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Seminal Vesicle Removal

Date: Mon, 25 Aug 1997 12:26:51 -0700
From: Daniel Shoskes
Subject: Seminal Vesicle removal
The indications for seminal vesiculectomy (surgical removal of seminal vesicle) are limited to very unusual and specific cases of infertility or chronic infection. In the FEW patients in whom it may be indicated however, there is justifiable reluctance to proceed due to the difficulty of the standard surgical approach (which often involves division of the bladder neck or prostate) and the high complication rate.
Along with my colleague Dr.J Rajfer (who specializes in infertility), we have developed a new surgical approach to remove a seminal vesicle that avoids the above mentioned problems completely. It is done through a lower abdominal incision (called a "Gibson", which incidentally is the incision I use for a kidney transplant) and leaves the bladder and prostate untouched. Between the 2 of us, we have done about 20 of these operations now, although only one was in my own patient with documented obstruction and infection who failed antibiotics and massage. It was a technical success, but we are too soon after to assess changes in symptoms or EPS.The other 19 operations, mostly infertility related, were unassociated with any major complications such as impotence or incontinece.
In any case, we are planning to write up the operation for publication, but the lag time for journals even if it is accepted right away can be several months or even a year. Therefore, if anyone has been considering this operation for a valid, documented indication, I would be glad to discuss this approach with their own urologist. Please have them email me, or they can leave a message for me at my prostatitis clinic.
Daniel Shoskes MD

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