Transutricular Seminal Vesiculoscopy in Hematospermia: Technical Considerations and Outcomes

Abstract

Several methods of endoscopic management of seminal vesicular disease have been reported. We describe our current technique of transutricular seminal vesiculoscopy and review the outcomes in diagnosing and treating disorders of the seminal vesicles. From November 1995 to April 2006, 70 patients with hematospermia underwent transutricular seminal vesiculoscopy. All patients underwent either transrectal ultrasonography or magnetic resonance imaging with an endorectal coil. When definite abnormalities were seen in the imaging studies and did not improve with medication within a period >3 months, transutricular seminal vesiculoscopy was performed using a 6F or 9F rigid ureteroscope. In our 70 patients, the mean age was 46.5 years (range 28-68). The mean follow-up period was 12.3 months (range 1-48). Hematospermia subsided in 55 patients (78.6%) who did not respond to medical therapy with endoscopic fenestration alone. However, hematospermia recurred in 7 patients (10%). Hemorrhage was found in the seminal vesicles and in the ejaculatory ducts in 48 (68.6%) and 5 (7.1%) patients, respectively. Transutricular seminal vesiculoscopy can be performed easily using conventional endoscopic equipment. This technique enables useful diagnostic and therapeutic approaches to disorders of the seminal vesicles.