| Summary: | Ke Ding,1 Wei Wang,2 Ye Kang,3 Lei Zhang,2 Shuo Tan,1 Zhengyan Tang1 1The Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2The Department of Urology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 3The Department of Urology, Hunan Provincial People’s Hospital, Hunan Normal University, Changsha, Hunan, People’s Republic of ChinaCorrespondence: Shuo Tan; Zhengyan Tang, Department of Urology, Xiangya Hospital, Central South University, 87 Xiangya Street, Changsha, Hunan, 410008, People’s Republic of China, Tel +8615273133018 ; +8613507318268, Email tanshuo@csu.edu.cn; xytzyan@163.comBackground: To illustrate the transperitoneal laparoscopic unroofing (TLU) and compare the efficacy and safety of TLU to fenestration under seminal vesiculoscopy (FUSV) in treating symptomatic seminal vesicle cyst (SVC).Methods: We retrospectively reviewed all patients with symptomatic SVC who underwent TLU or FUSV between 2008 and 2020 at 3 institutions in Hunan. The two groups were evaluated with reference to radiological failure-free survival (R-FFS), fertility outcome, symptoms, and complications at a median 33.5-month follow-up.Results: Of the 98 males, 58 (59.2%) received TLU, and 40 (40.8%) underwent FUSV. Baseline characteristics were comparable. Semen analysis, prostatitis-like symptoms, and the maximum diameter of cyst were partially improved after both surgeries at 12-month follow-up. The TLU groups suggested a higher incidence rate of fertility for SVC patients with comorbid infertility compared with the FUSV group (82.4% vs 70.3%, p = 0.041), as well as better R-FFS of cysts at five-year follow-up (Log rank test, p = 0.021). In addition, the number of patients with NIH-CPSI (National Institutes of Health Chronic Prostatitis Symptom Index) scores higher than 15 decreased more significantly after TLU (p = 0.004). Except for hematospermia within 3 months, no significant difference in adverse events was observed in the two groups during the long-term follow-up.Conclusion: TLU was superior for patients with large and symptomatic SVC to FUSV, with more relieved symptoms, better R-FFS of cysts and fertility outcomes.Registration Number of Clinical Trial: ChiCTR2100053850 in Chinese Clinical Trial Registry Platform (ChiCTR).Keywords: seminal vesicle cyst, laparoscopic unroofing, seminal vesiculoscopy, radiological failure-free survival, male infertility
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