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

Abstract

Introduction: There have been problems with low qualification operator-related complications and failures of transurethral seminal vesiculoscopy (TSV) in China. Aim: To study the guiding role of seminal tract anatomical study (STAS) in TSV. Material and methods: We performed STAS to study the structure, morphology, duct trajectory, and anatomical relationships between the seminal vesicles and the adjacent tissue in pelvic specimens from 12 adult cadavers. Then the surgical effects and complications of 82 cases of TSV performed by 3 doctors were retrospectively studied to compare the difference between the two groups of before and after the anatomical study. Results: The anatomical studies of the 12 adult cadaveric pelvis specimens identified the lengths and widths of the right-and left-side seminal vesicles and tracts. The TSV can treat lesions located in the distal seminal tract and vesicle, but proximal lesions cannot be reached, which is an anatomical limitation of this technique. There were significant differences in the surgical times and the surgical validity rates between the 2 groups. Conclusions: Our anatomical study of the seminal tract and seminal vesicles is valuable for guiding TSV in clinical practice.

Application of ultrasound‐guided seminal vesicle radiography combining CT three‐dimensional reconstruction technique in transurethral seminal vesiculoscopy

“…In this study, we implemented the preoperative ultrasound-guided seminal vesicle radiography technique combined with CT three-dimensional reconstruction and found the path of the ejaculation tubes in some cases. We found that the path was consistent with that in a previous study of cadaver specimens (Pang et al, 2020). We randomly divided 32 EDO or haemospermia patients who were scheduled to undergo TSV surgery into two groups, namely, with or without implementation of preoperative ultrasound-guided seminal vesicle radiography combined with the CT three-dimensional reconstruction technique.…”

“…This problem leads to higher surgical failures than the studies have reported. The percentage of cases in which seminal vesiculoscopy of the seminal vesicle failed was approximately 13%-46%, which was much higher than the success rate reported in recent articles (Christodoulidou, Parnham, & Nigam, 2017;Liao et al, 2019;Miao et al, 2019;Pang et al, 2020;Zhang et al, 2017).…”

“…It is urgent to find ways to improve the success rate of TSV surgery and reduce the occurrence of complications. We found in a previous study (Pang et al, 2020) that the anatomy of the seminal vesicle can significantly improve the success rate of TSV surgery.…”

“…Many techniques were developed to improve the success rate of TSV, including the approach with the combination of transrectal ultrasound and a fluoroscope (Manohar, Ganpule, & Desai, 2008) and the approach of TURED (Wang et al, 2012). We found earlier that the participation of surgeons in the seminal tract anatomical study can improve the success rate of seminal vesicle entry during TSV (Pang et al, 2020). However, due to limited conditions, it is impossible for every surgeon to receive anatomical training.…”

“…However, many of the TSV operators cannot locate the ejaculatory duct opening in some cases, which leads to surgical failures (Pang et al, 2020). As the opening of the ejaculatory duct varies and is hidden, finding the opening of the ejaculatory duct and entering the seminal vesicle safely and quickly are the greatest challenges and focus of the TSV procedure.…”