经直肠超声实时监测下经尿道射精管切开术的临床疗效观察  

Evaluation of transrectal ultrasound-guided transurethral resection of ejaculatory ducts for treatment of azoospermia with ejaculatory duct obstruction (EDO)

作　　者：黄吉炜[1] 夏磊[1] 马源[1] 刘毅东[1] 孙凯[1] 薛蔚[1] 陈斌[1] 黄翼然[1] 

机构地区：[1]上海交通大学医学院附属仁济医院泌尿外科,上海200127

出　　处：《中国男科学杂志》2010年第9期47-49,52,共4页Chinese Journal of Andrology

摘　　要：目的探讨经直肠超声实时监测下尿道射精管切开术(TURED)治疗射精管梗阻(EDO)引起的无精子症的可行性和疗效。方法回顾性研究自2006年7月至2009年12月收治的35例进行TURED术的射精管开口梗阻患者,其中术中行输精管穿刺注入美蓝液掌握电切深度和范围的有23例,术中使用经直肠超声实时监测的有12例,并进行术后随访。结果美蓝组平均手术时间为(69.2±45.3)min,显著高于直肠超声组(32.5±17.8)min,美蓝组术后膀胱冲洗时间为(37.3±21.5)h,显著高于直肠超声组(21.7±8.9)h;共有26例患者术后随访2～43个月,均未发生严重并发症,两组间术后精液质量改善率及配偶自然怀孕率差异无统计学意义。结论经直肠超声实时监测下TURED术,术中定位准确、手术时间短、恢复快、疗效确切,值得推广。Objecfive To evaluate the clinical effect of transrectal ultrasound-guided transurethral resection of the ejaculatory duct （TURED） in the treatment of azoospermia with ejaculatory duct obstruction （EDO）. Methods Thirty-five patients with EDO underwent TURED from June 2006 to December 2009, 23 patients （group MB） were subjected to seminal vesicle aspiration followed by seminal vesiculography using methylene blue mixed with contrast In these patients, the ejaculatory duct was opened until the obstruction was relieved as confirmed by free flow of methylene blue 12 patients （group TRUS） were under the detection of transrectal ultrasound to determine the depth and extent during resection 26 patients were followed-up. Results The mean operative time of group MB（69.2±45.3）min was significantly longer than that of group TRUS （32.5±17.8）min. The mean bladder irrigating time of group MB（37.3±21.5）h was significantly longer than that of group TRUS （21.7±8.9）h. During the period of 2-43 months follow-up, no severe complications occurred in 26 patients. No significant differences in the ratio of the semen quality improvement and spontaneous pregnant rate were found between two group. Conclusion Transrectal Ultrasound- guided TURED might be a safe and somewhat effective approach for treatment of EDO.

关 键 词：不育 无精子症 射精管梗阻 经尿道射精管切开术 

分 类 号：R698.2[医药卫生—泌尿科学] R699.8[医药卫生—外科学]