Abstract
Objectives:
The most common pathologies of the seminal tract are persistent hematospermia, seminal vesicle stones, and seminal duct obstruction. Endoscopic diagnostic work-up of the seminal tract is impeded by complex anatomy and lack of technical equipment. To date, there is no standardized endoscopic approach. Purpose of this study was to investigate the applicability and feasibility of a flexible micro-optical device for atraumatic endoscopy of the seminal tract in a human male cadaver.
Materials and Methods:
The transurethral endoscopic examination was performed on a male cadaver. No premortal interventions or diseases of the genitourinary tract had been reported. The seminal orifice was identified through cystoscopy and accessed by Seldinger technique using a hydrophilic guidewire and ureteral catheter. Retrograde endoscopic inspection of the distal seminal tract was performed using a miniaturized flexible endoscope. An antegrade endoscopical inspection of the seminal tract was carried out through high scrotal access to the vas deferens.
Results:
Structures of the seminal tract such as the ejaculatory duct, seminal vesicles, and distal portion of the ductus deferentes were observed using the miniaturized endoscope. Image quality allowed identification of anatomical structures and characterization of tissue properties. The technical limitations we observed involved the system's maneuverability.
Conclusions:
Initial results of this novel endoscopic approach to the seminal tract using a flexible micro-optical system are encouraging. However, considerable anatomical limitations of the targeted organs necessitate further refinements of the technical equipment. This approach might improve diagnostics and treatment of genitourinary diseases. Future surgical techniques may include intraseminal laser therapy or endo-occlusion to monitor fertility in men.
Acknowledgment:
We would like to thank Schoelly Fiberoptics GmbH, Denzlingen, Germany, for providing the instruments and technical support for this study. The cadaver (body donor) was provided by the Institute for Anatomy, Medical Faculty, Justus-Liebig-University, Giessen.
Institutional funding (Medical Faculty of the University of Freiburg) and nonfinancial industrial funding (providing the instruments and technical support for the study) were by Schoelly Fiberoptic GmbH, Denzlingen, Germany. D.S., M.M., S.H., F.A., and W.W. have no conflicts of interest or financial ties to disclose. M.S. consultant contract with Schoelly Fiberoptics GmbH, Denzlingen, Germany, and NeoTract, Inc., Pleasanton, USA. T.D. Lilly Deutschland GmbH (stocks/stock options, employee: through family member), Pfizer (speaker honorarium), Takeda Pharma GmbH (speaker honorarium), AMS Deutschland (speaker honorarium), Jenapharm GmbH (speaker honorarium), Glenwood (speaker honorarium), Cheplapharm Arzneimittel GmbH (consultant), Marpinion GmbH (Advisory Board member, consultant), Advance Medical S.A., Barcelona (ESP) (Consultatnt, Reviewer). A.M. consultant contract with Schoelly Fiberoptics GmbH, Denzlingen, Germany.
Runtime of video: 6 mins 10 secs
