前列腺热疗后医源性射精管梗阻的诊断与治疗(附3例报告)  

Diagnosis and Treatment of Iatrogenic Ejaculatory Duct Obstruction Following Prostatic Hyperthermia(Report of 3 Cases)

作　　者：赵良运[1] 涂响安[1] 王文卫[1] 孙祥宙[2] 王修来[3] 邓春华[2] 

机构地区：[1]中山大学附属第一医院黄埔院区泌尿外科,广东广州510700 [2]中山大学附属第一医院泌尿外科,广东广州510080 [3]南京军区南京总医院博士后科研工作站,江苏南京210002

出　　处：《中华男科学杂志》2006年第10期906-909,共4页National Journal of Andrology

基　　金：江苏省"六大人才高峰"资助项目(2005A5)

摘　　要：目的:探讨前列腺热疗后医源性射精管梗阻的诊断及治疗特点。方法:回顾分析3例前列腺热疗后射精管梗阻患者的临床资料。结果:3例患者皆因前列腺炎行经尿道前列腺热疗而导致后尿道狭窄、变形,继发射精管梗阻。经精液分析、经直肠B超检查后确诊。行经尿道射精管电切开术(TURED)后患者梗阻解除,精液恢复正常。结论:经尿道微波热疗、射频和电极导融治疗等方法在用于前列腺炎治疗时应严格掌握适应证,使用不慎可导致继发医源性射精管梗阻。经尿道射精管切开术是其首选治疗方法。Objective： To investigate the characteristics of diagnosis and treatment of iatrogenic ejaculatory duct obstruction following prostatic hyperthermia. Methods ： Retrospective analyses were made of the clinical data of 3 cases of ejaculatory duct obstruction following prostatic hyperthermia. Results ： The 3 cases were diagnosed as urethrostenosis and deformity of the posterior urethra by transurethral ultrasound and semen analysis. And all the 3 patients had undergone prostatic hyperthermia for prostatitis. Transurethral resection of the ejaculatory duct （TURED） was performed to remove the obstruction and the postoperative semen analysis showed both semen volume and sperm count to be normal. Conclusion： Urethra microwave thermotherapy, urethra radiofrequency, or per urethra rheophore ablation can be adopted in the treatment of protatitis, but should be strictly indicated and cautiously selected lest secondary iatrogenic ejaculatory duct obstruction should result. For the treatment of this obstruction, TURED is the first choice.

关 键 词：射精管梗阻 医源性 前列腺热疗 经尿道射精管切开术 

分 类 号：R698.2[医药卫生—泌尿科学]