The scope this study is mainly the clinical infector of seminal duct division assisted by vesiculoscopy in the treatment of seminal duct obstruction caused by seminal duct cyst. We clarify that this procedure employing similar China is a very effective surgical method. The main challenge currently is that the incidence of ejaculatory duct obstruction caused by eject laterally duct cysts is very low and it is difficult to accumulate enough patients to conduct a large number of controlled studies with other surgical prosecutes.
Compared with other surgical mass, the mass can preserve the disanatomical structure of the signal can better and is less likely to cause complications are abnormal ejaculation, abnormal urination and rectal loss. And has a large risk rate of obstruction. In the future, we will focus on improving the endoscopic technology during more standard and clean endoscopes for the diagnosis and the treatment of seminal disease.
To begin, position the patient in lithotomy for anesthesia induction. Perform tracheal intubation to support breathing. Inject rocuronium bromide intermittently for inotropic relaxation.
Disinfect the lower abdomen and the perineal area three times with Iota 4. Connect the seminal vesicular scope to the display system and insert the endoscope through the external urethral opening. Then carefully advance it towards the posterior urethra.
To confirm the accurate position, observe the smooth and reddish urethral mucosa. Note the visibility of the colliculus seminalis and spot the two small openings of the ejaculatory ducts on either side. Guide a wire to the ejaculatory duct cyst through the opening on the affected side to reach the area filled with cloudy fluid.
After flushing the cyst with saline, look for abnormal opening in the seminal canal. Then enter the ipsilateral seminal vesicle through the abnormal ejaculatory duct cyst opening, revealing multiple honeycombed ductal lumens. Using a 40 watt holmium laser, expand the ejaculatory duct diameter.
To preserve the anti urine reflux mechanism, cut the ejaculatory duct opening along the direction of urine flow. Explore the symmetrical position of the abnormal ejaculatory duct opening on the affected side as well as the seminal vesicle of the healthy side. Then gently insert the wire into the seminal vesicle at the lower left and right of the cyst.
Finally, using the holmium laser, incise and widen the contralateral artificial opening. To prevent blood clots from blocking, indwell an 18 French catheter and rinse it continuously with physiological saline. Postoperative examination after a month showed the open ejaculatory duct on the affected side and the preserved verumontanum.
Endoscopy confirmed the presence of lateral ductus openings within the ejaculatory cyst. The same in parameters of patients improved significantly in the third month after the surgery.
