PMC9924158_01
Left ureter, left ejaculatory duct, and seminal vesicle.
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FIG1
Moreover, his left ureter emptied ectopically into the left seminal vesicle, which was notably enlarged and multicystic in appearance (Figure 1).
Puboprostatic ligament preservation and neurovascular bundles (intrafascial high-release preservation technique).
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FIG2
Key points of our technique were: (1) placement of five trocars; (2) preparation of the extraperitoneal space and of the space of Retzius; (3) opening of the endopelvic fascia; (4) preparation of the bladder neck and its preservation using our signature technique (which taking advantage of the catheter traction fully preserved the bladder neck in a circumferential manner); (5) preparation and dissection of vas deferans and seminal vesicles; (6) total preservation of the neurovascular bundles (Figure 2) using the "veil of Aphrodite" technique (we used a clipless technique for nerve sparing, employing ultrasound scissors); (7) preparation of the apex of the prostate using the "hood" technique (Figure 2), and dissection of the urethra with maximal preservation of membranous urethral length using the "collar" technique (Figure 3); and (8) vesicourethral anastomosis with "V lock" 3/0 sutures.
Maximum urethral length preservation technique.
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FIG3
Key points of our technique were: (1) placement of five trocars; (2) preparation of the extraperitoneal space and of the space of Retzius; (3) opening of the endopelvic fascia; (4) preparation of the bladder neck and its preservation using our signature technique (which taking advantage of the catheter traction fully preserved the bladder neck in a circumferential manner); (5) preparation and dissection of vas deferans and seminal vesicles; (6) total preservation of the neurovascular bundles (Figure 2) using the "veil of Aphrodite" technique (we used a clipless technique for nerve sparing, employing ultrasound scissors); (7) preparation of the apex of the prostate using the "hood" technique (Figure 2), and dissection of the urethra with maximal preservation of membranous urethral length using the "collar" technique (Figure 3); and (8) vesicourethral anastomosis with "V lock" 3/0 sutures.
Left seminal vesicle ectasia.
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FIG4
During the preparation of the left seminal vesicle, an area of ectasia was evidenced (Figure 4), in which the ipsilateral ureter ended up.
The ligated left ureter (ipsilateral renal agenesis).
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FIG5
We decided to ligate the left ureter, given that the patient had ipsilateral kidney agenesis (Figure 5).
Malformations of Zinner's syndrome leading to a positioning of the right ureteric orifice in very close proximity to the bladder neck.
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FIG6