Clinical practice for treatment of seminal tract stones by technology of seminal vesicle mirror
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摘要: 目的：探讨精道结石形成原因及精囊镜技术在治疗精道结石中的临床应用。方法：22例精道结石合并血精患者术前经彩超、CT及X线平片检查，诊断前列腺结石10例，前列腺钙化3例，精囊结石9例。均先采用精囊镜观察精阜前列腺小囊开口方向，然后在超滑镍钛导丝引导下将精囊镜插入前列腺小囊及精囊进行检查、取石、钬激光碎石或前列腺囊肿开窗冲洗治疗。结果：精囊镜检查发现精阜前列腺小囊开口朝向尿道内口方向6例，垂直尿道11例，尿道外口方向5例。18例精道结石经过冲洗或用异物钳取出，2例经钬激光碎石后取出结石，2例前列腺囊肿行尿道侧囊肿开窗冲洗并取结石。随访（4.9±1.8）个月，血精、疼痛症状均完全消失；结石残留4例，无自觉不适。结石成分分析：磷酸钙结石5例，碳酸钙结石8例，尿酸结石4例，混合性结石5例。结论：精道结石发生可能与精阜前列腺小囊开口方向变异或狭窄有关。经尿道精囊镜下取石是治疗精道结石的有效方法，具有创伤小、并发症少、疗效好、恢复快的优点。Abstract: Objective: To investigate reason of forming seminal tract stones and clinical application for treatment of them by technology of seminal vesicle mirror. Method: The 22 cases seminal vesicle stone was examined by the color dopplar ultrasound, CT and X-ray flat piece of inspection. The opening direction of prostatic utricle located colliculus seminalis was inspected by seminal vesicle mirror, then we examined, Holmium Laser Lithotripsy or Prostate cyst open the window after seminal vesicle mirror was interposed into prostatic utricle and seminal vesicle through Ultra smooth filar guide. Result: The results show the opening direction of prostatic utricle pointing internal urethral meatus, over against urethral wall and pointing external orifce of urethra were 6 cases, 11cases and 5 cases, respectively. 18 cases of seminal tract stones were taken by washing or foreign body forceps, 2 cases of seminal tract stones were broken to pieces by Holmium Laser Lithotripsy, and 2 cases of cyst of the prostate were treatment by prostate window. Symptom of hemospermia and pain of all cases was disappeared after following up visit (4.9±1.8) mouths. 4 cases of patients had retaihned stone. Conclusion: The formation of seminal tract stones was possibly stenosis or direction variation of the opening of prostatic utricle. seminal tract stones treated by technology of seminal vesicle mirror, as has characteristic of small trauma, Less complications, good curative effect and quick recover, was effective treatment methods.
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Key words:
- seminal tract /
- stones /
- seminal vesicle mirror /
- hemospermia
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