DE2816391A1 - X=ray contrast medium injection tool - for vaso-seminal ducts with inflatable balloon seals for pars prostatica - Google Patents

Abstract

A device for the introduction of X-ray contrast media in the spermatic ducts and vesicles of male patients for the prepn. of vasoseminal vesiculography consists of an elastic hose which can be inserted through the urethra into the bladder. A miniature balloom at the distal end can be inflated by fluid pressure to close the pars prostatica upstream, and a second miniature balloon at the downstream end closes the downstream side of this part. Openings between the two balloon seals can then be used to inject an x-ray contrast fluid into the spermatic ducts and vesticles. This is a method which is less likely to injure the patient than the conventional introduction of a special catheter through the urethra in the ductus ejeculatorius or the exposure of the vas deferens after a scrotal incision and puncture with a cannula.

Description

Device for introducing X-ray contrast

mediate in the seminal ducts and the seminal vesicles the The invention relates to a device for introducing X-ray contrast media into the seminal ducts and the seminal vesicles.

Indications for the radiographic examination of the sperm drainage Pathways and the vas deferens (vasoseminal vesiculography) are e.g. sterility, tumorous Processes of the ampulla, seminal vesicle or ejaculatory duct, as well as post-traumatic or post-infectious conditions.

There are two methods of introducing x-ray contrast media known in the sperm drainage pathways and the vas deferens (G. Hebert et al., Amer. J. Roentgenol. ist3, 734 [1971]) 1. Insertion of a special catheter through the urethra into the ejaculatory duct.

2. After a scrotal incision, exposure of the vas deferens and puncture with a cannula.

The first method is very difficult to perform. Apart from this, that it often fails, there is a great risk that the patient in the area injuring the mouth of the sperm-draining pathways into the urethra. The second too The method is not without risk, since after puncturing the vas deferens it leads to inoculation infections and in particular obliterating scar processes can occur (R.Schoysman, J.belge Radiol. 52, 269 [1969], reported in Zbl. total Radiol. 98, 278 [1970]). The indication must therefore be very strict for both methods. Despite years of Effort has not yet been found to make vasoseminal vesiculography one safe and easy to perform routine method.

The invention is based on the object with the introduction of X-ray contrast media in the seminal ducts and the seminal vesicles after the conventional methods avoid associated disadvantages and risks.

The object is achieved in that for filling the sperm drainage pathways and seminal vesicles using an X-ray contrast medium a device used consists of an elastic tube closed at the distal end (1), the outer diameter of which is an insertion through the male urethra up allowed into the bladder, the distal end an inflatable by fluid pressure Balloon cuff (2) to close the pars prostatica towards the bladder and a second one Balloon cuff (3) that can be inflated by fluid pressure to close off the pars prostatica to the outside and in the section between the balloon cuff (2) and the balloon cuff (3) is provided with one or more openings (4).

The advantages that can be achieved with the device according to the invention are in particular to see that now this is for a radiological representation the sperm drainage pathways and the seminal vesicles necessary introduction of X-ray contrast medium very gentle for this sensitive canal system7 without any surgical risk and without Risk of a scarred change that can result in infertility in a simple way Way can be done.

The invention is explained in more detail below with reference to the drawing will: Fig. 1 shows schematically an embodiment of the invention Contraption; Figure 2 shows schematically the device inserted through the urethra.

The device according to the invention shown schematically in FIG. 1 consists of an elastic tube 1, the distal end of which is closed la and the prosimal end Ib of which is open and, if desired, for the purpose of the easier one Can be connected to a container dispensing contrast agent with a larger diameter than the rest of the hose 1. The tube 1 is close to the distal end la with an inflatable balloon cuff 2, which is inserted into the wall of the tube 1 extending filling channel 2a, which is closed by a valve 2b, inflated can be at a distance that corresponds at least to the length of the pars prostatica, from balloon cuff 2 a BaDDnmanschette 3 is provided, which via filling channel 3a and valve 3b can be inflated. Between the balloon cuffs 2 and 3 the hose 1 has one or more, preferably two, lateral openings 4 on.

The external features of this device are due to the mixing ratios set. In the case of an adult man, it is advisable to use tube 1 for about 30 cm long to choose.

For the outer diameter, 13 to 19 Charriere is preferred 15 to 17 Charriere, especially 17 Charriere, attached (3 Charriere correspond 0.1 cm). The distance between the two inflated balloons 2 and 3 corresponds to at least the length of the pars prostatica and is expediently about 5 cm.

The balloon cuffs 2 and 3 are dimensioned so that the balloon cuff 2 in the inflated state a capacity of 4 to 8 ml, preferably about 5 ml, and balloon cuff 3 a capacity of 1 to 5 ml, preferably about 2 ml.

The device according to the invention consists of that for urinary bladder catheters common elastic materials, e.g. latex or another rubber or made of silicone or a similar elastomer. It is also possible to use the hose 1 made of PVC, preferably made of soft PVC, e.g. by extrusion. The attachment of the two balloon cuffs, which preferably consist of latex, is then expediently carried out by gluing by means of a suitable adhesive. The way the device is made is that those skilled in the catheter field are familiar.

Based on the schematic Fig. 2, the use of the Device according to the invention for filling the sperm drainage pathways and the seminal vesicles described with X-ray contrast agent: tube 1 is in the usual way through the Penile shaft 5 pushed in until the distal end la including the balloon cuff 2 lies in the urinary bladder 12. The balloon cuff 2 is then opened through valve 2b inflated by means of a fluid medium, preferably by means of liquid. hose 1 is then pulled outward until balloon cuff 2 covers the prostatic pars 13 closes down the bladder. By filling up balloon 3 via valve 3b by means of a fluid medium, preferably by means of liquid, is now the pars prostatica closed to the outside. The sealed pars prostatica can now pass through the lumen of the tube 1 and the opening 4 of the tube 1 with X-ray contrast medium be filled. Through the two ejaculatory ducts 11, those on the seed mound open into the pars prostatica, the contrast medium flows into the seminal vesicles 9 and into the vas deferens 7 coming from the gonads 8.

Claims (3)

Claims lit i device for introducing X-ray contrast media in the seminal ducts and the seminal vesicles consisting of one at the distal End of closed elastic hose (1), the outer diameter of which is an insertion through the male urethra into the bladder, the distal end a Balloon cuff (2) that can be inflated by fluid pressure to close off the pars prostatica towards the bladder and a second balloon cuff (3) that can be inflated by fluid pressure to close off the pars prostatica to the outside and in the section between Balloon cuff (2) and balloon cuff (3) with one or more openings (4) is provided. 2. Apparatus according to claim 1, characterized in that the hose (1) has an outer diameter of 15 to 17 Charriere. 3. Device according to one of claims 1 and 2, characterized in that that the section of the tube (1) between the balloon cuffs (2) and (3) is provided with two openings (4).