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The purpose of this study was to analyze the value of transrectal shear-wave elastography (SWE) in combination with multivariable tools for predicting adverse pathological features before radical prostatectomy (RP). Preoperative clinicopathological variables, multiparametric magnetic resonance imaging (mp-MRI) manifestations, and the maximum elastic value of the prostate (Emax) on SWE were retrospectively collected. The accuracy of SWE for predicting adverse pathological features was evaluated based on postoperative pathology, and parameters with statistical significance were selected. The diagnostic performance of various models, including preoperative clinicopathological variables (model 1), preoperative clinicopathological variables + mp-MRI (model 2), and preoperative clinicopathological variables + mp-MRI + SWE (model 3), was evaluated with area under the receiver operator characteristic curve (AUC) analysis. Emax was significantly higher in prostate cancer with extracapsular extension (ECE) or seminal vesicle invasion (SVI) with both P < 0.001. The optimal cutoff Emax values for ECE and SVI were 60.45 kPa and 81.55 kPa, respectively. Inclusion of mp-MRI and SWE improved discrimination by clinical models for ECE (model 2 vs model 1, P = 0.031; model 3 vs model 1, P = 0.002; model 3 vs model 2, P = 0.018) and SVI (model 2 vs model 1, P = 0.147; model 3 vs model 1, P = 0.037; model 3 vs model 2, P = 0.134). SWE is valuable for identifying patients at high risk of adverse pathology.
Subject(s)
Male , Humans , Prostate/pathology , Seminal Vesicles/diagnostic imaging , Elasticity Imaging Techniques , Retrospective Studies , Extranodal Extension/pathology , Neoplasm Staging , Prostatectomy/methods , Prostatic Neoplasms/pathology , Magnetic Resonance Imaging/methodsABSTRACT
Aim : To identify the diagnostic difficulties and management issues of benign pelvic masses in males and high light the diagnostic protocol for these rare pelvic masses. Methods : A prospective single center study over a period of six years and three months. History, physical examination, operative findings and histopathological (HPE) diagnosis were recorded. Results : A total of 20 male patients presented with retrovesical mass, aged 17 to 65 years old (mean age 36.7 years) were evaluated. masses were found to be of prostatic origin in seven cases (5 prostatic utricle cyst and 2 prostatic abscess), connective tissue in seven, seminal vesicle origin in four, mullerian duct remnant in one case, and embryonic urogenital vestigial remnants in one case. Of these 20 patients, 19 presented with acute or chronic lower urinary tract symptoms and in one case, the mass was asymptomatic and found incidentally. Ultrasound showed cystic lesions in 17 patients and solid masses in three. Nine cases underwent exploratory laparotomy. Further biopsies of specimen demonstrated tissue of origin in all cases (8/9) except one. HPE report confirmed the same clinical and operative diagnosis in six cases. Conclusion : Benign retrovesical mass presents with lower tract obstructive symptoms, palpable pelvic mass and retention of urine. Needle or open biopsy is required in most cases to establish a histopathological diagnosis. Benign retrovesical mass is rare, we faces difficulty in diagnosis and management. Hence, diagnostic protocols can be helpful to manage retrovesical pelvic masses.
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Objective:To investigate the effect of different imaging classifications of prostate cancer seminal vesicle invasion on positive surgical margins (PSM) after laparoscopic radical prostatectomy(LRP).Methods:114 patients with pT 3b stage prostate cancer admitted to Peking University Third Hospital from August 2009 to December 2020 were retrospectively analyzed. The age of the patients was (68.2±7.7) years old, the median pre-biopsy PSA was 20.20 (3.45-186.30) ng/ml, and the patients with biopsy Gleason score of ≤7, and ≥8 was 33 and 81 cases, respectively. The median prostate volume was 33.2 (12.1-155.4) ml. According to the imaging of the seminal vesicle invasion of prostate cancer, the patients were divided into the following types: type Ⅰ, the tumor directly invades the seminal vesicle along the vas deferens; type Ⅱa, the tumor invades the basal capsule of the prostate and invades the seminal vesicle; type Ⅱb, the tumor invades the periprostatic fat and retrogradely invades the seminal vesicles; type Ⅲ, solitary lesions in the seminal vesicles that do not continue with the prostate cancer. All patients underwent LRP, and the PSM were recorded as the base, bilateral, posterior, anterior and apical parts of the prostate. The differences in clinicopathological data of patients with different seminal vesicle invasion imaging types were compared, and the independent risk factors of PSM in pT 3b prostate cancer were evaluated by multivariate analysis. Results:The operative time of 114 cases in this group was (229.4±62.2) min, and the blood loss was 100(20-1 800)ml. The postoperative gross pathological Gleason score was ≤7 in 17 cases and ≥8 in 97 cases. In the imaging classification of prostate cancer with seminal vesicle invasion, there were 28 cases (24.6%) of type Ⅰ, 39 cases (34.2%) of type Ⅱa, 47 cases (41.2%) of type Ⅱb, and no type Ⅲ patients. There was no significant difference in age, body mass index, pre-biopsy PSA, prostate volume, and operation time among patients with type Ⅰ, Ⅱa, and Ⅱb seminal vesicle invasion ( P>0.05). There was a statistically significant difference in blood loss among the three types ( P = 0.001), and the difference in the proportion of lymph node metastasis was statistically significant ( P = 0.013). In the classification of prostate cancer seminal vesicle invasion, the PSM rates of type Ⅰ, Ⅱa and Ⅱb were 28.6% (8/28), 38.5% (15/39) and 70.2% (33/39), and the difference was statistically significant ( P=0.001). The PSM rates of type Ⅰ, Ⅱa, and Ⅱb were 21.4% (6/28), 23.1% (9/39), and 34.0% (16/47), respectively. The results of univariate analysis showed that the biopsy Gleason score ( P = 0.063) and the type of seminal vesicle invasion ( P<0.001) entered into multivariate analysis, and the results of multivariate logistic regression analysis showed that the type of seminal vesicle invasion ( P=0.001) was independent risk factor for PSM after LRP. Conclusions:The PSM rate in patients with type Ⅱb seminal vesicle invasion is significantly higher. The higher imaging type of seminal vesicle invasion is the independent risk factor of PSM after LRP.
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Metastatic seminal vesicle carcinoma is rare in clinic. The case of renal clear cell carcinoma metastasis to the seminal vesicle gland is more rare, which is difficult to be identified with bladder, prostate and colorectal tumors. In November 2017, 1 case of renal clear cell carcinoma metastasis to the left side of the seminal vesicle gland was admitted in our hospital.Laparoscopy seminal vesicle metastasis tumor resection was performed. Regular bladder irrigation and sunitib oral intake were conducted. No evidence of local recurrence was found within 19 months follow-up.
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Metastatic seminal vesicle carcinoma is rare in clinic.The case of renal clear cell carcinoma metastasis to the seminal vesicle gland is more rare,which is difficult to be identified with bladder,prostate and colorectal tumors.In November 2017,1 case of renal clear cell carcinoma metastasis to the left side of the seminal vesicle gland was admitted in our hospital.Laparoscopy seminal vesicle metastasis tumor resection was performed.Regular bladder irrigation and sunitib oral intake were conducted.No evidence of local recurrence was found within 19 months follow-up.
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SUMMARY INTRODUCTION Zinner's Syndrome is a triad of mesonephric duct anomalies comprising unilateral renal agenesis, seminal vesicle cyst, and ejaculatory duct obstruction. In this study, we present a kidney recipient with ectopic ureter associated with Zinner's syndrome and a literature review. CASE PRESENTATION A 59-year-old male with a history of chronic kidney disease and left renal agenesis underwent deceased donor kidney transplantation. After securing optimal renal functions, the patient underwent abdominal computed tomography (CT) scan for the seroma that occurred under the incision. The final diagnosis was an ectopic distal ureter ending in the seminal vesicle cyst's wall and ipsilateral renal agenesis. The patient was discharged without any complications and the clinical follow up was uneventful. DISCUSSION AND CONCLUSION Congenital seminal vesicle disorders are usually associated with ipsilateral urinary duct anomalies stemming from the same embryonic structure. To our knowledge, this is the first case report that describes kidney transplantation in a patient with ipsilateral renal agenesis and ectopic ureter ending in the seminal vesicle cyst. In patients with renal agenesis, during the ipsilateral urinary tract anastomosis, the possibility of ectopic ureter should be kept in mind otherwise graft loss can occur with a high morbidity rate.
RESUMO INTRODUÇÃO A Síndrome de Zinner é uma tríade de anomalias do ducto mesonéfrico que compreende agenesia renal unilateral, cisto da vesícula seminal e obstrução do ducto ejaculatório. Neste estudo, apresentamos um receptor de rim com ureter ectópico associado à Síndrome de Zinner e revisão da literatura. APRESENTAÇÃO DO CASO Homem de 59 anos com história de doença renal crônica e agenesia renal esquerda foi submetido a transplante de rim de doador falecido. Após função renal ideal, foi realizada tomografia computadorizada do abdome (TC) devido ao seroma sob incisão. O diagnóstico final foi um ureter distal ectópico que termina na parede do cisto da vesícula seminal e agenesia renal ipsilateral. O paciente recebeu alta sem complicações e o acompanhamento clínico ocorreu sem intercorrências. DISCUSSÃO E CONCLUSÃO Os distúrbios congênitos da vesícula seminal geralmente estão associados às anomalias do ducto urinário ipsilateral devido a uma mesma estrutura embrionária. Até onde sabemos, é o primeiro relato de caso que descreve o transplante renal em um paciente com agenesia renal ipsilateral e ureter ectópico terminado no cisto da vesícula seminal. Em pacientes com agenesia renal, durante a anastomose do trato urinário ipsilateral, deve-se ter em mente a possibilidade do ureter ectópico, caso contrário, poderá ocorrer perda do enxerto com alta taxa de morbidade.
Subject(s)
Humans , Male , Ureter , Cysts , Genital Diseases, Male , Seminal Vesicles , Kidney Transplantation , Kidney , Middle AgedABSTRACT
Acute effect of purified mimosine (MiMo) extracted from Leucaena leucocephala on testicular histopathology has been documented with seminal vesicle (SV) atrophy. Since protein phosphorylation and seminal secretions play important roles in sperm physiology, this study aimed to study the alteration of substances including tyrosine phosphorylated (TyrPho) proteins in seminal vesicle treated with MiMo. Male mice were divided into a control and experimental groups treated with purified MiMo at 3 doses of 15, 30, and 60 mg/KgBW, respectively for 35 consecutive days. The morphology and weights of SV were compared among groups. The levels of magnesium and fructosamine in SV fluid were assayed. The profiles of equally SV total proteins were compared using SDS-PAGE. The expression of seminal TyrPho proteins was detected by western blotting. Recent results showed the decreased weights of SV in MiMo treated mice compared to control. However MiMo in all doses did not affect the levels of magnesium and fructosamine in SV fluid. The SV protein expression of 130 and 55 kDas was obviously decreased in a high dose MiMo. In dose-dependent response, the expressions of 72 and 55 kDas TyrPho proteins of SV were increased. In conclusion, MiMo could affect SV morphological size and protein secretions especially TyrPho proteins.
El efecto agudo de la mimosina purificada (MiMo) extraída de Leucaena leucocephala en la histopatología testicular se ha documentado con atrofia de vesícula seminal (VS). Debido a que la fosforilación de proteínas y las secreciones seminales tienen un papel importante en la fisiología de los espermatozoides, este estudio tuvo como objetivo estudiar la alteración de sustancias como la proteína tirosina fosforilada (TyrPho) en vesículas seminales tratadas con MiMo. Los ratones se dividieron en un grupo control y un grupo experimental y se trataron con MiMo purificado en 3 dosis de 15, 30 y 60 mg / KgBW, respectivamente, durante 35 días seguidos. La morfología y los pesos de VS se compararon entre los grupos. Fueron analizados los niveles de magnesio y fructosamina en el fluido VS. Los perfiles de las proteínas totales de VS se compararon utilizando SDS-PAGE. La expresión de la proteína TyrPho en las vesículas seminales se detectó mediante transferencia de Western blot. Los resultados recientes muestran la disminución del peso de las VS en ratones tratados con MiMo, en comparación con el grupo control. Sin embargo, en ninguna de las dosis se vieron afectados por mimosina purificada los niveles de magnesio y fructosamina en el líquido de las VS. La expresión de la proteína en VS de 130 y 55 kDas disminuyó notablemente en una dosis alta de MiMo. En la respuesta dependiente de la dosis, aumentaron las expresiones de 72 y 55 kDas de las proteínas TyrPho en las VS. En conclusión, la mimosina purificada podría afectar el tamaño morfológico de las VS y la expresión de proteínas, especialmente las proteínas TyrPho.
Subject(s)
Animals , Male , Mice , Phosphoproteins/drug effects , Seminal Vesicles/drug effects , Mimosine/administration & dosage , Organ Size , Phosphoproteins/metabolism , Phosphorylation , Seminal Vesicles/pathology , Tyrosine/analogs & derivatives , Blotting, Western , Phosphotyrosine , Electrophoresis, Polyacrylamide Gel , Mice, Inbred ICR , Mimosine/pharmacologyABSTRACT
Objective To improve the recognition and knowledge of autosomal dominant polycystic kidney disease (ADPKD) related male infertility through investigation for MRI characteristics of this disease. Methods Fourteen patients confirmed with ADPKD related obstructive azoospermia were retrospectively analyzed. All patients referred to clinic with male infertility, and obstructive azoospermia were additionally confirmed by laboratory tests and clinical examination. Subsequent abdominopelvic MR examinations were performed to comfirm obstructive factors and obstructive location. All patients were performed an abdominopelvic MR examination including non-enhanced and enhanced MR. MR imaging characteristics were analyzed and summarized by two experienced radiologists. Results MRI results for all cases were classified into 4 groups:10 cases with bilateral polycystic kidneys and bilateral seminal vesicle cysts, 2 cases with bilateral polycystic kidneys, polycystic liver and bilateral seminal vesicle cysts, 1 case with bilateral polycystic kidneys, polycystic liver and absence of bilateral seminal vesicles, 1 case with bilateral cystic kidneys, bilateral seminal vesicle cysts as well as Müllerian duct cyst. A wide range of coronal T2WI scan was necessary to observe cystic lesions in both liver and bilateral kidneys as well as abnormal changes in pelvis. The obstructive sites in all cases were located in level from ejaculatory duct to seminal vesicle. Bilateral seminal vesicle cysts presented as significantly dilated glandular ducts of seminal vesicles, in which flocculence or nodular sediment can be found. Conclusion Male infertility caused by ADPKD-related deferential duct obstrution is characterized by bilateral polycystic kidney disease and Seminal vesicle ejaculatory duct obstruction in MRI, which can be combined with other abnormalities.
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Premature ejaculation is a common male sexual dysfunction disorder, and there are many controversies over its definition. With deeper insights into the etiology and pathogenesis of premature ejaculation, more and more auxiliary examinations are used in its diagnosis, prognostic evaluation and treatment, such as transrectal ultrasonography of seminal vesicles, determination of serum 5-hydroxytryptamine (5-HT) concentration, serum hormone levels, penile sensitivity detection, brain function tests, and genetic sequencing. This review outlines the latest advances in the auxiliary examination of premature ejaculation and provides clinicians with some diagnostic indexes or methods of premature ejaculation for reference.
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This study attempted to examine the acute effect of purified minosine extracted from Leucaena leucocephala on male reproductive system. Adults male mice were divided into 4 groups (n =8); control and 3 experimental groups treated with purified mimosine at different doses of 15, 30, and 60 mg/KgBW, respectively for 7 consecutive days. The morphological features and weights of body and reproductive organs including testis, epididymis plus vas deferens, and seminal vesicle were compared among groups. In addition, epididymal sperm concentration and the changes of histopathology of testicular tissues in all groups were observed. The results showed that mimosine in all doses did not affect mice body weights. However, all doses of mimosine could significantly reduce the absolute and relative weights of testis and seminal vesicle but not of epididymis plus vas deferens. Significantly, mimosine at doses of 30, and 60 mg/KgBW could decrease sperm concentration. Moreover, the seminiferous atrophy and degeneration were obviously found in mimosine treated mice as compared to the control. In conclusion, consumption of Leucaena leucocephala edible parts containing mimosine could damage male reproductive organs which may cause acute male subfertility or infertility.
Este estudio intentó examinar el efecto agudo de la mimosina purificada extraída de Leucaena leucocephala en el sistema reproductivo masculino. Se dividieron ratones machos adultos en 4 grupos (n = 8): un grupo control y tres grupos experimentales tratados con mimosina purificada a diferentes dosis de 15, 30 y 60 mg / Kg por peso, respectivamente, durante 7 días consecutivos. Se compararon entre los grupos, las características morfológicas y el peso corporal, los órganos reproductivos, incluyendo los testículos, el epidídimo más conducto deferente y vesícula seminal. Además, se observó la concentración de espermatozoides epididimarios y los cambios de la histopatología de los tejidos testiculares en todos los grupos. Los resultados mostraron que la mimosina no afectó los pesos corporales de los ratones. Sin embargo, todas las dosis de mimosina podrían reducir significativamente los pesos absolutos y relativos de los testículos y las glándulas seminales, pero no así del epidídimo y los conductos deferentes. La mimosina en dosis de 30 y 60 mg / Kg por peso podría disminuir significativamente la concentración de esperma. Además, se observó la atrofia y degeneración seminífera en ratones tratados con mimosina en comparación con el grupo control. En conclusión, el consumo de partes comestibles de Leucaena leucocephala que contienen mimosina podría dañar los órganos reproductivos masculinos, lo que puede causar subfertilidad masculina aguda o infertilidad.
Subject(s)
Animals , Male , Mice , Testis/drug effects , Fabaceae , Mimosine/pharmacology , Organ Size , Seminal Vesicles/drug effects , Mice, Inbred ICRABSTRACT
Methotrexate (MTX) is commonly used as a chemotherapy agent and immune system suppressant but its adverse effect on male reproductive system is still limited. This study aimed to investigate the effect of MTX on structure and functional proteins of testis and seminal vesicle. Adult male rats were divided into control and MTX groups (n =12). In 30 experimental days, the treated animals were injected with MTX (tail i.v., 75 mg/KgBW) at days 8 and 15. Then, the reproductive parameters and histology of both groups were examined. Thickness of seminal seminal vesicle epithelia was analyzed. Also, the expressions of testicular tyrosine phosphorylated proteins and steroidogenic acute regulatory (StAR) protein were investigated. The results showed that MTX could significantly decrease epididymal sperm concentration. In addition, the germ cell degeneration, increased spaces of interstitial tissues, and low epididymal sperm mass density were observed in MTX group. The thickness of seminal vesicle epithelia in MTX group was significantly lower than that of control group. Moreover, the intensity of testicular phosphorylated proteins of 31, 32, 72, and 85 kDas was significantly increased while of 42 and 47 kDas in MTX group was decreased as compared to control. The expression of testicular StAR protein in MTX group was also significantly decreased as compared to the control. In conclusion, MTX affects testicular and seminal tissues and changes testicular functional proteins in adult rats.
El metotrexato (MTX) se usa comúnmente como agente de quimioterapia y supresor del sistema inmunitario, pero su efecto adverso en el sistema reproductor masculino sigue siendo limitado. Este estudio tuvo como objetivo investigar el efecto del MTX sobre la estructura y las proteínas funcionales del testículo y la vesícula seminal. Ratas macho adultas se dividieron en grupos control y grupo con MTX (n = 12). En 30 días experimentales, a los animales tratados se les inyectó MTX (cola i.v., 75 mg / KgBW) los días 8 y 15. Luego, se examinaron los parámetros reproductivos y la histología de ambos grupos. Se analizó el espesor del epitelio de la vesícula seminal. Además, se investigaron las expresiones de la proteína tirosina testicular fosforilada y de la proteína reguladora aguda esteroidogénica (StAR). Los resultados mostraron que el MTX podría disminuir significativamente la concentración de espermatozoides epididimarios. Además, se observó la degeneración de las células germinales, el aumento de los espacios de los tejidos intersticiales y la baja densidad de masa del espermatozoide epididimal en el grupo de MTX. El grosor del epitelio de la vesícula seminal en el grupo MTX fue significativamente menor que el del grupo control. Además, la intensidad de las proteínas testiculares fosforiladas de 31, 32, 72 y 85 kDas aumentó significativamente, mientras que la de 42 y 47 kDas en el grupo MTX disminuyó en comparación con el control. La expresión de la proteína StAR testicular en el grupo MTX también se redujo significativamente en comparación con el control. En conclusión, el MTX afecta los tejidos testiculares y seminales y cambia las proteínas funcionales testiculares en ratas adultas.
Subject(s)
Animals , Male , Rats , Seminal Vesicles/drug effects , Testis/drug effects , Methotrexate/pharmacology , Organ Size , Phosphorylation , Spermatozoa/drug effects , Methotrexate/adverse effects , Blotting, Western , Rats, Sprague-Dawley , Phosphotyrosine/drug effectsABSTRACT
Objective@#To explore the etiological factors for calculus-associated seminal vesiculitis by analyzing the composition of seminal vesicle calculus samples.@*METHODS@#This retrospective study included 6 cases of recurrent hematospermia diagnosed with seminal vesicle calculus by non-contrast pelvic CT. The patients were aged 28 to 69 years, with persistent or recurrent hematospermia for 3 months to 6 years, and 5 of them with a history of acute urethritis. All the patients underwent seminal vesiculoscopy, which confirmed calculus-associated seminal vesiculitis. The calculus samples were obtained with a spiral dislodge and their composition was determined with a second-generation infrared calculus composition analyzer. The patients were followed up for 2 to 12 weeks postoperatively, during which non-contrast pelvic CT was employed for observation of recurrent calculus in the reproductive tract.@*RESULTS@#Pelvic CT scanning indicated recurrence of seminal vesicle calculus in 3 cases at 12 weeks postoperatively, of which, 2 were accompanied with recurrent hematospermia, both observed at 4 weeks after operation. As for the composition of the calculus, the infrared calculus composition analyzer revealed struvite (magnesium ammonium phosphate hexahydrate) in 5 cases and a mixture of calcium oxalate dihydrate, calcium oxalate monohydrate, and carbonate apatite in the other one.@*CONCLUSIONS@#Seminal vesicle calculi are most commonly composed of struvite, and infection is the main etiological factor for calculus-associated seminal vesiculitis.
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Apatites , Calcium Oxalate , Calculi , Chemistry , Diagnostic Imaging , Genital Diseases, Male , Diagnostic Imaging , Hemospermia , Postoperative Period , Recurrence , Retrospective Studies , Seminal Vesicles , Diagnostic Imaging , Struvite , Tomography, X-Ray Computed , UrethritisABSTRACT
Seminal vesicles are involved in semen accumulation in the process of ejaculation, contracting and releasing seminal vesicle fluid accounting for about 50－80% of the semen, and the fructose in their secretions is an indispensable nutrient for sperm maturation. Thus, seminal vesicles are important male accessary glands closely related with the quality and quantity of sperm. In the process of semen accumulation, sympathetic and parasympathetic nerves participate in the regulation of the secretory function of seminal vesicle epithelia and the contraction of the smooth muscle layer as well as the distribution of adrenonergic, cholinergic, dopaminergic and various neurotransmitter receptors in the seminal vesicle epithelia and smooth muscle layer, which play a significant role in male fertility. This review discusses the neurophysiological effects of seminal vesicles in ejaculation.
Subject(s)
Animals , Male , Ejaculation , Physiology , Semen , Physiology , Semen Analysis , Seminal Vesicles , Physiology , SpermatozoaABSTRACT
<p><b>Objective</b>To investigate the effect of finasteride on the microvascular density (MVD) and the expression of the vascular endothelial growth factor (VEGF) in the seminal vesicle of rats.</p><p><b>METHODS</b>Forty male SD rats were randomly and equally divided into groups A, B, C and D, those in groups A and B fed with normal saline as the control and those in C and D with finasteride at 40 mg per kg of the body weight per day, A and C for 14 days and B and D for 28 days. Then the seminal vesicles of the animals were harvested for HE staining, measurement of MVD, determination of the expressions of CD34 and VEGF by immunohistochemistry, and observation of histomorphological changes in the seminal vesicle.</p><p><b>RESULTS</b>The expressions of CD34 in groups C and D were decreased by 6.7% and 15.8% as compared with those in A and B (P<0.01), and that in group D decreased by 9.3% in comparison with that in C (P<0.01). The expression indexes of VEGF in groups C and D were decreased by 6.9% and 14.1% as compared with those in A and B (P<0.01), and that in group D decreased by 9.0% in comparison with that in C (P<0.01).</p><p><b>CONCLUSIONS</b>Finasteride can inhibit the expression of VEGF in the seminal vesicle tissue of the rat and hence suppress the angiogenesis of microvessels of the seminal vesicle.</p>
Subject(s)
Animals , Male , Rats , Angiogenesis Inhibitors , Pharmacology , Antigens, CD34 , Metabolism , Finasteride , Pharmacology , Immunohistochemistry , Neovascularization, Physiologic , Random Allocation , Rats, Sprague-Dawley , Seminal Vesicles , Metabolism , Vascular Endothelial Growth Factor A , MetabolismABSTRACT
Symptomatic seminal vesicle cysts (SVCs), especially those of a large size, can be removed by surgical treatments. Currently, open surgeries for SVC are rarely performed due to their extensive surgical trauma, and minimally invasive surgical therapies for treating seminal vesicle cysts are still in the early stages. In addition, relevant studies are mostly confined to case reports. In this study, we retrospectively reviewed 53 patients who had received transperitoneal laparoscopic unroofing or fenestration under seminal vesiculoscopy for SVC in our institution. Both surgeries decreased the cyst volume to a significant extent; however, according to the remnant lesion size after rechecking images, seminal vesiculoscopic fenestration tended to have a higher recurrence than laparoscopic unroofing. Regarding complications, two individuals in the laparoscopic unroofing group experienced ureteral injury and rectal injury, while patients in the fenestration group only had temporary hemospermia, which indicates that fenestration surgery tends to have less severe complications than laparoscopic unroofing. There was no solid evidence confirming semen improvement after these surgical therapies in our study. Future studies with a prospective design, larger sample size, and longer follow-up period are required to verify and further explore our findings.
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Objective To discuss the clinical effects of transurethral seminal vesiculoscopy in refractory hemospermia caused by seminal vesicle diseases.Methods The clinical data of 50 patients suffered from refractory hemospermia caused by seminal vesicle gland diseases were retrospectively analyzed from February 2012 to February 2014.Patients' age varied from 25 to 54 years old,mean (39.2 ± 9.2) years.The course of disease was (7.44 ± 2.6) months.There were 24 seminal vesiculitis,10 seminal ducts obstruction disease,and 16 seminal vesicle calculi disease.According to patients' priority,the patients were divided into surgical treatment group and conservative treatment group.In surgical group,there were 38 patients with age of (38.9 ± 8.8) years old,and the course of disease was (7.5 ± 2.5) months.There were 18 seminal vesiculitis,8 seminal ducts obstruction,and 12 seminal vesicle calculi.Whereas in conservative treatment group,there were 12 patients,with age of (40.2 ± 10.5) years old,and the course of disease was (7.3 ±2.9) months.Among them,there were 6 seminal vesiculitis,2 seminal ducts obstruction,and 4 seminal vesicle calculi.There was no significant difference between the two groups in patients age,course of disease and constitution of disease.The clinical data derived from the two treatment groups including the white blood cell counts (WBC) and red blood cell counts (RBC) in the seminal fluid,hematospermia rate,quality of life score,cure rate and improvement rate before and after the treatment were analysed.Results 1,3,6 months and 1 year after treatment,all observation indexes in the two groups had been ameliorated and had significant difference compared with those before treatment including WBC and RBC in the seminal fluid,hematospermia rate and quality of life score.No operative complications occurred in conservative treatment group.While a patient in surgical treatment group suffered from infection and recovered after levofloxacin treatment for a day.Six months after two kinds of treatment,in surgical treatment group,the cure rate was 55.2％,and the improvement rate was 36.8％.In the meanwhile,in conservative treatment group,the cure rate and the improvement rate were both 25.0％.A year after two different treatment,in surgical treatment group,the cure rate was 60.5％,the improvement rate was 34.2％.However,in conservative treatment group,the cure rate and improvement rate were both 8.3％.The effective rate of surgical group was much higher than that of conservative treatment group and the difference were significant.Conclusions Both transurethral seminal vesiculoscopy and conservative treatment have certain effects in relieving hemospermia.The transurethral seminal vesiculoscopy has obvious advantages over conservative treatment in improving the clinical effects of hemospermia after long duration.It could be used as a good supplement when medication fail.
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Objective To investigate the clinical significance of urinary continence after laparoscopic radical prostatectomy with the technique of preserving bladder neck with sling suspension technique by the seminal vesicle.Methods Sixty-eight patients' clinical data from January 2014 to December 2016 in our hospital who underwent laparoscopic radical prostatectomy were retrospectively analyzed.35 cases with sling suspension (experimental group).Preoperative Gleason score ≤ 6,11 cases;Gleason score 7,15 cases;Gleason score ≥8,9 cases.Stage T1 1 cases,stage T2 28 cases,and T3a 6 cases.The traditional method of bladder neck group(control group) contained 33 cases.Preoperative Gleason score ≤6,9 cases;Gleason score 7,14 cases;Gleason score ≥8,10 cases.Stage T1 2 cases,stage T2 29 cases,and T3a 2 cases.The mean ages [(64.3 ± 4.3) years old and (62.6 ± 3.8) years old],BMI [(22.85 ±1.69) kg/m2 and (22.15 ± 1.32) kg/m2],prostate volume [(45.93 ± 9.08) ml and (44.12 ± 6.85) ml],preoperative PSA[(18.76 ± 5.43) ng/ml and (21.18 ± 6.55) ng/ml],preoperative Gleason of the two groups were not statistically different (both P ＞ 0.05).All patients had no urinary incontinence.All the surgery was done by the same senior surgeon.The continence status was assessed at 1 month,2 month,3 month,and 6 month after operation.The operation time,bleeding volume,urinary leakage rate,the length of hospital stay,and positive margin between the two groups were compared.Urinary continence was assessed by daily urinary pad volume:0-1 /d for urinary continence was normal,2-3/d for mild urinary incontinence,and ＞ 3/d for severe urinary incontinence.Results 68 cases were operated successfully.There was no conversions to open surgery.1 month,2 month,3 month and 6 month after operations,the continence rates of the experimental group were 57.1％ (20/35),77.1％ (27/35),85.7％ (30/35),97.14％ (34/35),respectively.The control group's continence rates were 36.4％ (12/35),54.5％ (18/35),75.8％ (25/35),93.9％ (31/35),respectively.At 1 month and 2 month after surgery,there was a statistically significant difference in urinary continence between the two groups (P =0.047 and P =0.040),and there was no significant difference in urinary continence between the two groups at 3 and 6 month (P =0.274 and P =0.523).There were 3 cases and 4 cases of positive margins in the experimental group and the control group,with no statistical significance (P =0.705).Conclusions Technique of preservation of bladder neck by sling suspension technique at seminal vesicle may improve the recovery of early postoperative urinary continence,and does not increase the rate of positive margin.
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Monosodium glutamate (MSG) is widely used as a food additive but its excessive intake leads to oxidative stress of severalorgans. However, the oxidative effect of MSG on male accessory reproductive organs remains unclear. Therefore, theaim of this study was to evaluate the effect of MSG on the status of oxidative stress and morphological alterations in themale accessory reproductive organs such as epididymis, prostate glands and seminal vesicle of Sprague-Dawley rats.A total of 24 male Sprague-Dawley rats were randomly divided into three groups with 8 rats per group. Control groupreceived distilled water (1 ml/kg) while MSG60 and MSG120 received 60 mg/kg and 120 mg/kg of MSG, respectively.All the substances were administered via force feed oral for 28 consecutive days. At the end of the study, the rats weresacrificed to obtain the accessory organs for biochemical analysis and histological observations. The SOD activity in theepididymis showed a significant increase in MSG60 and MSG120 compared to control (p < 0.05). The GSH levels in theepididymis of MSG 120 showed a significant reduction (p < 0.05) compared to the control group. The levels of MDA andPC in the epididymis and prostate gland of MSG60 and MSG120 showed a significant increased (p < 0.05) comparedto the control group. Histological alterations were found in the epididymis and prostate gland of MSG treated rats. Inconclusion, MSG at both doses induced oxidative stress in the epididymis and prostate gland of experimental rats.
ABSTRACT
Objective@#To investigate the clinicopathological characteristics, diagnosis, and treatment of primary seminal vesicle adenocarcinoma (SVAC).@*METHODS@#We analyzed the clinical data and clinicopathological characteristics of 4 cases of primary SVAC treated in the Department of Urology of the Second Hospital of Tianjin Medical University and reviewed relevant literature.@*RESULTS@#All the 4 patients were treated by open radical resection of the seminal vesicle and prostate and pathologically diagnosed with SVAC. Preoperative prostatic biopsy had shown 1 of the cases to be negative, while preoperative CT and transrectal ultrasound had revealed a huge pelvic cystic neoplasm in another patient. Immunohistochemistry manifested that the 4 cases were all negative for prostate-specific antigen (PSA), prostatic acid phosphatase (PAP), and cytokeratin 20 (CK20), but positive for cancer antigen 125 (CA125) and CK7. All the patients recovered smoothly after surgery and experienced no recurrence or metastasis during 154, 41, 20, and 12 months of follow-up.@*CONCLUSIONS@#Primary seminal vesicle carcinoma is extremely rare and presents in an advanced stage. Immunohistochemistry plays a valuable role in its differential diagnosis. Various combinations of radical surgery, radiotherapy, androgen-deprivation therapy, and chemotherapy are recommended for the treatment of the disease.