关键词: 血精, 精囊镜, 射精管

Abstract: Objective：To explore the feasibility,safety,and effectiveness of transurethral seminal vesiculoscopy(TSV) for the treatment of refractory hematospermia.Methods：31 patients with refractory hematospermia underwent transurethral seminal vesiculoscopy in different approaches between January 2016 and August 2018.Seminal vesicles were lavaged with antibiotics and blood clots,stones,and inflammatory substances were removed from the seminal vesicles.Postoperative followup was conducted for 6 to 12 months to observe the postoperative effect and the occurrence of complications.Results：12 patients underwent TSV successfully through bilateral ejaculatory duct openings,3 patients underwent TSV through unilateral ejaculatory duct openings and contralateral prostatic utricle,11 cases underwent TSV through prostatic utricle,5 patients underwent TSV through resected verumontanum.In 21 cases,hemospermia disappeared completely within 3 months postoperatively.Hemospermia disappeared in 7 cases within 6 months after surgery.Hemospermia did not improve in 3 cases 1year after surgery.Acute epididymitis occurred in one patient after operation.The cure rate was 90.3% and the incidence of complications was 3.2%.Conclusion：Transurethral seminal vesiculoscopy is safe and effective in the treatment of refractory hematospermia,and generally does not cause serious complications.Although the opening of the ejaculatory duct is the preferred approach,the success rate is low.Although the prostatic utricle route and electrocution of verumontanium destroyed the normal anatomical structure of the ejaculatory duct,no adverse consequences were found.

Key words: hemospermia, seminal vesiculoscopy, ejaculatory duct