title: A novel surgical management for male infertility secondary to midline prostatic cyst.
abstract: BACKGROUND
  To summary the procedure and experience of a novel surgical management for male infertility secondary to midline prostatic cyst (MPC).
  
  
  METHODS
  From February 2012 to February 2014, 12 patients were diagnosed with PMC by semen analysis, seminal plasma biochemical analysis, transrectal ultrasonography (TRUS), and pelvic magnetic resonance imaging (MRI). All patients underwent the transurethral unroofing of MPC using resectoscope, the dilation of ejaculatory duct, and the irrigation of seminal vesicle using seminal vesiculoscope. All patients were followed up at least 3 months after operation.
  
  
  RESULTS
  Preoperative semen analyses of 12 patients showed oligoasthenozoospermia (5/12) or azoospermia (7/12), low semen volume (0-1.9 mL), and low pH level (5.5-7.0). Preoperative seminal plasma biochemical analyses showed reduced semen fructose. TURS and MRI revealed a cyst lesion located in the midline of prostatic. After 3 months follow up, the semen quality of 80% patients (4/5) with oligoasthenozoospermia improved obviously. The spermatozoa were present in the semen in 5 of 7 cases with azoospermia. In one patient, the spermatozoa occurred in the urine after ejaculation.
  
  
  CONCLUSIONS
  Surgical management using transurethral resectoscopy and seminal vesiculoscopy is effective, minimally invasive, and safe for male infertility secondary to MPC.
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. drg_cheng@163.com.
authors.forename: Gong
authors.initials: G
authors.lastname: Cheng
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. bjliu@njmu.edu.cn.
authors.forename: Bianjiang
authors.initials: B
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. drz_song@163.com.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Song
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. dram_xu@163.com.
authors.forename: Aiming
authors.initials: A
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. nh_song@163.com.
authors.forename: Ninghong
authors.initials: N
authors.lastname: Song
authors.affiliation: State Key Laboratory of Reproductive Medicine and Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China. zengjunwang@njmu.edu.cn.
authors.forename: Zengjun
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D003560:Cysts / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011469:Prostatic Diseases / Q000601:surgery*; D012669:Seminal Vesicles / Q000601:surgery; D020728:Transurethral Resection of Prostate / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult