Transurethral seminal vesiculoscopy in the treatment of refractory hemospermia / 中华泌尿外科杂志

ABSTRACT

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.