精囊镜技术在血精诊治中的应用价值  

Application value of ureteroscopytherapy in the treatment of hematospermia

作　　者：叶利洪[1] 蒋小强[1] 李雨林[1] 陈永良[1] 陶水祥[1] 尚庆亚[1] 钱卫良[1] 何建松[1] 李王坚[1] 

机构地区：[1]浙江省绍兴县中心医院暨中国医科大学绍兴医院泌尿外科,312030

出　　处：《中华泌尿外科杂志》2011年第8期558-560,共3页Chinese Journal of Urology

摘　　要：目的探讨精囊镜技术在血精诊治中的应用价值。方法顽固性血精患者19例，经直肠超声，精囊MRI或CT扫描等检查排除精囊肿瘤、结核、前列腺占位，行前列腺液培养加药敏试验。4．5—6．0F输尿管镜经尿道于射精管口直视下进镜，入囊后镜检，冲洗精囊内陈旧性血块；精囊结石用钬激光碎石；切除微小息肉；喹诺酮类药物0．3g／100ml精囊保留灌注。结果19例患者中，18例行双侧1例行患侧精囊镜检、冲洗及药物保留灌注；5例并发精囊结石者以钬激光碎石；3例微小息肉成功切除。手术时间10～75rain，平均35min；术中、术后无并发症发生。18例术后3个月血精完全消失，随访6—12个月，血精所致症状消失；1例术后5个月血精复发经敏感抗生素治疗后好转。结论4．5～6F输尿管镜经正常解剖路径行精囊镜检及相关治疗是微创、安全、有效治疗顽固性血精的方法。Objective To treat hematospermia by ureteroscopy and investigate its application value for the treatment of hematospermia. Methods Nineteen patients with persistent hematospermia, TRUS, seminal vesicle Mill or CT were examined to exclude seminal vesicle tumor, tuberculosis, prostatic occupancy and preoperative prostatic fluid and drug sensitivity. Transurethral 4.5 - 6 F ureteroscopy entered through the microscopic seminal vesicle, wash of the old blood, reserved perfusion with Quinolones, and the lithoelasty on the seminal stones by holmium laser, resection of small polypi. Results The ureteroscopy was successful in 18 （95%） eases for bilateral seminal vesicle, wash and drug reserved perfusion, and one case was also successful seminal vesicle microscopy on the affected side; five eases with the seminal stones by holmium laser, three eases with small polypi by resection. The average duration of the procedure was 35 （ 10 - 75） rain. There were no complioeations during or after the operation. In 18 cases at 6 - 12 months follow-up the hematospermia and symptoms of hematospermia disappeared fully after 90 d. There was recurrence in one ease which improved with anti-inflammaotry treatment. Conclusions Uretcroscopic treatment for persistent hematospermia by 4.5 - 6 F ureteroscopy through the seminal vesicle is effective and safe method and results in a micro-wound.

关 键 词：血精 输尿管镜 内镜外科手术 

分 类 号：R697[医药卫生—泌尿科学]