemorrhage, calculi or/and purulent material in the patients with midline cyst of the prostate. The role of transutricular seminal vesiculoscopy in reducing symptoms may be mediated through the effects of endoscopic fenestration, removal of blood clots, calculi, or whitish debris and/or electrocautery of intracystic hemorrhage. This endoscopic technique enables useful diagnostic and therapeutic approaches for symptomatic midline cysts of the prostate.

Authors+Show Affiliations

Department of Urology, Kosin University Gospel Hostial, Busan, Korea.Department of Urology, Inje University Busan Paik Hospital, Gaegeum-dong, Busanjin-gu, Busan, 614-735, Korea.Department of Urology, Inje University Busan Paik Hospital, Gaegeum-dong, Busanjin-gu, Busan, 614-735, Korea.Department of Urology, Kosin University Gospel Hostial, Busan, Korea.Department of Urology, Inje University Busan Paik Hospital, Gaegeum-dong, Busanjin-gu, Busan, 614-735, Korea. prosdoc@hanmail.net.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26387919

Citation

Kang, Pil Moon, et al. "Transutricular Seminal Vesiculoscopy in the Management of Symptomatic Midline Cyst of the Prostate." World Journal of Urology, vol. 34, no. 7, 2016, pp. 985-92.
Kang PM, Seo WI, Yoon JH, et al. Transutricular seminal vesiculoscopy in the management of symptomatic midline cyst of the prostate. World J Urol. 2016;34(7):985-92.
Kang, P. M., Seo, W. I., Yoon, J. H., Kim, T. S., & Chung, J. I. (2016). Transutricular seminal vesiculoscopy in the management of symptomatic midline cyst of the prostate. World Journal of Urology, 34(7), 985-92. https://doi.org/10.1007/s00345-015-1689-y
Kang PM, et al. Transutricular Seminal Vesiculoscopy in the Management of Symptomatic Midline Cyst of the Prostate. World J Urol. 2016;34(7):985-92. PubMed PMID: 26387919.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transutricular seminal vesiculoscopy in the management of symptomatic midline cyst of the prostate. AU - Kang,Pil Moon, AU - Seo,Won Ik, AU - Yoon,Jang Ho, AU - Kim,Taek Sang, AU - Chung,Jae Il, Y1 - 2015/09/20/ PY - 2015/06/07/received PY - 2015/09/10/accepted PY - 2015/9/22/entrez PY - 2015/9/22/pubmed PY - 2017/4/14/medline KW - Cyst KW - Hematospermia KW - Prostate KW - Utricle SP - 985 EP - 92 JF - World journal of urology JO - World J Urol VL - 34 IS - 7 N2 - PURPOSE: To evaluate the utility of transutricular seminal vesiculoscopy as a diagnostic and therapeutic option for symptomatic midline cyst of the prostate in patients with hematospermia and symptoms associated with prostatitis. MATERIALS AND METHODS: From January 2005 to July 2013, 61 patients with symptomatic (hematospermia, pain on ejaculation, scrotal discomfort) midline cyst of the prostate, who did not improve with medication within a 4-week period, were included. Diagnosis of a midline cyst of the prostate was based on an anechoic round or spheroid-shaped lesion in the median, above the level of the verumontanum, extending into the prostatic base on transrectal ultrasonography (TRUS). All patients underwent transutricular seminal vesiculoscopy using a 9.0 Fr rigid ureteroscope and Bugbee electrode. Medical records, the Chronic Prostatitis Symptom Index (NIH-CPSI), and TRUS were used for assessment for more than 3 months after the procedure. RESULTS: Of the 61 patients, 32 (52.4 %) had hematospermia, 20 (32.7 %) had symptoms associated with chronic pelvic pain syndrome, such as perineal pain, scrotal discomfort, and testicular pain, and nine (14.7 %) patients had ejaculatory disturbances, such as painful or uncomfortable ejaculation and anejaculation as major complaints/symptoms. In endoscopic findings, hemorrhage was present in the dilation of the prostatic utricle and in the seminal vesicle in 11 (18.0 %) and 21 (34.4 %) of the patients, respectively. Calculi were found in the dilation of the prostatic utricle and in the seminal vesicle in 12 (19.7 %) and six (9.8 %), respectively. Hematospermia resolved in 29 of 32 (90.6 %) patients after transutricular seminal vesiculoscopy. In 29 patients with chronic pelvic pain syndrome and ejaculatory disturbances, NIH-CPSI scores improved, from 19.0 ± 3.8 to 11.8 ± 3.6 (p < 0.001), after treatment. The pain domain and quality-of-life domain scores of the NIH-CPSI were better postsurgery than presurgery (p < 0.001). Acute epididymitis, as a postoperative complication, was observed in two patients (3.3 %). CONCLUSIONS: There are various endoscopic findings in the dilation of prostatic utricle and seminal vesicle such as hemorrhage, calculi or/and purulent material in the patients with midline cyst of the prostate. The role of transutricular seminal vesiculoscopy in reducing symptoms may be mediated through the effects of endoscopic fenestration, removal of blood clots, calculi, or whitish debris and/or electrocautery of intracystic hemorrhage. This endoscopic technique enables useful diagnostic and therapeutic approaches for symptomatic midline cysts of the prostate. SN - 1433-8726 UR - https://www.unboundmedicine.com/medline/citation/26387919/Transutricular_seminal_vesiculoscopy_in_the_management_of_symptomatic_midline_cyst_of_the_prostate_ DB - PRIME DP - Unbound Medicine ER -