title: Transurethral seminal vesiculoscopy using a 6F vesiculoscope for ejaculatory duct obstruction: initial experience.
abstract: Ejaculatory duct obstruction (EDO) is a surgically correctable condition  that occurs in some infertile men. The standard therapy is transurethral  resection of ejaculatory ducts (TURED). However, TURED has been associated  with a high risk of complications, including the impairment of semen  parameters and retrograde ejaculation. In our clinical practice, vesiculoscopy  has demonstrated potential as a minimally invasive alternative technique for  the diagnosis and treatment of EDO. Very few studies have examined  transurethral seminal vesiculoscopy (TRU-SVS) in recent years, and no study  has examined 6F vesiculoscopes. Therefore, we performed a retrospective study  of TRU-SVS using a 6F vesiculoscope and its effect on the diagnosis and  treatment of EDO. A total of 21 patients who underwent this procedure were  included in the study. The mean patient age was 28.8 years (range, 23-36  years). The procedure was completed successfully in all patients within a mean  time of 31.5 minutes and a mean hospital stay of 1.17 days. All patients had  EDO. Calculi were found in the ejaculatory ducts or in the seminal vesicles of  5 patients. Sperm was detected in 11 patients 1-3 months postsurgery and  in another 8 patients 3-12 months postsurgery. No sperm was detected in  the remaining 2 patients by 12 months postsurgery. Epididymitis, retrograde  ejaculation, urinary incontinence, and rectal injury were not observed. These  data indicate that TRU-SVS using a 6F vesiculoscope affords direct access to  the seminal vesicle and offers the advantages of fewer complications and more  optimal sperm recovery as well as direct, dynamic video imaging.
authors.affiliation: Department of Urology, Changhai Hospital, Second Military University, Shanghai, China.
authors.forename: Haifeng
authors.initials: H
authors.lastname: Wang
authors.forename: Huamao
authors.initials: H
authors.lastname: Ye
authors.forename: Chuanliang
authors.initials: C
authors.lastname: Xu
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Liu
authors.forename: Xu
authors.initials: X
authors.lastname: Gao
authors.forename: Jianguo
authors.initials: J
authors.lastname: Hou
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Shuguang
authors.initials: S
authors.lastname: Piao
authors.forename: Yinghao
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000328:Adult; D002137:Calculi / Q000601:surgery; D003251:Constriction, Pathologic / Q000150:complications; D004543:Ejaculatory Ducts / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005832:Genital Diseases, Male / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D012669:Seminal Vesicles / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography