Tek Taraflı Renal Agenezili veya Agenezisiz Seminal Vezikül Kisti: Tanı ve Tedavi Seçenekleri

Year 2022, , 536 - 543, 29.09.2022

Anıl Erdik , Yavuz Tarık Atik , Deniz Gül , Hacı İbrahim Çimen , Osman Köse

https://doi.org/10.31832/smj.1104876

Abstract

Amaç: Son derece nadiren veya doğuştan bir patoloji olan seminal vezikül kistinin yönetimi hakkındaki tecrübemizi bildirmektir.
Gereç ve Yöntemler: Kliniğimizde 2011-2020 yılları arasında seminal vezikül kisti tanısı alan yedi hasta retrospektif olarak incelendi. Hastaların şikayeti, fertilitesi, fizik muayene bulguları, tanısal testleri, görüntülemesi ve elde edilen bulguları, cerrahi türü, takip süresi, komplikasyonlar ve rekürens varlığı, kist duvarının histolojik incelemesi kaydedildi.
Bulgular: Seminal vezikül kisti saptanan yedi erkek hastanın, ortalama yaş 36.29 ± 13.45, IPSS 13.57 ± 4.89, Qmax: 21.77 ± 3.42ml/sn idi. Dev seminal vezikül kisti olan hastada perineal ağrı ve alt karın ağrısı, altı hastada depolama alt üriner system semptom şikayetleri mevcuttu. Beş hasta infertil ve spermiogram normal aralıklardaydı, iki hasta infertildi. Altı hastada ipsilateral renal agenezi, bir asemptomatik hasta ve üç hasta depolama alt üriner sistem semptomları tedavisiz takip edildi. İki infertil hasta transüretral rezeksiyon ile opera edildi. Seminal vezikül kisti> 12 cm dev kistler olarak değerlendiridli ve açık eksizyon uygulandı. Komplikasyon veya nüks gözlenmedi. Numunelerinin histopatolojik incelemesinin seminal vezikül kisti ile uyumlu olduğu bildirildi. Ortanca takip süresi 96 aydı.
Sonuç: Açık cerrahi yaklaşım, dev kistler için kesin tedavi şekli olarak kabul edilebilir. Her ne kadar küçük asemptomatik seminal vezikal kistin müdahale olmadan takip edilebilse de, mesaneye protrüde semptomatik kist transüretral yolla tedavi edilebilir.

Keywords

İnfertilite, renal agenezi, seminal vezikül kisti; teşhis; tedavi.

Seminal Vesicle Cyst with or without Unilateral Renal Agenesis: Diagnosis and Treatment Options

Abstract

Objective: The aim of this study is to report our experience on the management of seminal vesicle cyst which is an exceedingly rare acquired or congenital pathology.
Materials and Methods: A retrospective chart review was conducted on seven patients diagnosed with seminal vesicle cyst between March 2011 to March 2020. Patients’ complaints, fertility, physical signs, diagnostic tests or intervention and the obtained findings, surgical intervention, duration of follow-up period, complications, recurrence and histologic examination of the cysts wall were evaluated in patients included.
Results: Seven male patients, mean aged 36.29±13.45, IPSS 13.57±4.89, Qmax:21.77±3.42ml/s with seminal vesicle cysts were identified. The patients’ complaints included lower abdominal pain in one patient with giant seminal vesicle cyst and perineal pain, storage lower urinary tract symptoms in six patient. Five patients were fertile and spermiogram was within normal ranges, two patients were infertile. Six patients have ipsilateral renal agenesia. One asymptomatic patient and three patients with storage lower urinary tract sympmtoms followed without intervention. Two infertile patients were operated with transurethral resection. Seminal vesicle cyst >12 cm are evaluated as giant cysts and operated with open excision. Neither complications nor recurrences were observed. Histopathologic examination of the samples were reported to be compatible with seminal vesicle cyst. The median follow–up period was 96 months.
Conclusion: The open surgical approach might be considered the definitive form of treatment for giant cysts. Although small asymptomatic seminal vesical cyst can be followed without intervention, the symptomatic cyst protruding to bladder can be managed by transurethral route.

Keywords

Key Words: Infertility, renal agenesis, seminal vesicle cyst; diagnosis; treatment.

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