RESUMO
BACKGROUND: Prostatic cysts are rare lesions with a reported incidence from 1 to 7.9%. They have been associated with primary infertility. The main characteristic is the benign course and positive prognosis after correct surgical management. CLINICAL CASES: We present three clinical cases, two with primary infertility and another with a history of primary infertility who presented with recurrent hemospermia and refractory medical treatment. All patients had hypospermia and alteration of the seminal parameters represented by moderate oligospermia (MOS), asteno- and teratozoospermia, in addition to hemospermia in two patients. Diagnosis was confirmed by transrectal ultrasound. Transurethral resection (TUR) of the cyst was performed in two cases and resection of the veru montanum in one, obtaining improvement in the seminal parameters after 1 month of follow-up and acceptable parameters for spontaneous conception at 6 months. CONCLUSIONS: Infertility associated with partially obstructed ejaculatory ducts may be suspected clinically by hypospermia. Transrectal ultrasound is essential to confirm the diagnosis. TUR of this lesion reestablishes the free passage of semen in almost all patients, with potential recovery of fertility 6 months after treatment.
Assuntos
Cistos/complicações , Ductos Ejaculatórios/cirurgia , Hemospermia/etiologia , Infertilidade Masculina/etiologia , Oligospermia/etiologia , Doenças Prostáticas/complicações , Adulto , Cistos/congênito , Cistos/diagnóstico por imagem , Cistos/cirurgia , Ductos Ejaculatórios/diagnóstico por imagem , Feminino , Implante de Prótese de Valva Cardíaca , Humanos , Transplante de Rim , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Gravidez , Doenças Prostáticas/congênito , Doenças Prostáticas/diagnóstico por imagem , Doenças Prostáticas/cirurgia , Ressecção Transuretral da Próstata , Ultrassonografia , Ultrassom Focalizado Transretal de Alta Intensidade , Adulto JovemRESUMO
BACKGROUND: Prostatic cysts are rare lesions with a reported incidence from 1 to 7.9%. They have been associated with primary infertility. The main characteristic is the benign course and positive prognosis after correct surgical management. CLINICAL CASES: We present three clinical cases, two with primary infertility and another with a history of primary infertility who presented with recurrent hemospermia and refractory medical treatment. All patients had hypospermia and alteration of the seminal parameters represented by moderate oligospermia (MOS), asteno- and teratozoospermia, in addition to hemospermia in two patients. Diagnosis was confirmed by transrectal ultrasound. Transurethral resection (TUR) of the cyst was performed in two cases and resection of the veru montanum in one, obtaining improvement in the seminal parameters after 1 month of follow-up and acceptable parameters for spontaneous conception at 6 months. CONCLUSIONS: Infertility associated with partially obstructed ejaculatory ducts may be suspected clinically by hypospermia. Transrectal ultrasound is essential to confirm the diagnosis. TUR of this lesion reestablishes the free passage of semen in almost all patients, with potential recovery of fertility 6 months after treatment.