RESUMEN
PURPOSE: To evaluate the etiology and treatment of options in patients with hematospermia, we performed endoscopy of the seminal vesicles in 37 patients with hematospermia. MATERIALS AND METHODS: The patients were evaluated with either transrectal ultrasound (TRUS) or endorectal MRI. Mean age was 47.1 years (range 28-68 years) with duration of infliction being 37 months (range 3 months to 10 years). When the patients who had the definite abnormalities on the imaging studies and did not improve by medications for more than 3 months, transutricular seminal-vesiculoscopy using 6Fr or 9Fr rigid ureteroscope was performed. Patients were followed for more than 3 months after the endoscopic treatment. RESULTS: Hemorrhage was found in the seminal vesicles and the ejaculatory ducts in 23 (62.2%) and 3 (8.1%), respectively. Calculi were present in the seminal vesicles and the ejaculatory ducts in 6 (16.2%) and 2 (5.4%), respectively. Prostatitis was present in 9 (24.3%) patients. All patients except one reported improvement of hematospermia. Postoperative complications including epididymitis or retrograde ejaculation were not observed. CONCLUSIONS: Our series is the first large-scale experience of the seminal vesicle endoscopy in vivo. Transutricular seminal vesiculoscopy can be performed easily with conventional endoscopic equipment. The endoscopic evaluation and management of the hematospermia is a viable clinical option.
Asunto(s)
Humanos , Masculino , Cálculos , Eyaculación , Conductos Eyaculadores , Endoscopía , Epididimitis , Hemorragia , Hematospermia , Imagen por Resonancia Magnética , Complicaciones Posoperatorias , Prostatitis , Vesículas Seminales , Ultrasonografía , UreteroscopiosRESUMEN
PURPOSE: Premature ejaculation is the most common problem in patients with ejaculatory dysfunction and frequently occurs with erectile dysfunction. Although sildenafil (Viagra(R)) has dramatically improved the treatment of patients with erectile dysfunction, many still complain of premature ejaculation. We investigated the combined clinical efficacy of sildenafil and SS-cream in patients with erectile dysfunction and premature ejaculation. MATERIALS AND METHODS: Of men aged over 20 years who visited our Andrology clinic with erectile dysfunction, a total of 52 patients with concomitant premature ejaculation were enrolled. Each patient was administered with sildenafil for 4 weeks and then sildenafil plus SS-cream for 4 weeks. Sexual function was measured before and after therapy using an abbreviated version of the International Index of Erectile Function-5 (IIEF-5), which includes 5 categories regarding sexual function. RESULTS: Mean score of IIEF-5 was 10.2+/-4.1 at baseline, 18.8+/-5.2 after treatment with sildenafil and 22.2+/-4.2 after treatment with sildenafil and SS-cream, respectively. Mean score of four domains of sexual function, that is, overall satisfaction, orgasmic function, erectile function, intercourse satisfaction was 1.8+/-0.4, 2.1+/-0.5, 3.8+/-0.9, 1.8+/-0.4 at baseline, 4.0+/-0.6, 3.6+/-0.6, 8.0+/-1.2, 3.4+/-0.6 after treatment with sildenafil, and 4.4+/-0.8, 4.2+/-0.6, 9.2+/-1.4, 4.4+/-0.8 after treatment with sildenafil and SS-cream, respectively. Patient satisfaction was significantly higher after sildenafil and SS-cream administration (90.4%) compared to sildenafil alone 80.8%. CONCLUSIONS: The combination of sildenafil and SS-cream is more effective in patients with erectile dysfunction and premature ejaculation compared to sildenafil alone.