Diagnosis and treatment of ejaculatory duct cyst: A report of 2 cases and review of the literature / 中华男科学杂志

<p><b>Objective</b>To investigate the diagnosis and treatment of ejaculatory duct cyst.</p><p><b>METHODS</b>This study included 2 male patients present at the hospital for hemospermia and abnormal sensation in the perineal region in July and August 2014. Both underwent transrectal ultrasonography, routine semen examination, CT, MRI, cystoscopy, and vesiculography before transurethral fenestration of the cysts and pathological examination of the cyst wall specimens. Analyses were made on the clinical presentations, imaging features, pathological characteristics, differential diagnosis and treatment of ejaculatory duct cyst and relevant literature was reviewed.</p><p><b>RESULTS</b>The cyst wall was mainly composed of smooth muscle, the inner wall lined with pseudostratified ciliated columnar epithelia, and with positive expressions of CD10 and Muc6 proteins on immunohistochemical staining, which indicated renal iatrogenic ejaculatory duct cyst. The patients were followed up for 18 and 20 months, respectively. All symptoms disappeared and no recurrence occurred after surgery. Routine semen examination for the two patients showed the semen volumes to be 3.5 and 3.1 ml, sperm concentrations 35 and 32 ×10⁶/ml, grade a sperm 32.0 and 26.0%, grade b sperm 18.0 and 31.0%, and semen liquidation time 30 and 34 minutes, respectively.</p><p><b>CONCLUSIONS</b>Pelvic cystic masses can be detected by transrectal ultrasonography, CT and MRI, but definite diagnosis relies on vesiculography, pathological examination and immunohistochemical staining. Transurethral fenestration is safe and effective for the treatment of ejaculation duct cyst.</p>

Clinical application of the disposable vasographic interventional therapy kit in vasoseminal vesiculography / 中华男科学杂志

Objective@#To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK).@*METHODS@#This study included ninety-six 19－65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia.@*RESULTS@#Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography.@*CONCLUSIONS@#The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.

No incision percutaneous seminal vesiculography / 대한비뇨기과학회지

Seminal vesiculography is an excellent method of evaluating the male genital tract not only for obstruction but also for other structural lesions that may cause infertility. To date it has been usually performed under general or spinal anesthesia as a preliminary to an operative procedure or durirre the epididymovasastomy. We report on no incision percutaneous seminal vesiculography under local anesthesia prior to the surgical correction of infertility. It was developed by applying the percutaneous vas puncture technique to seminal vesiculography and needed neither incision nor dissection. Thirty azoospermic patients were evaluated by this method for patency and image of the vas, seminal vesicles and ejaculatory ducts before corrective surgery. Not more than three punctures were made on one vas. To clarify the possibility that it may be complicated by the stenosis of the vas at the puncture site, fifteen patients were evaluated by intraoperative seminal vesiculography two months later and among them three patients were additionally evaluated pathologically. In cases whose vases were punctured more than twice at the same site of the vas, there were partial or severe obstruction but there was no obstruction when multiple punctures were done on the different sites of one vas. Although this procedure requires a fair skill. it is simple to an expert. We could suggest that no incision percutaneous seminal vesiculography is plausible, safe and valuable in saving unnecessary scrotal exploration and shortening the surgical time. The future roles of this imaging technique are discussed.

The Normal Vasoseminal Vesiculography / 대한비뇨기과학회지

Vasoseminal vesiculography was performed on 40 asymptomatic men. Considerable variability in the appearance of the normal adult seminal tract was seen. The average lengths of the left and right ampullae were 4.23+/-0.77cm and 4.09+/-0.78cm respectively. Most ampullaes (75%) began at the vesicular fundus; the remainder projected either slightly more lateral (18%) or medial (7%) to the fundus. The average lengths of the left and right vesicle were 3.21+/-0.61cm and 3.24+/-0.49cm respectively ; the average widths were 1.36+/-0.30cm and 1.36+/-0.27cm. Eighty-seven per cent of subjects had symmetric-appearing vesicles. The average lengths or the left and right ejaculatory duct were 12.7+/-0.27mm and 13.0+/-0.59mm respectively; the average widths were 1.9+/-0.59mm and 1.8+/-0.58mm. Two normal configurations were noted; straight (70% ) and curved (30%). All ducts appeared symmetric. Criteria for normality are presented and the radiographic techniques were reviewed.