Transurethral Resection of Ejaculatory Ducts

2019; Linguagem: Inglês

10.1002/9781119524328.ch89

Autores

Noel A. Armenakas, John A. Fracchia, Ron Golan,

Tópico(s)

Urinary and Genital Oncology Studies

Resumo

This chapter offers practicing and trainee urologists succinct and precise operative dictations for transurethral resection of ejaculatory ducts, discussing the indications, alternatives, benefits, and risks with the patient. The patient with imaging and semen analysis evidence of ejaculatory duct obstruction is presented for transurethral resection of the ejaculatory ducts. Transrectal ultrasonography was performed and the seminal vesicles identified. A spinal needle was introduced into each seminal vesicle and 10 ml diluted methylene blue/indigo carmine were instilled under direct vision. A 24Fr (continuous flow) resectoscope sheath with a visual obturator and a 30° oblique lens was advanced under direct vision into the bladder. The anterior urethra appeared normal in its entirety. The prostatic urethra was elongated with bilobar/trilobar hyperplasia. On cystoscopic evaluation with both the 30° and 70° lenses, the media was clear, the bladder capacity was normal, and the bladder wall noted to expand symmetrically in all dimensions.

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