Abstract：Objective:To analyze the efficacy of holmium laser incision through ureteroscopy and simple ureteroscopy treatment for distal seminal tracts diseases. Methods:We retrospectively analyzed 71 cases of distal seminal tracts diseases, including 57 cases of hematospermia, 8 cases of simple ejaculatory duct cysts, and 6 cases of azoospermia. All the patients underwent semen analysis, transrectal ultrasonography, and seminal vesicle ultrasonography, and some patients given pelvic CT or MRI. Results:In 54 cases of hemospermia, 24 cases received simple ureteroscopy, and 30 cases were given holmium laser incision through ureteroscopy. Varying degrees of ejaculatory duct stenosis or obstruction were observed: 7 cases of ejaculatory duct cysts and 6 cases of azoospermia were subjected to holmium laser. During the postoperative follow-up, 2 cases experienced recurrence 6 or 8 months later in 24 cases of simple ureteroscopy. In 7 cases of prostatitis with simple ejaculatory duct cysts, 3 cases were cured, 3 cases improved, and 1 case invalid. In 6 cases of azoospermia, 2 patients' spouses were pregnant 7 or 14 months after surgery. Sperms were detected in 4 cases within 1 to 3 months after surgery. Epididymitis occurred in 3 cases. No such complications as retrograde ejaculation, urinary incontinence or rectal injury were observed postoperatively. Conclusions:The efficacy of holmium laser incision through ureteroscopy for distal seminal tracts diseases is better than simple ureteroscopy, whether it is worthy of clinical application needs further observation and summary.
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