혈정액증의 치료에서 경소낭 정낭내시경술의 유용성

Abstract

Purpose: To evaluate the etiology and treatment of options in patients with hematospermia, we performed endoscopy of the seminal vesicles in 37 patients with hematospermia. Materials and Methods: The patients were evaluated with either transrectal ultrasound (TRUS) or endorectal MRI. Mean age was 47.1 years (range 28-68 years) with duration of infliction being 37 months (range 3 months to 10 years). When the patients who had the definite abnormalities on the imaging studies and did not improve by medications for more than 3 months, transutricular seminal-vesiculoscopy using 6Fr or 9Fr rigid ureteroscope was performed. Patients were followed for more than 3 months after the endoscopic treatment. Results: Hemorrhage was found in the seminal vesicles and the ejaculatory ducts in 23 (62.2%) and 3 (8.1%), respectively. Calculi were present in the seminal vesicles and the ejaculatory ducts in 6 (16.2%) and 2 (5.4%), respectively. Prostatitis was present in 9 (24.3%) patients. All patients except one reported improvement of hematospermia. Postoperative complications including epididymitis or retrograde ejaculation were not observed. Conclusions: Our series is the first large-scale experience of the seminal vesicle endoscopy in vivo. Transutricular seminal vesiculoscopy can be performed easily with conventional endoscopic equipment. The endoscopic evaluation and management of the hematospermia is a viable clinical option.