NJA中华男科学杂志NationalJournalofAndrologyZhonghuaNanKeXueZaZhi2022，28(11):1011－1014http://www．androl．cn·论著·ClinicalＲesearch(临床研究)精道内镜技术治疗顽固性血精的疗效和安全性刘家钦，陈锐，沈明，于建红，董彪，江专新(昆明医科大学第二附属医院男性科，云南昆明650101)【摘要】目的:探讨应用精道内镜技术经前列腺小囊途径治疗顽固性血精的疗效和安全性。方法:通过6F输尿管镜经前列腺小囊途径治疗顽固性血精及精道远端梗阻性疾病患者103例，其中精道远端囊肿合并顽固性血精12例，术中冲洗精囊腔并清除结石，钬激光将囊肿壁切除，术后随访12个月。结果:103例手术均顺利进行，1例(0．9%)顽固性血精患者未成功进入双侧精囊腔，其余手术均顺利完成，手术时间为(47±9)min，术中无直肠损伤、急性附睾炎等手术并发症发生，术后无发热、长期尿痛、长期血尿等不适，术后2例(1．9%)精液带血症状无明显缓解，4例(3．9%)精液带血症状明显好转，3例(2．9%)顽固性血精症患者精液带血症状复发，均再次行手术后症状好转，其余93例(90．3%)精液带血症状治愈。结论:应用精道内镜技术治疗顽固性血精具有解剖清晰、疗效显著、创伤小等特点，同时应用钬激光切除囊肿壁相对于等离子电切具有一定优势。【关键词】精道内镜;顽固性血精;精道远端囊肿中图分类号:Ｒ697+．4文献标志码:Adoi:10．13263/j．cnki．nja．2022．11．007①Seminalvesiculoscopy:SafeandeffectiveforthetreatmentofrefractoryhemospermiaLIUJia-qin，CHENＲui，SHENMing，YUJian-hong，DONGBiao，JIANGZhuan-xinDepartmentofAndrology，TheSecondAffiliatedHospitalofKunmingMedicalUniversity，Kunming，Yunan650101，China【Abstract】Objective:Toinvestigatetheclinicaleffectandsafetyoftransutricularseminalvesiculoscopyinthetreatmentofre-fractoryhemospermia．Methods:Using6Frureteroscopythroughtheprostaticutricle，wetreated103casesofrefractoryhemosper-miawithdistalseminalductobstructivelesions，including12casescomplicatedbydistalseminalductcyst．Werinsedtheseminalductcavity，cleanedoutthestones，removedthecystwallwithholmiumlaserandfollowedupthepatientsfor12monthspostoperatively．Ｒesults:Theoperationsweresuccessfullycompletedinallthecasesbut1(0．9%)，inwhichtheureteroscopefailedtoenterthebilat-eralseminalvesicles．Theop...
