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[Transurethral seminal vesiculoscopy in treatment of oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction: A report of 8 cases].
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Aug 18; 52(4):642-645.BD

Abstract

OBJECTIVE

To evaluate the utility of transurethral seminal vesiculoscopy with a slender ureteroscope in the treatment of severe oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction (EDO).

METHODS

From March 2018 to September 2018, the clinical data of 8 patients with severe oligoasthenozoospermia secondary incomplete EDO treated by the technique of transurethral seminal vesiculoscopy in the Peking University Third Hospital Reproductive Center were analyzed. Preoperative routine included semen analysis, hormone determination, transrectal ultrasonography, pelvic magne-tic resonance examination and other examinations. All the patients were diagnosed with severe oligoasthenozoospermia secondary to incomplete EDO. All the patients were operated by the same surgeon with multiple cases of experience in transurethral surgery, and 1 year follow-up was conducted to evaluate the surgical effect.

RESULTS

The average age of the 8 patients was 29 years, and the average operation time was 32 min. Preoperative transrectal ultrasound indicated 6 cases of ejaculatory duct cyst or Mullerian cyst, 1 case of prostate calcification and bilateral seminal vesicle dilatation. The average maximum transverse diameter of the right seminal vesicle in pelvic MRI was 33.60 mm (24.63-42.28 mm), the average maximum transverse diameter of the left seminal vesicle was 32.85 mm (25.91-44.89 mm), the ave-rage maximum antero-posterior diameter was 27.99 mm (21.36-33.12 mm), the average maximum width of the seminal vesicle duct was 10.53 mm (5.93-19.39 mm). There were 5 cases of ejaculatory duct cyst, 2 cases of seminal vesicle hemorrhage, and 1 case of Mullerian cyst. The semen volume [(2.64±0.80) mL], the sperm concentration [(49.76±8.50)×106/mL], and the motility (grade a+b) [(25.76±6.48)%] in postoperation were significantly higher than those in preoperation [(1.46±0.50) mL, (28.78±5.17)×106/mL, and (2.88±0.93)%, P < 0.05]. Two patients conceived naturally during the follow-up of 6 months after surgery. There were no severe complications, such as retrograde ejaculation, urinary incontinence or rectal injury.

CONCLUSION

The technique of transurethral seminal vesiculoscopy is safe and effective for treating severe oligoasthenozoospermia secondary to incomplete EDO. However, due to the small sample size of this study, short follow-up time, and the uncertainty in seminal vesicle surgery, it still needs to be further confirmed by long-term follow-up studies with large samples.

Authors+Show Affiliations

Peking University Third Hospital Reproductive Center, Beijing 100191, China. Department of Urology, Ningcheng County Central Hospital, Chifeng 024200, Inner Mongolia, China.Department of Urology, Peking University Third Hospital, Beijing 100191, China.Department of Urology, Peking University Third Hospital, Beijing 100191, China.Peking University Third Hospital Reproductive Center, Beijing 100191, China.Peking University Third Hospital Reproductive Center, Beijing 100191, China.Department of Urology, Peking University Third Hospital, Beijing 100191, China.Department of Urology, Peking University Third Hospital, Beijing 100191, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

32773793

Citation

Wang, H B., et al. "[Transurethral Seminal Vesiculoscopy in Treatment of Oligoasthenozoospermia Secondary Incomplete Ejaculatory Duct Obstruction: a Report of 8 Cases]." Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences, vol. 52, no. 4, 2020, pp. 642-645.
Wang HB, Zhao LM, Hong K, et al. [Transurethral seminal vesiculoscopy in treatment of oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction: A report of 8 cases]. Beijing Da Xue Xue Bao Yi Xue Ban. 2020;52(4):642-645.
Wang, H. B., Zhao, L. M., Hong, K., Mao, J. M., Liu, D. F., Lin, H. C., & Jiang, H. (2020). [Transurethral seminal vesiculoscopy in treatment of oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction: A report of 8 cases]. Beijing Da Xue Xue Bao. Yi Xue Ban = Journal of Peking University. Health Sciences, 52(4), 642-645.
Wang HB, et al. [Transurethral Seminal Vesiculoscopy in Treatment of Oligoasthenozoospermia Secondary Incomplete Ejaculatory Duct Obstruction: a Report of 8 Cases]. Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Aug 18;52(4):642-645. PubMed PMID: 32773793.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Transurethral seminal vesiculoscopy in treatment of oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction: A report of 8 cases]. AU - Wang,H B, AU - Zhao,L M, AU - Hong,K, AU - Mao,J M, AU - Liu,D F, AU - Lin,H C, AU - Jiang,H, PY - 2020/8/11/entrez PY - 2020/8/11/pubmed PY - 2020/8/14/medline KW - Asthenozoospermia KW - Ejaculatory ducts obstruction KW - Oligospermia KW - Seminal vesiculoscope SP - 642 EP - 645 JF - Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences JO - Beijing Da Xue Xue Bao Yi Xue Ban VL - 52 IS - 4 N2 - OBJECTIVE: To evaluate the utility of transurethral seminal vesiculoscopy with a slender ureteroscope in the treatment of severe oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction (EDO). METHODS: From March 2018 to September 2018, the clinical data of 8 patients with severe oligoasthenozoospermia secondary incomplete EDO treated by the technique of transurethral seminal vesiculoscopy in the Peking University Third Hospital Reproductive Center were analyzed. Preoperative routine included semen analysis, hormone determination, transrectal ultrasonography, pelvic magne-tic resonance examination and other examinations. All the patients were diagnosed with severe oligoasthenozoospermia secondary to incomplete EDO. All the patients were operated by the same surgeon with multiple cases of experience in transurethral surgery, and 1 year follow-up was conducted to evaluate the surgical effect. RESULTS: The average age of the 8 patients was 29 years, and the average operation time was 32 min. Preoperative transrectal ultrasound indicated 6 cases of ejaculatory duct cyst or Mullerian cyst, 1 case of prostate calcification and bilateral seminal vesicle dilatation. The average maximum transverse diameter of the right seminal vesicle in pelvic MRI was 33.60 mm (24.63-42.28 mm), the average maximum transverse diameter of the left seminal vesicle was 32.85 mm (25.91-44.89 mm), the ave-rage maximum antero-posterior diameter was 27.99 mm (21.36-33.12 mm), the average maximum width of the seminal vesicle duct was 10.53 mm (5.93-19.39 mm). There were 5 cases of ejaculatory duct cyst, 2 cases of seminal vesicle hemorrhage, and 1 case of Mullerian cyst. The semen volume [(2.64±0.80) mL], the sperm concentration [(49.76±8.50)×106/mL], and the motility (grade a+b) [(25.76±6.48)%] in postoperation were significantly higher than those in preoperation [(1.46±0.50) mL, (28.78±5.17)×106/mL, and (2.88±0.93)%, P < 0.05]. Two patients conceived naturally during the follow-up of 6 months after surgery. There were no severe complications, such as retrograde ejaculation, urinary incontinence or rectal injury. CONCLUSION: The technique of transurethral seminal vesiculoscopy is safe and effective for treating severe oligoasthenozoospermia secondary to incomplete EDO. However, due to the small sample size of this study, short follow-up time, and the uncertainty in seminal vesicle surgery, it still needs to be further confirmed by long-term follow-up studies with large samples. SN - 1671-167X UR - https://www.unboundmedicine.com/medline/citation/32773793/[Transurethral_seminal_vesiculoscopy_in_treatment_of_oligoasthenozoospermia_secondary_incomplete_ejaculatory_duct_obstruction:_A_report_of_8_cases]_ L2 - http://xuebao.bjmu.edu.cn/EN/Y2020/V52/I4/642 DB - PRIME DP - Unbound Medicine ER -