Seminal Vesiculoscope for the treatment of Severe Oligoasthenospermia Caused by Atrophic Seminal Vesicles

W. Yu

severe oligoasthenospermia; atrophic seminal vesicles; vesiculoscopy

This video demonstrates the use of a seminal vesicle endoscope to examine the seminal vesicles of a patient with severe oligoasthenospermia. Preoperative evaluations revealed reduced semen volume, along with low fructose and pH levels in the seminal plasma, suggesting possible seminal vesicle abnormalities. Subsequent ultrasound and magnetic resonance imaging confirmed reduced seminal vesicle volume. For such patients, conventional treatments typically include medication or assisted reproductive technology (ART). However, some patients respond poorly, and repeated ART failures are not uncommon. The underlying reasons may include poor semen quality and high sperm DNA fragmentation index (DFI), leading to suboptimal embryo quality. Therefore, exploring new therapeutic approaches to improve sperm quality is clinically significant. Currently, two main novel treatment strategies are being investigated: one involves using seminal vesicle endoscopy to clear obstructed ejaculatory ducts and flush out inflammatory material from the seminal vesicles, aiming to enhance sperm quality and increase ART success rates; the other involves testicular sperm extraction via testicular biopsy to bypass the adverse effects of accessory gland environments on sperm. In this case, the patient had experienced multiple failed ICSI cycles, and achieved favorable outcomes following seminal vesiculoscope treatment. Thus, while seminal vesicle endoscopy shows promise as a potential treatment option for such patients, further clinical data are needed to establish its indications and efficacy

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