Transurethral Seminal Vesiculoscopy via Prostatic Utricle Fenestration for Severe Asthenozoospermia Treatment

Xu, C, Li, Z, Yang, B, Dai, Y, Song, T, Zhao, X

Transurethral Seminal Vesiculoscopy, Prostatic Utricle Fenestration, Severe Asthenospermia

Transurethral Seminal vesiculoscopy (TSV) is one of the standard surgical procedures for treating azoospermia caused by ejaculatory duct obstruction, but its use in treating severe asthenozoospermia has rarely been reported. Severe asthenozoospermia is a major cause of male infertility. Currently, routine diagnostic and treatment protocols do not seem to consider ejaculatory duct and seminal vesicle factors, or rather, clinicians do not regard these factors as potential causes of severe asthenozoospermia. Our prospective study was conducted on patients with severe asthenozoospermia using the TSV via Prostatic Utricle Fenestration method. Unpublished findings confirmed the effectiveness of this surgical approach in treating severe asthenozoospermia. In this video, the surgical procedure is presented, along with a summary of key aspects such as surgical indications, techniques for rapidly locating the fenestration site within the prostatic utricle, and other operative experiences. 

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1. Lv KL, Sun WG, Zhang TB, et al. Efficacy analysis of 26 cases of ejaculatory duct obstruction treated by prostatic utricle neck endoscopy. Front Surg. 2022;9:1031739.

2. Yao RJ, Xiao H, Chen SS, et al. Efficacy of various surgical approaches in treating hematospermia using transurethral seminal vesiculoscopy. BMC Surg. 2023;23(1):385.