单侧输精管缺如4例临床分析及文献复习  

A report on 4 cases of unilateral absence of vas deferens

作　　者：柴军[1] 赵连明[2] 唐文豪[2] 洪锴[2] 姜辉[2] 

机构地区：[1]首都医科大学附属复兴医院泌尿外科,北京100038 [2]北京大学第三医院泌尿外科,北京100191

出　　处：《中国性科学》2012年第11期14-16,共3页Chinese Journal of Human Sexuality

摘　　要：目的:先天性单侧输精管缺如(Congenital unilateral absence of vas deferens,CUAVD)临床上罕见,诊疗过程中需要我们及时细致体检以便明确诊断,同时需要对病人适当的管理,注意预防对侧输精管病变,若罹患输精管疾患应采取积极合理的治疗。方法:我们回顾了2011年5月～2012年1月诊治的4例CUAVD患者的临床资料,对每例进行分析、总结各自特点。结果:经分析发现,通过计算机辅助精液分析(CASA)、仔细地体检、经直肠超声可以区分梗阻部位以及引起少弱精症、无精症的原因。4例CUAVD病例中,超声发现患侧精囊腺发育不良或缺如。其中2例出现健侧输精管炎症,1例经抗炎治疗精液常规恢复。结论:对临床病人仔细体检,通过经直肠前列腺、精囊腺和射精管超声检查能够明确CUAVD的存在。因为只是经过门诊无创性的检查,即可以提供有效的确诊证据。如果患者一旦确诊为CUAVD,应告之患者预防健侧输精管发生梗阻的后果,并能积极预防,避免导致梗阻性无精。Objectives： Congenital unilateral absence of vas deferens are clinically rare. We need timely and careful physi- cal examination to confirm our diagnosis. At the same time, appropriate patient management should be provided to prevent against pathological changes of the contralateral vas deferens. Methods ： We reviewed the clinical data of four patients, and analyzed the characteristics of each patient. Results ：The analysis showed CASA, careful physical examination, transrectal ultrasound test can help to detect the site of obstruction and determine the cause of asthenozoospermi and azoospermia. Ultrasound exam indicated ab- sence of the ipsilateral seminal vesicle or dysplasia in all the four CUAVD patients. Among them, two cases was found to have combined contralateral vas deferens inflammation. One patient got recovered after anti - inflammatory treatment. Conclusions： Careful physical examination and ultrasound test can clearly detect the presence of congenital unilateral absence of vas deferens. If the patient is diagnosed as having CUAVD, he should be warned against the risk of contralateral vas deferens obstruction so as to actively prevent and avoid the occurence of obstructive azoospermia.

关 键 词：输精管缺如 计算机辅助精液分析 梗阻性无精 

分 类 号：R697.25[医药卫生—泌尿科学]