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Clinical Trial
. 2015 Mar 14:15:18.
doi: 10.1186/s12894-015-0015-8.

A novel surgical management for male infertility secondary to midline prostatic cyst

Gong Cheng  1 , Bianjiang Liu  2 , Zhen Song  3 , Aiming Xu  4 , Ninghong Song  5 , Zengjun Wang  6
Affiliations
Clinical Trial

A novel surgical management for male infertility secondary to midline prostatic cyst

Gong Cheng et al. BMC Urol. .

Abstract

Background: To summary the procedure and experience of a novel surgical management for male infertility secondary to midline prostatic cyst (MPC).

Methods: From February 2012 to February 2014, 12 patients were diagnosed with PMC by semen analysis, seminal plasma biochemical analysis, transrectal ultrasonography (TRUS), and pelvic magnetic resonance imaging (MRI). All patients underwent the transurethral unroofing of MPC using resectoscope, the dilation of ejaculatory duct, and the irrigation of seminal vesicle using seminal vesiculoscope. All patients were followed up at least 3 months after operation.

Results: Preoperative semen analyses of 12 patients showed oligoasthenozoospermia (5/12) or azoospermia (7/12), low semen volume (0-1.9 mL), and low pH level (5.5-7.0). Preoperative seminal plasma biochemical analyses showed reduced semen fructose. TURS and MRI revealed a cyst lesion located in the midline of prostatic. After 3 months follow up, the semen quality of 80% patients (4/5) with oligoasthenozoospermia improved obviously. The spermatozoa were present in the semen in 5 of 7 cases with azoospermia. In one patient, the spermatozoa occurred in the urine after ejaculation.

Conclusions: Surgical management using transurethral resectoscopy and seminal vesiculoscopy is effective, minimally invasive, and safe for male infertility secondary to MPC.

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Figures

Figure 1
Figure 1
The representative images of MPC. A, TRUS; B, pelvic MRI. The arrow indicates the cystic lesion.
Figure 2
Figure 2
Transurethral unroofing of MPC. A, the cyst is visualized through the resectoscope. B and C, the ridgy posterior wall of the urethra is resected for unroofing the MPC. D, TURED is performed to make the ejaculatory duct unobstructed.
Figure 3
Figure 3
Transurethral irrigation of seminal vesicle. A, seminal vesiculitis contains the congestive wall, and milky, yellow or pink vesicle fluid filled with flocculent turbidity and dark blood clots. B, seminal vesicle stones. C and D, the seminal vesicle is washed clearly and irrigated using a levofloxacin solution.
See this image and copyright information in PMC

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