No incision percutaneous seminal vesiculography

Paick, Jae Seung; Choo, Myung Soo; Lee, Sung Won

Abstract

Seminal vesiculography is an excellent method of evaluating the male genital tract not only for obstruction but also for other structural lesions that may cause infertility. To date it has been usually performed under general or spinal anesthesia as a preliminary to an operative procedure or durirre the epididymovasastomy. We report on no incision percutaneous seminal vesiculography under local anesthesia prior to the surgical correction of infertility. It was developed by applying the percutaneous vas puncture technique to seminal vesiculography and needed neither incision nor dissection. Thirty azoospermic patients were evaluated by this method for patency and image of the vas, seminal vesicles and ejaculatory ducts before corrective surgery. Not more than three punctures were made on one vas. To clarify the possibility that it may be complicated by the stenosis of the vas at the puncture site, fifteen patients were evaluated by intraoperative seminal vesiculography two months later and among them three patients were additionally evaluated pathologically. In cases whose vases were punctured more than twice at the same site of the vas, there were partial or severe obstruction but there was no obstruction when multiple punctures were done on the different sites of one vas. Although this procedure requires a fair skill. it is simple to an expert. We could suggest that no incision percutaneous seminal vesiculography is plausible, safe and valuable in saving unnecessary scrotal exploration and shortening the surgical time. The future roles of this imaging technique are discussed.