Tianjin Medical Journal

Tianjin Medical Journal ›› 2021, Vol. 49 ›› Issue (12): 1303-1307.doi: 10.11958/20211508

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Efficacy analysis of F4.8 visual nephroscope under ultrasound-guided spermatic cord block in the treatment of benign epididymal tumors

LI Can-qiang, XU Le, LIANG Hong-yi, QIU Min-jie, YANG Yi   

  1. Objective To evaluate the safety and efficacy of F4.8 visual nephroscope in the diagnosis and treatment of epididymal benign mass under ultrasound-guided spermatic cord block. Methods A total of 82 patients with epididymal masses were randomly divided into the blind puncture group and the ultrasound-guided puncture group, with 41 cases in each group. All patients underwent scrotal surgery with F4.8 visual nephroscope. In the blind puncture group, spermatic cord block was performed by blind puncture at the outer ring of inguinal canal. The ultrasound-guided puncture group completed spermatic cord block with color doppler ultrasound diagnostic instrument. The operation condition, perioperative complications, success rate of spermatic cord block, vascular complications, addition of anesthetic drugs during operation and change of anesthesia mode were recorded. Visual analogue scale (VAS) was used to evaluate the pain after operation, and the patients were followed up. Results The total of 64 patients with epididymal cysts underwent endoscopic holmium laser capsulotomy. Eighteen patients with solid tumors of epididymis were diagnosed as incomplete torsion of epididymal appendages under microscope and underwent holmium laser resection. Compared with the blind puncture group, the success rate of spermatic cord block was higher, the incidence of vascular complications and the change rate of anesthesia mode were lower in the ultrasound-guided group (P＜0.05). There was no significant difference in the addition rate of narcotic drugs between the two groups. The VAS at 5 min and 2 h after operation and the total cost of hospitalization were lower in the ultrasound-guided group than those in the blind puncture group (P＜0.05). There were no significant differences in 6 h VAS and 12 h VAS after operation and hospital stay between the two groups. The patients were followed up 1 month, 3 months and 12 months after operation. No abnormality was found in testis, epididymis and spermatic cord. Conclusion The technique of F4.8 visual nephroscope under ultrasound-guided spermatic cord block is safe and effective in the treatment of epididymal benign mass. It can be used as an ideal inspection and treatment method, and it is worth promoting.
  • Received:2021-06-28 Revised:2021-09-07 Published:2021-12-15 Online:2021-12-27
  • Contact: Corresponding Author E-mail: dr_xule@sina.com E-mail:supe_lican@163.com

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Abstract: Objective To evaluate the safety and efficacy of 4.8Fr micro-percutaneous nephrolithotomy in the diagnosis and treatment of epididymal benign mass under ultrasound-guided spermatic cord block. Methods Eighty-two patients diagnosed with epididymal mass underwent scrotal surgery with the application of 4.8Fr micro-percutaneous nephrolithotomy from January 2018 to May 2021 in our hospital. They were randomly divided into conventional blind puncture group (group R, 41 cases) and ultrasound-guided puncture group (group U, 41 cases). The surgical efficacy, scrotum pain score, complications and recurrence of lesions were recorded. Results All the 82 patients were successfully performed scrotal cystoscopy without severe complications occurred, such as scrotal hematoma, testicular rupture or epididymis injury. Sixty-four cases diagnosed with epididymal cyst accepted laser resection of the cyst. Eighteen cases of epididymal solid mass were diagnosed as incompletely torsion of the testicular or epididymosis accessory, and underwent holmium laser ablation. The U group had higher successful rate of spermatic cord block, lower rate of vascular complications and conversion of anesthesia mode, compared with R group, which had significantly statistical differences (P<0.05). However, there was no significant difference in intraoperative anesthetic drug addition between two groups (P>0.05). There were significantly statistical differences according to the pain score of 5 min and 2h, and hospitalization cost between two group (P<0.01), while the differences of pain score of 6h and 12h, and time of hospitalization were not significant (P> 0.05). The scrotal ultrasonography was performed after 1 and 3 month, and no abnormal structure was observed. Conclusion The technique of 4.8Fr micro-percutaneous nephrolithotomy under ultrasound-guided spermatic cord block could be an ideal inspection and treatment method for epididymal benign mass, and it is worth promoting.

Key words: epididymis, spermatocele, spermatic cord, anesthesia, scrotum, F4.8 micro-percutaneous nephrolithotomy, ultrasound-guided punctur

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