Analysis of the success rate and complications of three different approaches for endoscopic access in seminal vesicle surgery

Abstract

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 operation, so it has certain safety. Key words: Genital Diseases, Male; Seminal Vesicles; Surgical Procedures, Minimally Invasive; Postoperative Complications