title: Flexible Vesiculovasoscopy Using a Microoptical System in a Human Cadaver Model: An Experimental Approach for Atraumatic Endoscopy of the Seminal Tract.
abstract: The most common pathologies of the seminal tract are persistent hematospermia, seminal vesicle stones, and seminal duct obstruction. Endoscopic diagnostic work-up of the seminal tract is impeded by complex anatomy and lack of technical equipment. To date, there is no standardized endoscopic approach. The purpose of this study was to investigate the applicability and feasibility of a flexible microoptical device for atraumatic endoscopy of the seminal tract in a male human cadaver.
  
  
  
  The transurethral endoscopic examination was performed on a male cadaver. No premortal interventions or diseases of the genitourinary tract had been reported. The seminal orifice was identified via cystoscopy and accessed by the Seldinger technique using a hydrophilic guidewire and ureteral catheter. Retrograde endoscopic inspection of the distal seminal tract was performed using a miniaturized flexible endoscope. An antegrade endoscopic inspection of the seminal tract was carried out via high scrotal access to the vas deferens.
  
  
  
  Structures of the seminal tract, such as the ejaculatory duct, seminal vesicles, and distal portion of the ductus deferentes, were visualized using the miniaturized endoscope. Image quality allowed identification of anatomical structures and characterization of tissue properties. The technical limitations we observed involved the system's maneuverability.
  
  
  
  Initial results of this novel endoscopic approach to the seminal tract using a flexible microoptical system are encouraging. However, considerable anatomical limitations of the targeted organs necessitate further refinements of the technical equipment. This approach might improve diagnostics and treatment of genitourinary diseases. Future surgical techniques may include intraseminal laser therapy or endoocclusion to monitor fertility in men.
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Daniel
authors.initials: D
authors.lastname: Schlager
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Moritz
authors.initials: M
authors.lastname: Maas
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Simon
authors.initials: S
authors.lastname: Hein
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Fabian
authors.initials: F
authors.lastname: Adams
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Martin
authors.initials: M
authors.lastname: Schoenthaler
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wetterauer
authors.affiliation: 2 Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen , Giessen, Germany .
authors.forename: Thorsten
authors.initials: T
authors.lastname: Diemer
authors.affiliation: 2 Department of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen , Giessen, Germany .
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Weidner
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Miernik
mesh_terms: D002102:Cadaver; D002137:Calculi; D003558:Cystoscopy / Q000295:instrumentation / Q000379:methods*; D004543:Ejaculatory Ducts / Q000601:surgery*; D019723:Endoscopes; D004724:Endoscopy / Q000295:instrumentation / Q000379:methods; D051516:Hemospermia; D006801:Humans; D008297:Male; D012669:Seminal Vesicles / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014649:Vas Deferens / Q000601:surgery*