Introduction
Materials and methods
Clinical data
Age, year (mean ± SD) | 40.49 ± 11.40 |
Duration, month, median (interquartile range) | 14.50 (9.25, 36.0) |
Side of the lesion, n (percentage) | |
Unilateral | 39 (57.35%) |
Bilateral | 29 (42.65%) |
Fresh bleeding revealed by MRI, n (percentage) | |
Yes | 7 (10.29%) |
No | 61 (89.71%) |
Seminal tract stones/cysts, n (percentage) | |
Yes | 43 (63.24%) |
No | 25 (36.76%) |
Surgical approach, n (percentage) | |
A | 45 (66.18%) |
B | 14 (20.59%) |
C | 9 (13.23%) |
Observation indicators
Surgical methods
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Method A: Retract the endoscope body to the verumontanum to assess the normal appearance and shape of the verumontanum. Subsequently, the seminal vesiculoscope was inserted into the PU to explore and exit the PU. At the 5 o'clock position, the left seminal vesicle cavity was assessed to examine for bleeding, stones, cysts, or old blood clots. Normal saline was used for repeated rinsing. If stones were present, seminal vesicle lithotripsy was performed using a holmium laser to crush the stones into powder, followed by thorough rinsing and clearance. In cases of a seminal vesicle cyst or ejaculatory duct cyst, a relevant cystectomy was performed. The endoscope was then withdrawn to the left ejaculatory duct orifice, repositioning the PU, and subsequently, the right seminal vesicle was accessed at the 7 o'clock position in the PU. The exploration and treatment of the seminal vesicle cavity followed the same procedure (Fig. 1).
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Method B: Resection/incision through the ejaculatory duct of the urethra if the ejaculatory duct orifice or PU orifice were obstructed. Subsequently, the seminal vesicle cavity was accessed through the ejaculatory duct using the same approach; The exploration and treatment of the seminal vesicle cavity followed the same procedure (Fig. 2).
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Method C: If locating the ejaculatory duct orifice was challenging or when the orifice was obstructed or not amenable to recanalization at the PU, the seminal vesicle cavity was penetrated through the weak mucosa side channel, guided by the Zebra Urological Guidewire (Fig. 3).
Statistical analysis
Results
Surgical efficacy
Surgical methods | recurrent | Non-recurrent | Recurrence rate (%) | P |
---|---|---|---|---|
Method A | 11 | 34 | 24.44 | 0.144 |
Method B | 7 | 7 | 50.00 | |
Method C | 4 | 5 | 44.44 |
Analysis of predictive factors of good postoperative outcome (A method)
Univariate Logistic Analysis | Multivariate Logistic Analysis | |||
---|---|---|---|---|
OR (95%CI) | P | OR (95%CI) | P | |
Age | 1.032 (0.981, 1.085) | 0.220 | ||
Duration of disease | 1.008 (0.997, 1.019) | 0.165 | ||
Unilateral/Bilateral lesions | 0.582 (0.173, 1.954) | 0.381 | ||
Whether combined with seminal tract stones/cysts | 0.250 (0.076, 0.821) | 0.022* | 0.244 (0.083, 0.716) | 0.010* |
Whether the seminal vesicle MRI manifested fresh bleeding or non-fresh bleeding | 0.281 (0.026, 3.102) | 0.300 |