经尿道精囊镜钬激光碎石治疗精囊结石症  

Transurethral seminal vesiculoscopy combined with holmium laser in the treatment of seminal stones

作　　者：范涛[1] 董洋[1] 董秉政[1] 周家合 马伟明 韩从辉[1] 张文达[1] FAN Tao;DONG Yang;DONG Bing-zheng;ZHOU Jia-he;MA Wei-ming;HAN Cong-hui;ZHANG Wen-da(Department of Urology,Xuzhou Central Hospital Affiliated to Southeast University,Xuzhou 221009,China)

机构地区：[1]东南大学附属徐州市中心医院泌尿外科,江苏徐州221009

出　　处：《现代泌尿外科杂志》2018年第10期752-754,共3页Journal of Modern Urology

基　　金：江苏省科技厅重点研发计划项目(No.BE2016641)

摘　　要：目的总结并评价精囊镜钬激光碎石治疗精囊结石的临床效果。方法回顾性分析徐州市中心医院泌尿外科2014年8月至2017年8月收治精囊结石患者31例,23例单侧,8例双侧;25例伴有血精;18例伴有射精痛;会阴部不适15例。术前通过腹部立位平片、直肠超声和精囊CT诊断。利用F4～4.5精囊镜结合钬激光碎石。结果手术时间25～70min,住院时间为4～7d。术后随访6个月,31例精囊结石患者的血精全部消失;17例射精痛缓解;14例会阴部不适缓解;1例术后3d出现双侧附睾睾丸炎,给予抗炎治疗痊愈。结论精囊镜直接观察精囊内部进行钬激光碎石治疗精囊结石,具有安全性高、创伤小、恢复快等优点,值得临床进一步推广使用。Objective To evaluate the clinical efficacy of transurethral seminal vesiculoscopy combined with holmium laser in the treatment of seminal stones. Methods The clinical data of 31 patients with seminal stones treated during Aug.2014 and Aug.2017 were retrospectively analyzed,including 23 cases of unilateral and 8 cases of bilateral stones.Hematospermia was observed in 25 cases,painful ejaculation in 18 cases and perineal discomfort in 15 cases.Perioperative diagnosis was made by KUB,transrectal ultrasound and CT.All patients were treated with F4-4.5 transurethral seminal vesiculoscopy combined with holmium laser. Results The operation time was 25-70 min and hospital stay was 4-7 d.During the follow-up of 6 months,hematospermia was cured in all patients,painful ejaculation disappeared in 17 cases and perineal discomfort was relieved in 14 cases.Epididymo-orchitis occurred in 1 case 3 days after operation,which was cured with anti-inflammatory treatment. Conclusion Transurethral seminal vesiculoscopy combined with holmium laser is safe,effective and minimal invasive in the treatment of seminal stones.It is worthy of wide clinical application.

关 键 词：精囊结石 精囊镜 钬激光 血精 

分 类 号：R697.4[医药卫生—泌尿科学]