Clinical Diagnosis And Treatment Of Patients With Chronic Seminal Vesicular Adenitis

Objective:Through the analysis of the clinical data of the patients with chronic seminal vesicular adenitis,to explore the clinical characteristics and treatment methods of the patients with chronic seminal vesicular adenitis,to provide the basis for the clinical diagnosis and treatment of chronic seminal vesicular adenitis.Methods:Select patients with chronic seminal vesicular adenitis from the Department of Healing of the First Affiliated Hospital of Zhengzhou University from April 2013 to May 2018.According to the clinical manifestations of the patients at the time of consultation,the symptoms as the main complaint are counted.A summary analysis of the symptoms;combined with laboratory examination and imaging findings under transrectal ultrasound,the patients were divided into patients with simple seminal vesicular adenitis and patients with prostatitis,and the main symptoms and gland size differences between the two groups were compared;The patients under the program were followed up to observe the treatment effect and perform a retrospective analysis.Results:Finally,202 patients with seminal vesicular adenitis,aged 18-64(30.62±5.43)years,were selected.The course of the disease ranged from 3 months to 9 years,including 75 patients with simple seminal vesicular adenitis(37.13%)and 127 patients with prostatitis(63.87%).The main causes of all patients were local pain(abdominal pain,lumbosacral pain,groin pain,perineum pain,scrotal pain,testicular pain,penile pain,glans pain),semen abnormality(asthenia,hematospermia,oligospermia,semen liquefaction problem),lower urinary tract symptoms(frequency of urination)and other(frequent spermatozoa,wet scrotum,weak ejaculation),and there were multiple symptoms at the same time;Among them,the main clinical symptoms of patients with simple seminal vesicular adenitis are hematospermia,semen liquefaction problem and frequent spermatozoa,and the main local pain is groin pain and testicular pain;while the main clinical symptoms of patients with prostatitis are perineum pain and discomfort,blood semen and testicular pain and discomfort.There was no statistical difference in age between the two groups of patients(P=0.092).Comparing gland sizes under transrectal ultrasound,prostate size(anteroposterior diameter P=0.008,left and right diameter P=0.007,upper and lower diameter P=0.010),and seminal vesicle glands(Left long diameter P=0.023,transverse diameter P=0.003;right long diameter P<0.001,transverse diameter P=0.007)The differences are statistically significant,glandular expansion is more obvious on ultrasound images of patients with prostatitis;38 patients who underwent bacterial culture of seminal fluid were negative;64 patients were tested for nucleic acid in prostate fluid,and only 3 patients with prostatitis(4.69%)showed positive results(2 were ureaplasma urealyticum positive,1 was Chlamydia trachomatis positive);134 patients were treated with antibiotics,the course of treatment was 3-6 months,the average treatment time was 4.7 months.After one month of treatment,12 patients(8.96%)with short course of disease had better symptoms.After three months of treatment,41 patients(30.60%)had clinical symptoms improved or disappeared.After six months of treatment,109 patients(81.34%)had remission.During the treatment,31 patients(23.13%)had recurrent symptoms,and constipation,dry lips and gastrointestinal adverse reactions were more in the later stage of the patients;68 patients were operated by seminal vesicle,the average hospitalization days were 3.6±0.5 days,the average operation time was(40.56±8.27)minutes,the later period was combined with drug application,and after one month,46 patients(67.64%)had better or disappeared clinical symptoms than before,58 patients(85.29%)had disappeared symptoms after three months,and 62 patients(91.17%)achieved clinical cure after six months;The number of patients with clinical symptoms improved by seminal vesicle surgery is better than that of conservative treatment in the early stage(P<0.001 at 1 month and 3 months of treatment),and there is no significant statistical difference in the number of patients with improved symptoms at the later stage(at 6 months of treatment)(P=0.067).Conclusion:The clinical symptoms of chronic seminal vesiculitis are abnormal semen,local pain,lower urinary tract irritation and sexual dysfunction.Among them,blood sperm and perineal pain are the main symptoms of chronic seminal vesiculitis;the incidence of chronic seminal vesiculitis with prostatitis High,and the clinical symptoms of prostatitis tend to be local pain and discomfort,but patients with simple seminal vesicle adenitis are more likely to pain in the groin,which is common in the perineum.The size of seminal vesicle gland and prostate varies in different types of patients under transrectal ultrasound,and glandular expansion is more obvious in patients with prostatitis;The symptoms of seminal vesicular adenitis were improved by drug conservative treatment and surgical treatment.Compared with antibiotic therapy alone,the time-consuming,less complications and stable effect of seminal vesicle surgery are worth popularizing and applying.