经自然腔道精囊镜诊治顽固性血精的经验探讨  

Natural orifice transurethral seminal vesiculoscopy technology in diagnosis and treatment of intractable hematospermia

作　　者：丁见 汤育新[1] 唐正严[2] 王钊[2] 薛睿智 陈俊杰 Ding Jian1,2 , Tang Yuxin 1 , Tang Zhengyan2, Wang Zhao2, Xue Ruizhi2, Chen Junjie2(1. Department of Urology, The Third Xiang Ya Hospital, Central South University ; 2. Department of Urology, Xiang Ya Hospita)

机构地区：[1]中南大学湘雅三医院泌尿外科,湖南长沙410013 [2]中南大学湘雅医院泌尿外科

出　　处：《中国男科学杂志》2018年第1期37-41,共5页Chinese Journal of Andrology

基　　金：中南大学湘雅三医院““新湘雅人才工程”资助(编号:20160306)

摘　　要：目的探讨经自然腔道精囊镜技术诊治顽固性血精的诊断及治疗经验。方法回顾性分析2013年6月至2016年12月收治的247例采用精囊镜技术诊治顽固性血精患者。结果术中发现前列腺小囊黏膜炎症充血213例,精囊黏膜炎症充血229例,精囊内血凝块203例,精囊结石38例,1例黏膜可疑苔藓样改变。对结石,予以钬激光碎石或异物钳取出;对黏膜炎症充血、出血,予以低能量钬激光止血。术后随访6~29个月,有232例患者血精消失,5例患者血精无改善,1例患者2个月复发,再次手术后正常;9例患者3~5个月后复发。结论精囊镜是目前诊断与治疗顽固性血精的有效方法。Objective To summarize experience in the diagnosis and treatment of intractable hematospermia using transurethral seminal vesiculoscopy technique. Methods We retrospectively analyzed clinical data of 247 patients with intractable hematospermia who were treated by transurethral seminal vesiculoscopy in our institution from June 2013 to December 2016. Results All of the patients underwent transurethral seminal vesiculoscopy treatment. Of them, 213 cases had seminal vesicle mucous membrane inflammation, 229 cases seminal vesicle mucosa inflammatory, l case hyperemia, 203 cases blood clots inside seminal vesicle, 38 cases seminal vesicle calculus, 1 case mucosal suspicious moss lesion. We used holmium laser and ureteral forceps to remove the stones, applied low-energy Holmium laser to treat mucosal hemostasis, and cleaned blood clots and flushed them out thoroughly. All patients recovered well and were followed up for 6 ~ 29 months postoperatively. 232 cases of patients were confirmed to be free of hematospermia, 5 patients complained no improvement of the symptom, 1 case got a relapse in 2 months after the surgery, and became normal again after the second operation. While 9 cases of patients had hematospermia reappeared in 3-5 months after treatments. Conclusion In addition to the medical history and physical examination, imaging including transrectal ultrasound and MRI should be used comprehensively to achieve an accurate diagnosis. Transurethral seminal vesiculoscopy is an effective method for diagnosing and treating refractory hematospermia.

关 键 词：血精症 精囊镜 超声检查 磁共振成像 

分 类 号：R697.4[医药卫生—泌尿科学]