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Yao RJ, Xiao H, Chen SS, Feng ZH, Ding YL, Chen X, Tang SX, Zhou HL. Efficacy of various surgical approaches in treating hematospermia using transurethral seminal vesiculoscopy. BMC Surg 2023; 23:385. [PMID: 38129847 PMCID: PMC10740288 DOI: 10.1186/s12893-023-02290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To explore the efficacy of different approaches of seminal vesiculoscopy surgery and the predictive factors of good treatment outcome. MATERIALS AND METHODS A retrospective analysis of 68 patients who underwent seminal vesiculoscopy for hematospermia in our hospital from January 2015 to January 2021. According to different surgical approaches, they were divided into three groups: natural ejaculatory ducts (method A, 45 cases), assisted transurethral resection/incision of ejaculatory ducts (method B, 14 cases), fenestration in prostatic utricle (method C, 9 cases). We analyzed the recurrence rate of the three surgical approaches and the predictive factors of treatment efficacy. RESULTS The total recurrence rate after the seminal vesiculoscopy for hematospermia in this group was 32.35%. The postoperative recurrence rates of the three methods were 24.44% for method A, 50.00% for method B and 44.44% for method C, and there was no significant difference among the three methods (P > 0.05). The data of five predictors of 45 cases in method A group were included in the Univariate Logistic analysis, the results suggest that whether complicated with seminal tract stones/cysts was an effective predictor (OR 0.250, P = 0.022), which was still an effective predictor in the Multivariate Logistic analysis model (OR 0.244, P = 0.010). CONCLUSIONS The Transurethral seminal vesiculoscopy technique demonstrates a low postoperative recurrence rate in treating hematospermia. Among the various approaches, the intraoperative use of natural orifices through the ejaculatory duct exhibits the lowest recurrence rate. Additionally, seminal tract stones/cysts effectively predict favorable postoperative outcomes.
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Affiliation(s)
- Rui-Jie Yao
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Hong Xiao
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Shu-Shen Chen
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Zhi-Hao Feng
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Yi-Lang Ding
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Xi Chen
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China
| | - Song-Xi Tang
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.
| | - Hui-Liang Zhou
- Department of Andrology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, China.
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Vazirian-Zadeh M, Jones A, Phan YC, Mahmalji W. A case of persistent haematospermia secondary to seminal vesicle calculi in an ageing male. Aging Male 2020; 23:297-299. [PMID: 30651031 DOI: 10.1080/13685538.2018.1563064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Seminal Vesicle (SV) calculi are a rare pathology. Clinical presentation usually consists of nonspecific perineal pain and haematospermia. Adjuncts to aid diagnosis include US, MRI, and Vesiculography. This rare condition can be treated conservatively, however, surgical options are becoming more advanced with Vesiculoscopy now being the gold standard. Here, we present a case of a SV calculi treated conservatively.
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Affiliation(s)
| | - Adam Jones
- Department of Urology, Hereford County Hospital, Hereford, UK
| | - Yih Chyn Phan
- Department of Urology, Hereford County Hospital, Hereford, UK
| | - Wasim Mahmalji
- Department of Urology, Hereford County Hospital, Hereford, UK
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Yang H, Wang Y, Gao J, Wang P, Jiang X, Tian D, Hu H. Laparoscopic treatment of a huge seminal vesicle calculus: A case report and review of literature. Exp Ther Med 2019; 18:4799-4803. [PMID: 31798705 PMCID: PMC6880402 DOI: 10.3892/etm.2019.8160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 09/10/2019] [Indexed: 11/20/2022] Open
Abstract
A 67-year-old male patient had a history of repeated urinary tract infections for numerous years. X-ray examination revealed a large calcific density in the pelvic cavity, with a diameter of 10.4 cm and a CT value of ~792.9 HU. On MRI of the pelvis, the lesion displayed with extremely low signals. The inside of the stone had a concentric ring shape with a slightly higher signal and the patient was diagnosed with a large left seminal vesicle calculus. Laparoscopic surgery was selected to treat the stone. The patient recovered rapidly and the symptoms, including urgency, urinary frequency, as well as lower abdominal and perineal pain, were obviously improved. The present case study reports on the largest seminal vesicle calculus reported in the current English literature in addition to a brief literature review. Cases of seminal vesicle calculi (SVC) are rare. The present study reports on a case of SVC, which is the largest reported in current English literature, to the best of our knowledge.
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Affiliation(s)
- Han Yang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Yinlei Wang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Jie Gao
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Ping Wang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Xingkang Jiang
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Dawei Tian
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
| | - Hailong Hu
- Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, P.R. China
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Miao C, Liang C, Wang Y, Song Z, Xu A, Liu B, Li J, Song N, Wang Z. The management and composition of symptomatic seminal vesicle calculi: aetiological analysis and current research. BJU Int 2019; 125:314-321. [PMID: 30924591 DOI: 10.1111/bju.14758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report our experience in the diagnosis, minimally invasive treatment, and composition of seminal vesicle calculi (SVC). PATIENTS AND METHODS In the present study, we evaluated 20 patients who were admitted to our hospital from January 2013 to January 2018. All the patients were diagnosed with intractable haematospermia and SVC. The diagnosis was further confirmed by seminal vesiculoscopy. SVC were removed by basket extraction; with larger SVC fragmented by holmium laser before extraction. Scanning electron microscopy, X-ray diffraction, and infrared spectroscopy were used to determine the SVC composition. RESULTS All operations were completed successfully without surgical complications. SVC were mostly composed of hydroxyapatite and protein, suggesting that they were produced by infections. CONCLUSIONS Seminal vesiculoscopy is a simple, minimally invasive technique that can be used for diagnostic confirmation and treatment of seminal vesiculitis with SVC. This study improves our understanding of SVC and provides a theoretical basis for the prevention of postoperative recurrence of SVC.
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Affiliation(s)
- Chenkui Miao
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chao Liang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yamin Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhen Song
- Department of Urology, The Affiliated Hospital of Xuzhou Medical College, Xuzhou, China
| | - Aiming Xu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Bianjiang Liu
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jie Li
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ninghong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zengjun Wang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Zaidi S, Gandhi J, Seyam O, Joshi G, Waltzer WC, Smith NL, Khan SA. Etiology, Diagnosis, and Management of Seminal Vesicle Stones. Curr Urol 2019; 12:113-120. [PMID: 31316318 DOI: 10.1159/000489429] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/13/2018] [Indexed: 01/05/2023] Open
Abstract
Background/Aims Seminal vesicle (SV) stones are a rare, and thus readily misdiagnosed condition in practice. Understanding the etiology, diagnosis, and management are crucial to guide a urologist's care, and are provided in this literature review. Methods The inclusion criteria for the literature search, using the search engines MEDLINE® and PubMed was conducted using a combined query of "seminal vesicle stone" and the following keywords: calculi, hematospermia, calcification, and transrectal ultrasound (TRUS). Results The etiology of SV stones is currently unknown where majority of the patients present with having painful ejaculation and hematospermia. However, clinicians have reported potential etiologies by categorization as an inflammatory or non-in-flammatory. A majority of the previous cases had shown multiple stones being present in the SV duct system that are typically diagnosed through radiological examination such as TRUS, MRI, or plain radiographs. Amongst the many imaging approaches, TRUS remains the primary imaging diagnoses of SV calculi. Transurethral seminal vesiculoscopy has shown to be used in an abundant of the case reports to be an ideal surgical approach for managing small SV stones. In regard to larger stones, a transperitoneal laparoscopic protocol is proper. Conclusion The current imaging techniques have increased the case reports and diagnosis of SV calculi; however, more research is warranted for understanding the pathogenesis of the formation of SV stones. An optimal management of the extraction of SV stones depends on a number of factors such as size and location.
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Affiliation(s)
- Saher Zaidi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Jason Gandhi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Department of Urology, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Omar Seyam
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Gunjan Joshi
- Medical Student Research Institute, St. George's University School of Medicine, Grenada, West Indies
| | | | - Noel L Smith
- Department of Internal Medicine, Stony Brook Southampton Hospital, Southampton, NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Foley Plaza Medical, New York, NY, USA
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Williams SA, Christodoulidou M, Nigam R. Large bilateral seminal vesicle calculi presenting with spermolithiasis. BMJ Case Rep 2017; 2017:bcr-2017-219630. [PMID: 28576910 DOI: 10.1136/bcr-2017-219630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 34-year-old male presented with an 8-month history of passing increasingly painful 'grit' in his ejaculate. Semen analysis was normal as were urinary and blood tests. T1-weighted MRI revealed several bilateral high-signal areas measuring up to 1 cm in diameter, located in the seminal vesicles. These were confirmed as calculi on T2-weighted imaging and a seminal vesiculogram, with no drainage from the left ejaculatory duct and only minimal from the right duct. He is currently awaiting a robot-assisted laparoscopic vesiculotomy after completion of family.
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Affiliation(s)
| | | | - Raj Nigam
- Urology, The Royal Surrey County Hospital, Surrey, UK
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Christodoulidou M, Parnham A, Nigam R. Diagnosis and management of symptomatic seminal vesicle calculi. Scand J Urol 2017; 51:237-244. [PMID: 28332431 DOI: 10.1080/21681805.2017.1295398] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE The aim of this study was to review the management of patients with symptomatic seminal vesicle calculi, from presentation and diagnosis to postoperative outcomes. MATERIALS AND METHODS A systematic review of the English literature in MEDLINE and Embase was performed, based on the following model: patients with a diagnosis of seminal vesicle calculi; all interventions considered with or without control groups with single and comparator interventions; outcomes considered were incidence, presentation, diagnostic methods and treatment. A narrative synthesis of the data was performed according to PRISMA 2009 guidelines. The study protocol was registered on PROSPERO (CRD42016032971). RESULTS In total, 213 cases of seminal vesicle calculi from 37 studies were identified between 1928 and 2016. Published articles included cohort studies (16), case-control studies (two) and case reports (19). The most likely aetiology was stasis of ejaculate secondary to impaired drainage of secretions from the seminal vesicles. Transrectal ultrasound remains the primary investigation for haematospermia and painful ejaculation; however, magnetic resonance imaging seems to play an increasingly important role, especially when considering surgery. Transurethral seminal vesiculoscopy and lithotripsy is the ideal procedure for small calculi but requires surgical expertise. For larger calculi a transperitoneal laparoscopic approach is safe in the hands of experienced laparoscopic surgeons. CONCLUSIONS Modern imaging techniques and cross-sectional imaging are leading to an increased number of diagnosed cases of seminal vesicle calculi. Optimal treatment depends on the stone size and burden, and centralization of services will assist in the development of specialized centres.
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Affiliation(s)
| | - Arie Parnham
- b Department of Urology , University College London Hospital , London , UK
| | - Raj Nigam
- a Division of Surgery and Interventional Sciences , University College London , London , UK
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Bilateral very large calcium oxalate stones in the seminal vesicles: case report and literature review. ACTA ACUST UNITED AC 2011; 39:509-13. [PMID: 21380630 DOI: 10.1007/s00240-011-0371-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 02/21/2011] [Indexed: 10/18/2022]
Abstract
A 29-year-old man with hypospadias and bilateral undescended testicles presented with recurrent attacks of lower urinary tract infections and painful ejaculation. He was diagnosed to have very large bilateral seminal vesicle stones. The pelvis X-ray showed two radio-densities located in the pelvis with symmetrical appearance while Ultrasound showed them as echogenic structures with posterior acoustic shadowing. In magnetic resonance imaging (MRI) of the pelvis they appeared hypointense in both T1-weighted and T2-weighted images while pelvic computed tomography scan (CT scan) showed bilateral huge stones in the seminal vesicles. The stones were extracted by open surgery through the bladder after transurethral excision of the ejaculatory ducts. Here, we report the first case of bilateral, large, heart-shaped, calcium oxalate monohydrate of seminal vesicle caliculi with brief literature review.
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Cuda SP, Brand TC, Thibault GP, Stack RS. Case report: Endoscopic laser lithotripsy of seminal-vesicle stones. J Endourol 2007; 20:916-8. [PMID: 17144863 DOI: 10.1089/end.2006.20.916] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A 25-year-old man presented with painful ejaculation, an ejaculate volume of 0.75, and complaints of passing "granules" in the semen. Transrectal ultrasonography showed bilateral seminal vesicle enlargement. The patient underwent transurethral resection of the ejaculatory duct. The entry point of duct was resected using pure cutting current, resulting in the passage of multiple proteinaceous-appearing stones. Approximately 10 months later, the patient reported recurrent painful ejaculation and passage of granules in his semen. At cystoscopy, the ejaculatory duct openings were intubated with a cone-tipped catheter to perform bilateral seminal vesiculograms, which showed numerous mobile filling defects and a Steinstrasse appearance at the ejaculatory ducts. A 7F semirigid ureteroscope entered the lumen without difficulty over a guidewire, and the stones were fragmented with a 270-microm holmium laser fiber. The ejaculatory ducts were balloon dilated to 18F. To our knowledge, this is the first reported case where a ureteroscope was utilized to treat seminal-vesicle stones. The seminal vesiculogram proved to be extremely valuable in the diagnosis.
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Affiliation(s)
- Scott P Cuda
- Department of Urology, Tripler Army Medical Center, Honolulu, Hawaii 96859-5000, USA
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