精囊镜诊治顽固性血精的临床价值

杨学贞; 蒋旭; 王华; 朱宏建

doi:10.12122/j.issn.1674-4500.2019.01.11

精囊镜诊治顽固性血精的临床价值

doi: 10.12122/j.issn.1674-4500.2019.01.11

1.
蚌埠医学院第二附属医院泌尿外科，安徽蚌埠 233000
2.
北京武警总医院泌尿外科，北京 100039

基金项目: 安徽省人社厅留学人员创新项目择优资助计划（2016RSL18）

详细信息

作者简介:
杨学贞，博士，主任医师，副教授，硕士研究生导师，E-mail: engineyang@sina.com

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出版历程
- 收稿日期: 2018-11-03
- 刊出日期: 2019-01-01

Experiences exploration of seminal vesicle endoscopy technology in diagnosis and treatment of refractory hemospermia

1.
Department of Urology, The Second Affilated Hospital of Bengbu Medical College, Bengbu 233000, China
2.
Department of Urology, Beijing Armed Police General Hospital, Beijing 100039, China

摘要

摘要: 目的探讨精囊镜技术在血精诊治中的临床价值。方法 19例临床诊断为顽固性血精的患者，术前前列腺液培养加药敏，经直肠B超（TRUS），精囊MRI或CT扫描等检查排除精囊肿瘤、结核、前列腺癌；经尿道F4.5/6输尿管镜进行精囊镜检，冲洗精囊内陈旧性血块，合并精囊结石用钬激光碎石，术中喹诺酮类药物精囊保留灌注。术后应用非那雄胺4周。结果 19例患者中，18例（94.74%）成功获双侧精囊镜检、冲洗、药物保留灌注，1例成功获患侧精囊镜检、治疗，随访6月~1年，18例患者血精消失，1例复发经敏感抗生素抗炎治疗后好转。结论经尿道F4.5/6输尿管镜进行精囊镜检是一种治疗顽固性血精安全而有效的方法。
- 血精 /
- 输尿管镜 /
- 精囊镜 /
- 保留灌注 /
- 非那雄胺
Abstract: Objective To investigate the clinical value of seminal vesicle endoscopy technique in the diagnosis and treatment of hemospermia. Methods Nineteen patients clinically diagnosed with refractory hemospermia were included in the study. Prostatic fluid culture and drug sensitivity test were performed before the surgery. TRUS, seminal MRI or CT scan for seminal vesicles were carried out to exclude tumor of seminal vesicle, tubercle and carcinoma of prostate. Seminal vesicle endoscopy was conducted using urethra F4.5/6 ureteroscope, old coagulated blood in seminal vesicles was washed. Holmium laser was used to break calculus of seminal vesicle and quinolones was perfused into the seminal vesicles during the surgery. Four weeks finasteride therapy followed after operation. Results For 19 patients, 18 patients successfully received bilateral seminal vesicles endoscopy, washing and drug reserved perfusion. One patient completed injured seminal vesicle endoscopy and treatment. Six months to one year follow-up indicated that no hemospermia was found in 18 patients and one patient was diagnosed with hemospermia recurrence. The symptoms were improved after sensitive antibiotics anti-inflammatory treatment. Conclusion Seminal vesicle endoscopy per urethra using F4.5/6 ureteroscopes is a safe and effective method to treat refractory hemospermia.
- hematospermia /
- ureteroscopy /
- seminal vesicle endoscopy /
- reserved perfusion /
- finasteride

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图 1 术中进镜及碎石

A: 斑马导丝引导下输尿管镜扩张射精管, 进入精囊; B: 精囊结石, 钬激光碎石.

下载: 全尺寸图片幻灯片

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