OBSTRUCTED SEMINAL VESICLE CAUSING URINARY RETENTION REPAIRED BY VASOVESICLE ANASTOMOSIS

Abstract

The usual treatment for a congenitally obstructed seminal vesicle with an attached ectopic blind ureter and ipsilateral renal agenesis includes some type of transurethral resection of the ejaculatory duct or en bloc excision of the cyst and ectopic ureter. Carmignani et a1 described en bloc removal using video laparoscopic access.1 Nevertheless, these procedures leave a divided and ligated vas deferens, thereby abolishing the seminal function of a healthy testicle and introducing the risk of inducing antibodies to spermatozoa.2 We describe the restoration of seminal tract continuity by anastomosis of a sufficiently long vas to the contralateral vesicle. CASE REPORT A 21-year-old man presented to the emergency room in total urinary retention and with a long history of symptoms suggestive of lower tract obstruction. He denied any previous episodes of urinary or seminal tract infections, and sperm count was 22 x 106/ml. Rectal examination revealed a large soft mass under the bladder floor. The bladder was catheterized without difficulty and 800 ml. urine were drained. Abdominal ultrasound, excretory urogram and radioisotopic renal scan confirmed a cystic multiloculated mass under the bladder floor and total absence of the right kidney. Retrograde urethrocystography showed an enlarged protruding