CAJ | 학술논문

目的：评价运用微创输尿管精囊镜诊治慢性难治性精囊炎及伴发疾病的临床疗效。方法：30例慢性难治性精囊炎患者的临床资料，单侧24例，双侧4例，2例进镜失败，其中20例伴有血精，5例伴有前列腺炎，3例合并精囊结石。利用逆行输尿管镜插管诊治并冲洗，观察其临床疗效。结果：手术时间14～52 min，平均（32±5）min，住院时间3～7 d，术后随访6～10个月。2例进镜失败维持药物治疗；20例血精治愈，2例术后半年再发血精；8例射精疼痛基本消失，6例会阴部不适者术后缓解，5例前列腺炎治愈，1例好转，3例精囊结石治愈，1例残留，5例少精子患者术后6～9个月内精液量较前明显提高，精子活力亦有所提高，术中、术后均无严重并发症出现。其中20例痊愈，7例好转，3例无效，有效率90.0％，痊愈率66.6％。结论：经尿道输尿管精囊镜能直视下检查精囊腔内情况，有助于查找难治性精囊炎及伴发疾病的病因并对症处理，而且并发症少，是慢性难治性精囊炎的有效治疗方法。
목적：평개운용미창수뇨관정낭경진치만성난치성정낭염급반발질병적림상료효。방법：30례만성난치성정낭염환자적림상자료，단측24례，쌍측4례，2례진경실패，기중20례반유혈정，5례반유전렬선염，3례합병정낭결석。이용역행수뇨관경삽관진치병충세，관찰기림상료효。결과：수술시간14～52 min，평균（32±5）min，주원시간3～7 d，술후수방6～10개월。2례진경실패유지약물치료；20례혈정치유，2례술후반년재발혈정；8례사정동통기본소실，6례회음부불괄자술후완해，5례전렬선염치유，1례호전，3례정낭결석치유，1례잔류，5례소정자환자술후6～9개월내정액량교전명현제고，정자활력역유소제고，술중、술후균무엄중병발증출현。기중20례전유，7례호전，3례무효，유효솔90.0％，전유솔66.6％。결론：경뇨도수뇨관정낭경능직시하검사정낭강내정황，유조우사조난치성정낭염급반발질병적병인병대증처리，이차병발증소，시만성난치성정낭염적유효치료방법。
Objective:To evaluate the clinical effect of minimally invasive transurethral ureteroscopy for the treatment of chronic refractory seminal vesicul-itis and the concomitant diseases .Methods:The therapeutic effects were retrospectively examined in 30 patients with chronic refractory seminal vesiculitis undergone minimally invasive transurethral ureteroscopy.Of the total patients,24 were unilateral and 4 bilateral involvement.Twenty were associated with hemospermia,5 with prostatitis and 3 with seminal vesicle stones.Results:The operative time ranged from 14 to 52 min with an average of (32 ±5)min, and the hospital stay was between 3 and 7 days.Two failure treatment were managed with drug intervention.Twenty cases with hematospermia were cured, and relapse occurred in 2 in half a year.Painful ejaculation was subsided in 8 cases,and genital discomfort recovered in 6 after operation.Prostatitis was cured in 5 cases,and improvement in 1.Seminal vesicle stones were successfully removed,and residual stones occurred in 1.Five patients with azoospermia were improved significantly between 6 and 9 months after operation,with increased volume of ejaculation.No intra-or post-operative complication occurred. In the total patients,20 were cured,7 improved and 3,failed.The effective rate was 90.0% and the recovery rate,66.6%.Conclusion:Transurethral uret-eroscopy can be performed easily with few complications and is an effective therapeutic approach to the chronic refractory seminal vesiculitis.