经尿道射精管切开术治疗射精管梗阻的效果(附60例报告)  

Efficacy of transurethral resection of ejaculatory duct for treatment of ejaculatory duct obstruction: Report of 60 cases

作　　者：涂响安[1] 赵良运[1] 赵亮[1] 王文卫[1] 邓立文[1] 陈羽[1] 邓春华[1] 

机构地区：[1]中山大学附属第一医院黄埔院区泌尿外科,广州510700

出　　处：《北京大学学报（医学版）》2011年第4期559-561,共3页Journal of Peking University:Health Sciences

摘　　要：目的:探讨经尿道射精管切开术(transurethral resection of ejaculatory duct,TURED)治疗射精管梗阻(ejaculatory duct obstruction,EDO)的效果。方法:2004年10月至2010年10月期间收治60例EDO患者,常规采用精液分析、精浆果糖和经直肠超声检查对其进行诊断,必要时行输精管造影检查。60例EDO患者均行TURED治疗,术后随访其疗效。结果:60例EDO患者的精液量为0.2～3.5 mL,平均(1.10±0.76)mL,pH值5.8～7.6,平均6.5±1.4;精浆果糖为一次射精0～51.4μmol,平均为(5.86±2.19)μmol。经直肠超声检查结果为:单纯射精管扩张者15例,前列腺囊肿6例,单纯双侧精囊扩张10例,单侧精囊扩张4例,精囊扩张并射精管扩张10例,精囊扩张合并前列腺囊肿5例,单侧精囊扩张并对侧精囊发育不良或缺乏2例,精囊扩张并射精管扩张和钙化3例,单侧精囊扩张并射精管扩张和对侧精囊发育不良或缺乏5例。所有患者均完成手术,术后随访6～78个月。60例EDO患者行TURED术后,51例(85.0%)精液检查有不同程度的改善,16例(26.7%)妻子妊娠。结论:TURED是治疗EDO的一种简单、微创和有效的方法。Objective： To evaluate the effect of transurethral resection of ejaculatory duct（TURED） for treatment of ejaculatory duct obstruction（EDO）.Methods： The clinical data of 60 cases of EDO from Oct.2004 to Oct.2010 were analyzed.The diagnostic criteria included semen analyses,fructose in seminal plasma,transrectal ultrasonography（TRUS）,and vasography if necessary.All the patients were treated by TURED.Postoperative semen assay,postoperative patency rate and postoperative impregnation rate were followed.Results： Semen analyses in the majority of cases showed the typical characteristics of EDO,azoospermia,low semen volume（average 1.10±0.76 mL）,low pH（average 6.5±1.4）,absent or low semen fructose（average 5.86±2.19 μmol/one ejaculation）.TRUS showed pure dilation of both ejaculatory ducts in 15 cases,prostatic cyst in 6,pure dilated seminal vesicles on both sides in 10,unilateral dilated seminal vesicle in 4,dilation of both ejaculatory duct and seminal vesicles in 10,dilated seminal vesicles with prostatic cyst in 5,unilateral dilated seminal vesicle and contralateral aplasia of seminal vesicle in 2,dilated seminal vesicles with dilation and calcifications of both ejaculatory ducts in 3.The remaining 5 had unilateral dilated ejaculatory duct and seminal vesicle with contralateral aplasia of seminal vesicle.In all the cases followed up more than 6 to 78 months after TURED,51 patients（85.0%） had improved semen parameters and 16 patients＇ wives（26.7%） had pregnancies.Conclusion： TURED may be the simple,minimally invasive and effective method for the treatment of EDO.

关 键 词：射精管 不育 男性 泌尿生殖外科手术 预后 经尿道射精管切开术 

分 类 号：R781.33[医药卫生—口腔医学]