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- Title
Laparoscopic Approach of a Seminal Vesicle Cyst.
- Authors
Gingu, C.; A., Dick; Andresanu, A.; Ianiotescu, S.; Orezanu, A.; Barbu, A.; Cairac, N.; Stoica, R.; Domnisor, L.; Baston, C.; Sinescu, I.; Preda, A.
- Abstract
Introduction and Objectives. A seminal vesicle cyst is a very rare diagnosis, with a reported prevalence as low as 0.005% The cysts are usually congenital, a coexistence with Zinner syndrome being described (renal agenesis, ectopic ureteral orifice in the prostatic urethra or seminal vesicle and vas deferens stenosis). The aim of this paper is to present the management of a rare case of an acquired seminal vesicle cyst with normal upper urinary tract anatomy. Materials and Methods. A 33-yrs old male patient presented with chronic pelvic pain associated with dysuria and frequency. The ultrasound identified a right regular hypoechoic mass without Doppler signal. The imagistic diagnosis was sustained by computed tomography, revealing a high-volume (84/65/74 mm) inseparable mass from the right seminal vesicle, without contrast enhancement. The surgical approach was minimally invasive, represented by laparoscopic excision of the right seminal vesicle cyst. The patient was placed in Trendelenburg position and 4 trocars were inserted (a 12 mm optic trocar inserted 1 cm above the umbilical fold, 2 other trocars, one of 5 mm and one of 10 mm bilaterally between the umbilicus and the anterior iliac crest, and one of 5 mm on the midline below the umbilicus). A transperitoneal technique was used in order to identify the vas deferens, which guided the dissection to the cystic mass. Further, the right seminal vesicle and the cystic mass were detached from adjacent pelvic structures. The contents of the cyst were evacuated and the cystic wall was resected, the specimen removed through the 10 mm trocar. Results. The operation time was 100 minutes, with minimal blood loss. The postoperative period was uneventful and the patient was discharged on the third postoperative day, with no complications during follow-up. The pathological analysis of the specimen emphasized hyalinized fibrous tissue, ducto-acinar and seminal epithelial structures, with no evidence of malignancy. Conclusions. The proper management of seminal vesicle cyst is represented by laparoscopic excision. Whenever possible, the minimal invasive approach should be used, due to better postoperative outcomes regarding morbidity and convalescence, in comparison with open techniques.
- Subjects
SEMINAL vesicles; PELVIC pain; VAS deferens; SURGICAL excision; CYSTS (Pathology); LAPAROSCOPIC surgery; URINARY organs
- Publication
Romanian Journal of Urology, 2020, Vol 19, Issue 4, p44
- ISSN
1223-0650
- Publication type
Article