Anatomical study of the seminal vesicle system for transurethral seminal vesiculoscopy

Abstract

Because of a general lack of knowledge regarding the precise anatomy of the seminal vesicle system, efforts to use transurethral seminal vesiculoscopy (TSV) are currently constrained. We investigated 26 normal adult male specimens. Contrast medium was injected into the seminal vesicle system in 18 specimens and the openings of the ejaculatory ducts were examined with an operating microscope. India ink was injected into the urethra in four specimens to investigate the function of the ejaculatory duct valve. Another four specimens were examined histologically to identify the anatomical relationships of the seminal vesicle system. We found that the openings of the ejaculatory ducts were covered by the ejaculatory duct valve, which could be classified into two types and acted as a one-way valve. The apex of the seminal colliculus together with the right and left openings of the ejaculatory ducts formed a shape resembling an isosceles triangle. This could be used to locate the openings of the ejaculatory ducts during TSV. The ejaculatory ducts can be classified into two types according to their course. During surgery, efforts must be made to protect the ejaculatory duct valve. During inspection or surgery, the second segment and the angles of the ejaculatory ducts, particularly in Type I b and Type II cases, require particular attention.

Guiding role of seminal tract anatomical study in transurethral seminal vesiculoscopy.

“…Currently, identifying the location of the ejaculatory duct opening and making an approach for TSV is controversial. Some scholars assert that the ejaculatory duct openings are located at the 5 o'clock and 7 o'clock positions of the seminal colliculus cavity (prostatic utricle) [8,17,18]. Wang et al [19] performed transurethral procedures for 86 patients with benign prostatic hyperplasia or urethral stricture and simultaneously performed transrectal seminal vesicle massage and observed the ejaculatory There were no significant differences in the complications between the two groups (all p > 0.05), but the differences in surgical validity rates between the two groups were statistically significant (*p < 0.05).…”

“…The outer layer of the ejaculatory duct is longitudinal smooth muscle. At the proximal end, it becomes thin rapidly, and the inner smooth muscle disappears [8,24]. Therefore, the ejaculatory duct has no sphincter functions, such as peristalsis or contraction, and urinary reflux is prevented only by the presence of the sharp angle between the ejaculatory duct and the prostatic urethra [23].…”

“…Seminal tract obstruction may lead to obstructive azoospermia, and affected patients may experience intractable hemospermia, perineal discomfort and pain, ejaculation pain, azoospermia, or infertility [2]. In the past, the outcome of conservative treatment was poor, and open surgery, laparoscopic or even flexible vesiculovasoscopy surgery has been performed for common seminal vesicle diseases [3][4][5][6][7][8]. For seminal tract and seminal vesicle diseases in certain locations, there is no appropriate and effective treatment method [7].…”

Morphology of ejaculatory ducts: A systematic review

“…In a United States study, Nguyen et al (1996) found the mean value of this angle to be 75 . Subsequently, the ducts assumed a straight course until their termination adjacent to the prostatic urethra (Li et al, 2019;López & Angulo, 2013;Malalasekera et al, 2018;McMahon, 1938). In contrast, Banner and Hassler (1978) observed The ducts angulated posterolaterally as they entered the prostate.…”

“…Lanka (Malalasekera et al, 2018) and China (Li et al, 2019) described ejaculatory ducts angulating anteromedially within the substance of the prostate as they coursed towards the seminal colliculus. In a United States study, Nguyen et al (1996) found the mean value of this angle to be 75 .…”