膀胱尿道镜直视下精液排出状态的观察  

Semen expulsion under the ureterocystoscope

作　　者：杜强[1] 吴斌[2] 邹宝林[3] 李正涛[1] 杨大磊[1] 潘伯臣[1] 

机构地区：[1]中国医科大学附属盛京医院生殖中心,辽宁沈阳110004 [2]中国医科大学附属盛京医院泌尿外科,辽宁沈阳110004 [3]沈阳204医院生殖中心,辽宁沈阳110043

出　　处：《中华男科学杂志》2014年第4期334-337,共4页National Journal of Andrology

摘　　要：目的：确定男性射精管开口的具体解剖部位，为临床诊疗如精囊镜检查、射精管梗阻的治疗等提供直观依据。方法：对21例（其中血尿12例、血精2例、腺性膀胱炎6例、直肠癌根治手术后不射精1例）年龄在26—47岁的患者做膀胱镜检查时，在知情同意的情况下膀胱镜尿道直视下行前列腺以及尽可能地接近精囊腺的按摩，观察按摩后排出液排出位置并行按摩后排出液的显微镜检查，发现精子的视为含有射精管排出液。结果：所有2l例患者腔镜直视下前列腺按摩液和精液排出开口的具体解剖部位都在精阜上前列腺小囊开口侧方、前侧下方以及精阜的前侧方，13例患者在按摩后排出液中检查出大量精子。前列腺小囊开口没有看到任何液体（包括精液）的排出。结论：男性射精管开口位于精阜两侧、紧邻前列腺小囊开口，而非精阜上的前列腺小囊开口内。Objective： To determine the exact location of the opening of the ejaculatory duct in men and provide some basic anatomical evidence for seminal vesiculoscopy and the treatment of ejaculatory duct obstruction. Methods ： We performed ureterocys- toscopy for 21 male patients aged 26 - 47 years with hematuria （ n = 12 ）, hematospermia （ n = 2 ）, glandular cystitis （ n = 6 ）, and anejaculation after radical resection of rectal carcinoma （ n = 1 ）, and meanwhile, with the consent of the patients, massaged the pros- tate and ejaculatory duct and observed the outlet of the expelled fluid. Under the microscope, we described the fluid samples with sperm as the expulsion from the ejaculatory duct. Results ： Ureterocystoscopy showed that the exact anatomical sites of the expulsion of prostatic fluid and semen in the patients were the side and lower side of the prostatic utricle opening above the verumontanum and the ventral side of the verumontanum. Quantities of sperm were found in the expulsion fluid of 13 of the patients, and no expulsion, inclu- ding semen, was seen from the prostatic utricle opening. Conclusion ： Anatomically, the ejaculatory duct openings of males are loca- ted at the two sides of the verumontanum adjacent to the opening of the prostatic utricle, rather than in the prostatic utricle above the verumontanum. Natl J Adrol, 2014, 20 （4） ： 334 -337

关 键 词：前列腺 精阜 前列腺液 精液 射精管 

分 类 号：R698[医药卫生—泌尿科学]