Transurethral seminal vesiculoscopy (TSV) provides an efficient approach to diagnose and treat the hematospermia but still need further improvement in manipulation and corresponding instruments. In this study, we develop an innovative technique with ultrasonic lithotripter (EMS) to treat severe, persistent hematospermia.
Data of patients who underwent TSV with or without ultrasonic lithotripter between May 2012 and December 2015 was reviewed. For the innovative procedure, a 3.3F ultrasonic lithotripter was introduced through the working channel of an 8F seminal vesiculoscope to remove calculi, blood clots, or purulent material; while in routine procedure the holmium laser lithotripsy was performed with lower energy (maximum power 10W). Complication, hematospermia recurrence, the operative time and post-operative hospitalization were recorded.
A total of 30 patients, 16 in Group A (routine TSV) and 14 in Group B (TSV with ultrasonic lithotripter procedure), were involved in this study. The median follow-up time for patients in Group A and B was 28 months and 31 months, respectively. The mean operative time in Group A and B was 66 min and 50 min, respectively (P <0.05). All the TSV procedures in Group B were successful except one patient had a two-stage procedure because of right seminal vesicle stones accompanying with pus. One patient in Group A had the discontinuation of the procedure because of accidental bleeding during stone fragmentation. During the follow-up, 2 patients in Group A had recurrent hematospermia and underwent the second TSV, while no recurrence happened in Group B. No epididymitis, retrograde ejaculation, rectal injury, incontinence, bladder neck contracture, or erectile dysfunction happened in both groups.
TSV with ultrasonic lithotripter enables a more reliable, effective, and convenient procedure to diagnose and treat severe, persistent hematospermia. It controls the recurrent hematospermia with less operative time and complication.
Journal of endourology. 2017 Oct 19 [Epub ahead of print]
Wei Zhang, Guang'an Xiao, Shenfei Qin, Amanda B Reed-Maldonado, Jian Xu, Guanghua Chen, Lei Wang, Tie Zhou
shanghai, China ; ., Shanghai, China ; ., shanghai, China ; ., San Francisco, United States ; ., shanghai, China ; ., shanghai, China ; ., shanghai, China ; ., changhai road 168#shanghai, China , 200433 ; .