经尿道精囊镜治疗精囊结石症

目的:探讨精囊镜治疗精囊结石内镜手术治疗方法,评价其有效性。方法:18例精囊结石患者,年龄26~58岁,平均(41.5±5.3)岁,平均病程(6.6±3.6)个月,15例顽固性血精、3例会阴部不适、2例射精疼痛,术前经B超、X线片或CT诊断为精囊结石,单侧16例,双侧2例,17例利用精囊镜通过射精管开口进入精囊行精囊结石取石,1例结石较大行钬激光碎石术。结果:平均手术时间(35.6±13.4)min,平均住院时间(4.1±1.5)d,平均随访(6.4±3.1)个月。15例(15/15)血精完全消失,2例(2/2)射精疼痛消失,2例(2/3)会阴部不适明显缓解,1例(1/18)于术后1周出现右侧附睾炎,经抗炎治疗5 d后缓解。结论:利用精囊镜的腔内技术治疗具有创伤小、效果好、并发症少等优点,是治疗精囊结石的有效方法。

Transurethral endoscopic approach for seminal vesicle stone removal

Objective:To study the transurethral endoscopic approach for removal of seminal vesical stone and tO evaluate its efficacy.Methods:The diagnosis of 18 patients with seminal vesicle stones were confirmed by ultrasonography,X-ray or computerized tomography before operation.The patients,with a mean age of(41.5±5.3)years old and a mean disease course of (6.6±3.6)months,included 15 with intractable hemospermia,3 with perineal discomfort and 2 with painful ejaculation.Seminal vesical stones were found unilaterally in 16 cases and bilaterally in 2 cases.We passed a 6/7.5F rigid urethroscope through the utricular opening into the seminal vesicle,and all the stones in 1 7 patients were endoscopically removed using a grasper;one patient was treated by holmium-laser due to the large size of the stones.Results:The mean operation period was(35.6±13.4)min and the mean hospital stay was(4.1±1.5)days.The mean follow-up period was(6.4±3.1)months.Hematospermia disappeared in 15(15/15)cases after treatment;painful ejaculation disappeared in 2(2/2)cases and perineal discomfort was improved in 2(2/3)cases.One patient had epididymitis a week after the operation and the symptoms were relieved after 5-day-antibiotic therapy.Conclusion:Transurethral endoscopic approach for treatment of seminal vesicle stone has a better outcome,less trauma and few complications;it is an effective method for seminal vesicle stone removal.