SEMINAL VESICULOSCOPY: 2 YEARS FOLLOW UP

A 50 year old gentleman came with bleeding after coitus( he is a case of anejaculation).He underwent seminal vesiculoscopy 2 years back for hemospermia.He had hemospermia for 20 years.His imaging revealed seminal vesicular dilatation.

(SEMINAL VESICULOSCOPY: Summary of seminal vesiculoscopy previously done for him 

During urethroscopy the “colliculus seminales” landmark was identified on verumontanum. Resecting the veru with the resectoscope made a window into the prostatic utricle. A 6 Fr semirigid ureteroscope was introduced in the prostatic utricle. On entering the utricle, a bluish hue was seen on either sides (seminal vesicular methylene blue). The lateral walls of utricle were endoscopically fenestrated with the ureteroscope to enter the seminal vesicles. The seminal vesicles on both sides were cystic and distended and full of inspissated seminal material, stones and granulation tissue. With ureteroscopic forceps the inspissated material was flushed out, stones were fragmented and cleared with Holmium LASER.The granulation tissue was cleared with THULIUM LASER at 30 W power. The fenestrated opening on utricular wall was enlarged with Thulium LASER. The surgery was concluded with deroofing of utricle again with LASER assistance.)

huge deroofed seminal vesicular cavity in the prostatic fossa

We again introduced the cystoscope in the cavity and saw minimal granulation tissue in the cavity.This was fulgurated with THULIUM  LASER.