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Tek Taraflı Renal Agenezili veya Agenezisiz Seminal Vezikül Kisti: Tanı ve Tedavi Seçenekleri

Yıl 2022, Cilt: 12 Sayı: 3, 536 - 543, 29.09.2022
https://doi.org/10.31832/smj.1104876

Öz

Amaç: Son derece nadiren veya doğuştan bir patoloji olan seminal vezikül kistinin yönetimi hakkındaki tecrübemizi bildirmektir.
Gereç ve Yöntemler: Kliniğimizde 2011-2020 yılları arasında seminal vezikül kisti tanısı alan yedi hasta retrospektif olarak incelendi. Hastaların şikayeti, fertilitesi, fizik muayene bulguları, tanısal testleri, görüntülemesi ve elde edilen bulguları, cerrahi türü, takip süresi, komplikasyonlar ve rekürens varlığı, kist duvarının histolojik incelemesi kaydedildi.
Bulgular: Seminal vezikül kisti saptanan yedi erkek hastanın, ortalama yaş 36.29 ± 13.45, IPSS 13.57 ± 4.89, Qmax: 21.77 ± 3.42ml/sn idi. Dev seminal vezikül kisti olan hastada perineal ağrı ve alt karın ağrısı, altı hastada depolama alt üriner system semptom şikayetleri mevcuttu. Beş hasta infertil ve spermiogram normal aralıklardaydı, iki hasta infertildi. Altı hastada ipsilateral renal agenezi, bir asemptomatik hasta ve üç hasta depolama alt üriner sistem semptomları tedavisiz takip edildi. İki infertil hasta transüretral rezeksiyon ile opera edildi. Seminal vezikül kisti> 12 cm dev kistler olarak değerlendiridli ve açık eksizyon uygulandı. Komplikasyon veya nüks gözlenmedi. Numunelerinin histopatolojik incelemesinin seminal vezikül kisti ile uyumlu olduğu bildirildi. Ortanca takip süresi 96 aydı.
Sonuç: Açık cerrahi yaklaşım, dev kistler için kesin tedavi şekli olarak kabul edilebilir. Her ne kadar küçük asemptomatik seminal vezikal kistin müdahale olmadan takip edilebilse de, mesaneye protrüde semptomatik kist transüretral yolla tedavi edilebilir.

Kaynakça

  • Parviz K. Kavoussi (2020). Surgical, Radiographic, and Endoscopic Anatomy of the Male Reproductive System In A. W. Partin, C. A.
  • Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 6333-6405).Sheih CP, Hung CS, Wei CF, Lin CY. Cystic dilatations within the pelvis in patients with ipsilateral renal agenesis or dysplasia. J Urol 1990;144:324-7.
  • Dorota J. Hawksworth, Mohit Khera, Amin S. Herati (2020) Surgery of the Scrotum and Seminal Vesicles. In A. W. Partin, C. A. Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 8552-8630).
  • Florim, S., Oliveira, V., Rocha, D. (2018). Zinner syndrome presenting with intermittent scrotal pain in a young man. Radiology case reports, 13(6), 1224–1227.
  • Aumuller G, Riva A. Morphology and functions of the human seminal vesicle. Andrologia. 1992;24(4):183–196
  • Ndovi TT, Parsons T, Choi L, et al. A new method to estimate quantitatively seminal vesicle and prostate gland contributions to ejaculate. Br J Clin Pharmacol. 2007;63:404–420.
  • Clegg EJ. The arterial supply of the human prostate and seminal vesicles. J Anat. 1955;89(2):209–216
  • Paul J. Turek (2020). Male Reproductive Physiology. In A. W. Partin, C. A. Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 6406-6500).
  • Brian A. VanderBrink & Pramod P. Reddy (2020) Anomalies of the Upper Urinary Tract. In A. W. Partin, C. A. Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 3202-3326).
  • Davis TK, Hoshi M, Jain S. To bud or not to bud: the RET perspective in CAKUT. Pediatr Nephrol. 2014;29(4):597– 608.
  • Ashley DJ, Mostofi FK. Renal agenesis and dysgenesis. J Urol. 1960;83:211–230.
  • Ochsner MG, Brannan W, Goodier EH. Absent vas deferens associated with renal agenesis. JAMA. 1972;222(8):1055– 1056.
  • Donohue RE, Fauver HE. Unilateral absence of the vas deferens. A useful clinical sign. JAMA. 1989;261(8):1180– 1182.
  • Williams RD, Sandlow JI. Surgery of the seminal vesicles. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ, editors. Campbell’s Urology. 7th edn. Philadelphia: PA: Saunders; 2001.p. 3299– 3315.
  • Livingston L, Larsen CR. Seminal vesicle cyst with ipsilateral renal agenesis. AJR Am J Roentgenol 2000;175:177–80.
  • Arora SS, Breiman RS, Webb EM, Westphalen AC, Yeh BM, Coakley FV. CT and MRI of congenital anomalies of the seminal vesicles. AJR Am J Roentgenol 2007;189:130-5.
  • Van den Ouden D, Blom JH, Bangma C, de Spiegeleer AH: Diagnosis and management of seminal vesicle cysts associated with ipsilateral agenesis. A pooled analyzis of 52 cases. Eur Urol. 33: 433-440, 1998.
  • Razi, A., Imani, B. (2000). Seminal vesicle cyst presenting with lower urinary tract symptoms and huge abdominal mass. The Journal of urology, 164(4), 1309–1310.
  • Altunrende F, Kim ED, Klein FA, Waters WB. Seminal vesicle cyst presenting as rectal obstruction. Urology 2004;63:584-585.
  • Ates Y, Kilciler G, Bedir S, Aslan M, Kilciler M, Tüzün A, et al. Large vesicula seminalis cyst: a very rare cause of constipation and male infertility. Kaohsiung J Med Sci 2007;23:318
  • Heaney JA, Pfister RC, Meares EM Jr. Giant cyst of the seminal vesicle with renal agenesis. AJR 1987;149:139–140.
  • Gonzales CM, Dalton DP: Endoscopic incision of a seminal vesicle cyst. Urology. 1998;5:831-832.
  • Basillote JB, Shanberg AM, Woo D, Perer E, Rajpoot D, Clayman RV. Laparoscopic excision of a seminal vesicle cyst in a child j. Urol 2004;171:369-371
  • Anmar N. Symptomatic cystic seminal vesicle: a laparoscopic approach for effective treatment CUAJ 2009;6:81-83

Seminal Vesicle Cyst with or without Unilateral Renal Agenesis: Diagnosis and Treatment Options

Yıl 2022, Cilt: 12 Sayı: 3, 536 - 543, 29.09.2022
https://doi.org/10.31832/smj.1104876

Öz

Objective: The aim of this study is to report our experience on the management of seminal vesicle cyst which is an exceedingly rare acquired or congenital pathology.
Materials and Methods: A retrospective chart review was conducted on seven patients diagnosed with seminal vesicle cyst between March 2011 to March 2020. Patients’ complaints, fertility, physical signs, diagnostic tests or intervention and the obtained findings, surgical intervention, duration of follow-up period, complications, recurrence and histologic examination of the cysts wall were evaluated in patients included.
Results: Seven male patients, mean aged 36.29±13.45, IPSS 13.57±4.89, Qmax:21.77±3.42ml/s with seminal vesicle cysts were identified. The patients’ complaints included lower abdominal pain in one patient with giant seminal vesicle cyst and perineal pain, storage lower urinary tract symptoms in six patient. Five patients were fertile and spermiogram was within normal ranges, two patients were infertile. Six patients have ipsilateral renal agenesia. One asymptomatic patient and three patients with storage lower urinary tract sympmtoms followed without intervention. Two infertile patients were operated with transurethral resection. Seminal vesicle cyst >12 cm are evaluated as giant cysts and operated with open excision. Neither complications nor recurrences were observed. Histopathologic examination of the samples were reported to be compatible with seminal vesicle cyst. The median follow–up period was 96 months.
Conclusion: The open surgical approach might be considered the definitive form of treatment for giant cysts. Although small asymptomatic seminal vesical cyst can be followed without intervention, the symptomatic cyst protruding to bladder can be managed by transurethral route.

Kaynakça

  • Parviz K. Kavoussi (2020). Surgical, Radiographic, and Endoscopic Anatomy of the Male Reproductive System In A. W. Partin, C. A.
  • Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 6333-6405).Sheih CP, Hung CS, Wei CF, Lin CY. Cystic dilatations within the pelvis in patients with ipsilateral renal agenesis or dysplasia. J Urol 1990;144:324-7.
  • Dorota J. Hawksworth, Mohit Khera, Amin S. Herati (2020) Surgery of the Scrotum and Seminal Vesicles. In A. W. Partin, C. A. Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 8552-8630).
  • Florim, S., Oliveira, V., Rocha, D. (2018). Zinner syndrome presenting with intermittent scrotal pain in a young man. Radiology case reports, 13(6), 1224–1227.
  • Aumuller G, Riva A. Morphology and functions of the human seminal vesicle. Andrologia. 1992;24(4):183–196
  • Ndovi TT, Parsons T, Choi L, et al. A new method to estimate quantitatively seminal vesicle and prostate gland contributions to ejaculate. Br J Clin Pharmacol. 2007;63:404–420.
  • Clegg EJ. The arterial supply of the human prostate and seminal vesicles. J Anat. 1955;89(2):209–216
  • Paul J. Turek (2020). Male Reproductive Physiology. In A. W. Partin, C. A. Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 6406-6500).
  • Brian A. VanderBrink & Pramod P. Reddy (2020) Anomalies of the Upper Urinary Tract. In A. W. Partin, C. A. Peters, L. R. Kavoussi, R. R. Dmochowski, & A. J. Wein (Eds.), Campbell-Walsh-Wein Urology (12th ed., pp. 3202-3326).
  • Davis TK, Hoshi M, Jain S. To bud or not to bud: the RET perspective in CAKUT. Pediatr Nephrol. 2014;29(4):597– 608.
  • Ashley DJ, Mostofi FK. Renal agenesis and dysgenesis. J Urol. 1960;83:211–230.
  • Ochsner MG, Brannan W, Goodier EH. Absent vas deferens associated with renal agenesis. JAMA. 1972;222(8):1055– 1056.
  • Donohue RE, Fauver HE. Unilateral absence of the vas deferens. A useful clinical sign. JAMA. 1989;261(8):1180– 1182.
  • Williams RD, Sandlow JI. Surgery of the seminal vesicles. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ, editors. Campbell’s Urology. 7th edn. Philadelphia: PA: Saunders; 2001.p. 3299– 3315.
  • Livingston L, Larsen CR. Seminal vesicle cyst with ipsilateral renal agenesis. AJR Am J Roentgenol 2000;175:177–80.
  • Arora SS, Breiman RS, Webb EM, Westphalen AC, Yeh BM, Coakley FV. CT and MRI of congenital anomalies of the seminal vesicles. AJR Am J Roentgenol 2007;189:130-5.
  • Van den Ouden D, Blom JH, Bangma C, de Spiegeleer AH: Diagnosis and management of seminal vesicle cysts associated with ipsilateral agenesis. A pooled analyzis of 52 cases. Eur Urol. 33: 433-440, 1998.
  • Razi, A., Imani, B. (2000). Seminal vesicle cyst presenting with lower urinary tract symptoms and huge abdominal mass. The Journal of urology, 164(4), 1309–1310.
  • Altunrende F, Kim ED, Klein FA, Waters WB. Seminal vesicle cyst presenting as rectal obstruction. Urology 2004;63:584-585.
  • Ates Y, Kilciler G, Bedir S, Aslan M, Kilciler M, Tüzün A, et al. Large vesicula seminalis cyst: a very rare cause of constipation and male infertility. Kaohsiung J Med Sci 2007;23:318
  • Heaney JA, Pfister RC, Meares EM Jr. Giant cyst of the seminal vesicle with renal agenesis. AJR 1987;149:139–140.
  • Gonzales CM, Dalton DP: Endoscopic incision of a seminal vesicle cyst. Urology. 1998;5:831-832.
  • Basillote JB, Shanberg AM, Woo D, Perer E, Rajpoot D, Clayman RV. Laparoscopic excision of a seminal vesicle cyst in a child j. Urol 2004;171:369-371
  • Anmar N. Symptomatic cystic seminal vesicle: a laparoscopic approach for effective treatment CUAJ 2009;6:81-83
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Anıl Erdik 0000-0002-5132-7447

Yavuz Tarık Atik 0000-0002-6398-8410

Deniz Gül 0000-0003-0873-0000

Hacı İbrahim Çimen 0000-0002-0824-3926

Osman Köse 0000-0002-1053-3551

Yayımlanma Tarihi 29 Eylül 2022
Gönderilme Tarihi 17 Nisan 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 12 Sayı: 3

Kaynak Göster

AMA Erdik A, Atik YT, Gül D, Çimen Hİ, Köse O. Seminal Vesicle Cyst with or without Unilateral Renal Agenesis: Diagnosis and Treatment Options. Sakarya Tıp Dergisi. Eylül 2022;12(3):536-543. doi:10.31832/smj.1104876

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