The Imaging Features and Diagnostic Value of Computerised Tomography in Seminal Duct Tuberculosis.

Objective: To analyse the computerised tomography (CT) imaging features and diagnostic value of seminal duct tuberculosis (TB). Methods: The imaging data of male patients with ejaculatory duct TB who underwent surgical treatment in our hospital from 1 January 2019 to 31 December 2019 were retrospectively analysed. Through CT images, seminal duct TB was divided into different types, and the CT image features of different types of TB were analysed. The differences in diagnosis between CT and pathological results were compared. Results: According to the CT manifestations of TB of the intrapelvic segment of seminal duct TB, this disease could be divided into an intra-tubular calcification type, a lumen dilatation and effusion type and a wall thickening type, among which 6 cases (15.8%) were intra-tubular calcification types, 14 cases (36.8%) were lumen dilatation and effusion types and 18 cases (47.4%) were wall thickening types. The diagnostic efficacy of CT in the diagnosis of ejaculatory duct TB: sensitivity = 63.89% (23/36), specificity = 80.01% (44/53), accuracy = 75.28% (67/89), positive predictive value = 51.87% (43/109), negative predictive value = 77.19% (44/57) and kappa = 0.558. Conclusion: CT has high sensitivity and specificity in the diagnosis of seminal duct TB. The classification of seminal duct TB using CT images is of great significance for the diagnosis and treatment of the disease.

[Seminal vesiculoscopy: Safe and effective for the treatment of refractory hemospermia].

OBJECTIVE: To investigate the clinical effect and safety of transutricular seminal vesiculoscopy in the treatment of refractory hemospermia. METHODS: Using 6Fr ureteroscopy through the prostatic utricle, we treated 103 cases of refractory hemospermia with distal seminal duct obstructive lesions, including 12 cases complicated by distal seminal duct cyst. We rinsed the seminal duct cavity, cleaned out the stones, removed the cyst wall with holmium laser and followed up the patients for 12 months postoperatively. RESULTS: The operations were successfully completed in all the cases but 1 (0.9%), in which the ureteroscope failed to enter the bilateral seminal vesicles. The operation time was (47 ± 9) min. No rectal injury or acute epididymitis occurred intraoperatively, nor fever, long-term dysuria or long-term hematuria after surgery. Postoperative follow-up showed that bloody semen symptoms vanished in 93 (90.3%) of the cases, improved significantly in 4 (3.9%) and not significantly in 2 (1.9%), and 3 cases of recurrence (2.9%) were all relieved after reoperation. CONCLUSION: Transutricular seminal vesiculoscopy has the advantages of clear anatomic vision, minor invasiveness and significant effectiveness in the treatment of refractory hemospermia. What's more, holmium laser is better than plasmakinetic resection in removal of the cyst wall.

[Clinical application of the disposable vasographic interventional therapy kit in vasoseminal vesiculography].

OBJECTIVE: To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK). METHODS: This study included ninety-six 19－65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia. RESULTS: Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography. CONCLUSIONS: The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.