Transurethral endoscopy technique with a ureteroscope for diagnosis and management of seminal tracts disorders: a new approach.

PURPOSE: To apply a transurethral endoscopic technique for examining and managing suspicious distal seminal tracts disorders with a ureteroscope.

PATIENTS AND METHODS: Sixteen patients with distal seminal tracts disorders underwent transurethral endoscopy through the distal seminal tracts using a semirigid ureteroscope. Of the 16 patients, 6 had suspected hemospermia, 4 spermatocele, and 6 male infertility.

RESULTS: The ejaculatory duct, seminal vesicle, and ampulla of the vas deferens were observed under direct vision with the ureteroscope. The vas deferens was investigated by cannulation with a guidewire or an epidural anesthesia catheter. Four patients received a diagnosis of spermatocele, four seminal vesiculitis, and three vas deferens obstruction. All patients received appropriate treatment. The remaining five patients had no anatomic disorders. All patients received careful postoperative observation and treatment, and were monitored for at least 3 months. Three patients had postoperative discomfort in the perineal region. There were no further complications.

CONCLUSIONS: This new technique with the ureteroscope enables diagnosis and management of distal seminal tracts disorders through the normal anatomic tract. This endoscopic technique can be performed easily with minimal complications.