摘要
目的探讨射精管梗阻性无精子症的诊断及经尿道射精管电切术(TURED)的可行性和疗效。方法回顾分析2003年6月～2005年9月间收治的46例射精管梗阻性无精子症患者的临床资料。采用精液常规分析、精浆果糖测定和经直肠超声检查(TRUS)对其进行诊断,患者均使用TURED治疗,术后随访至少3个月以上。结果46例患者精液量0．4～1．9ml,pH值5．6-7．0,精浆果糖降低,一次射精(0～10．8)μmol。TRUS检查：单纯双侧精囊扩张8例,单侧精囊扩张3例,精囊扩张并射精管扩张18例,精囊扩张合并前列腺囊肿者12例,单纯射精管部分扩张或前列腺囊肿者5例。所有患者均完成手术。术后随访3～28个月,40例(86．96%)精液检查有不同程度的改善,22例(47．82%)精液中出现精子,9例(19．56%)精液检查正常；4例(8．7%)妻子妊娠。结论精液分析、精浆果糖测定和TRUS是射精管梗阻的主要诊断方式。TURED是治疗射精管梗阻性无精子症的首选方法。
Objective To investigate the characteristics of diagnosis and treatment of azoospermia with ejaculatory duct obstruction（EDO） and the effect of transurethral resection of ejaculatory duct（TURED） for EDO. Methods The clinical information of 46 cases of azoospermia with EDO were retrospectivly analyzed. The diagnostic criteria included semen analyses, semen fructose measurement, and transrectal ultrasonography （TRUS）. All patients were treated by TURED and followed up more than 3 months after the treatment. Results Semen analyses in all 46 cases showed the typical characteristics of EDO, azoospermia, low semen voloume（0.4～1.9mL）, low pH（5.6～7.0）, absent or low semen fructose. TRUS showed pure dilated seminal vesicles on both sides in 8 cases, half dilated seminal vesicles in 3, dilation of both ejaculatory duct and seminal vesicles in 18, dilated seminal vesicles with prostatic cyst in 12, the remaining 5 men had dilated ejaculatory duct or cystic lesions without dilated seminal vesicles. Among all the cases followed up more than 3～28 months after TURED, 40146（86.96%） the semen parameters were improved and sperm were appeared in semen in 22（47.82%） cases, normal semen analysis were found in 9（19.56%） cases and 4/46（8.7%） had pregnancies. Conclusion Semen analyses, semen fructose measurement, and TRUS are major diagnostic methods for EDO. Transurethral resection of ejaculatory duct may be the standard and effective method for the treatment of azoospermia with EDO.
出处
《中国男科学杂志》
CAS
CSCD
2006年第7期20-24,共5页
Chinese Journal of Andrology
关键词
不育
男性
射精管梗阻
无精子症
经尿道射精管切开术
infertility, male
ejaculatory duct obstruction
azoospermia
transurethral resection of ejaculatory duct
