Ectopic seminal tract opening in enlarged prostatic utricle: A report of 22 cases / 中华男科学杂志

Objective@#To explore the diagnosis, classification and treatment of ectopic seminal tract opening in enlarged prostatic utricle (EPU).@*METHODS@#We retrospectively analyzed the clinical data on 22 cases of ectopic seminal tract opening in EPU confirmed by spermography, EPU open cannula angiography or intraoperative puncture of the vas deferens and treated by transurethral incision of EPU, cold-knife incision or electric incision of EPU, full drainage of the anteriorwal, and open or laparoscopic surgery from October 1985 to October 2017.@*RESULTS@#Five of the patients were diagnosed with ectopic opening of the vas deferens and the other 17 with ectopic opening of the ejaculatory duct in EPU. During the 3－48 months of postoperative follow-up, symptoms disappeared in all the cases, semen quality was improved in those with infertility, and 2 of the infertile patients achieved pregnancy via ICSI.@*CONCLUSIONS@#Ectopic seminal tract opening in EPU is rare clinically. Spermography is a reliable method for the diagnosis of the disease, and its treatment should be aimed at restoring the smooth flow of semen based on proper classification and typing of the disease.

Análisis de parámetros seminales en varones subfértiles sin y con varicocele (Pre-Postquirúrgico) / Analysis of seminal parameters in subfertile males without and with varicocele (Pre-Surgical)

Introducción: Durante años, el varicocele se ha propugnado como la causa más común de infertilidad, siendo esta patología la de mayor incidencia en los varones como factor causal (19 - 41%). Material y Métodos: Se evaluaron 228 pacientes, sexo masculino (18 y 39 años) con subfertilidad primaria con o sin varicocele. Se realizó historia clínica, examen físico, laboratorio y espermograma por duplicado. Se dividieron un grupo de 120 pacientes con subfertilidad primaria, varicocele izquierdo y por lo menos un parámetro seminal alterado en dos muestras sometidos a varicocelectomía y control seminal 6 y 9 meses post-operatorio y otro grupo 108 pacientes de iguales características pero sin varicocele. Se utilizaron criterios OMS en concentración, motilidad y morfología espermática. Estudio de casos y controles. Resultados: La mejoría en la concentración de espermatozoides tras el tratamiento quirúrgico fue de 20,06% (p‹ 0,0001) a los 6 meses y 26,31% (p‹ 0,0001) a los 9 meses. La motilidad aumentó 21,32% (p‹ 0,001) a los 6 meses y 28,28% (p‹ 0,0001) a los 9 meses y la morfología mejoró un 26,8% (p‹ 0,0001) a los 6 meses y 57,38% (p‹ 0,0001) a los 9 meses. Todas las variables resultaron estadísticamente significativas tras el tratamiento quirúrgico. No hubo diferencia estadísticamente significativa en ninguna de las variables entre el grupo pre-quirúrgico y el grupo control, y si las hubo en todas las variables estudiadas entre el grupo control comparado con el post- quirúrgico, a favor de este último. Los porcentajes de mejoras entre el grupo post-quirúrgico a los 6 meses y 9 meses de la cirugía, a favor de este último fueron 7,5% (p‹ 0,0001) en la concentración, 5,28 % (p‹ 0.0001) en la motilidad y 25,32% (p‹ 0.0001) en la morfología... Conclusiones: Los parámetros seminales evidenciaron cambios positivos luego de la varicocelectomia y más aún con el transcurrir del tiempo.

Introduction: Varicocele has been proposed for years as the most common cause of infertility, and this condition is the prevalent incidence as causal factor. (19-41%) Material and methods: 228 male patients (between 18 and 39 years old) were evaluated with primary sub fertility with or without varicocele. The records included history, physical examination and two spermogram for patient. The population was divided in two groups. The first one of 120 patients with primary subfertility, left varicocele and at least one abnormal seminal parameter in two samples, with surgical resection of varicocele and final seminal post-surgical evaluation at 6 and 9 months. The other group included 108 patients with similar characteristics but without varicocele. The WHO criteria for spermatic concentration, motility and morphology were applied. Evaluation of cases and controls. Results: The improvement in spermatozoa concentration after treatment was of 20.06% (p<0,0001). The motility improved 21,32% at 6 months (p<0,0001) and 28,28% at 9 months (p<0,0001).The morphology improved 26,8% at 6 months (p<0,0001) and 57,38% at 9 months (p<0,0001)All the parameters were statistically significant after surgery. While there were no significant differences in any parameter between the pre-surgical group and the control group, there were differences in all the parameters evaluated between the control group and the post-surgical group, with best results in the latter.The percentages of improvement in the post-surgical group were 7,5%(p < 0,0001) in concentration, 5,28% in motility and 25,32% in morphology...Conclusions: The seminal parameters showed positive changes after varicocelectomy, especially over time.