显微镜下输精管交叉吻合治疗梗阻性无精子症临床研究  

Clinical study on the treatment of obstructive azoospermia with cross microsurgical vasovasostom

作　　者：汪中兴[1] 江志勇[1] 李学德[1] 何庆鑫[1] 樊胜海[1] WANG Zhongxing;JIANG Zhiyong;LI Xuede;HE Qingxin;FAN Shenghai(Department of Urology and Andrology,No. 181 Hospital of People’s Liberation Army of China,Guilin 541002 ,Guangxi,China)

机构地区：[1]解放军第一八一医院泌尿男科中心,广西桂林541002

出　　处：《中国性科学》2019年第3期39-41,共3页Chinese Journal of Human Sexuality

摘　　要：目的探讨双侧输精管梗阻位置不同患者行输精管交叉吻合治疗梗阻性无精子症疗效。方法选取2008年6月至2013年1月解放军第一八一医院泌尿男科诊治的梗阻性无精子症并行阴囊探查102例患者为研究对象。阴囊探查明确8例梗阻性无精子症患者存在梗阻位置不同,其中左侧输精管盆段梗阻并右侧附睾梗阻3例;左侧输精管腹股沟段及阴囊段长段梗阻并右侧附睾梗阻2例;左侧附睾梗阻并右侧输精管盆段梗阻1例;左侧附睾梗阻并右侧输精管腹股沟段及阴囊段长段梗阻1例。行远端通畅输精管游离并穿过阴囊中隔,采用显微外科精微点定位输精管分层吻合技术与对侧近端通畅输精管吻合。结果 8例随访9个月～22个月,8例精液中检出精子,复通率为100%(8/8),精子密度>20×1 0~6/m l。检出精子时间为,术后1个月5例,2个月1例,3个月1例。患者配偶自然受孕4例,受孕率50.0%(4/8),受孕时间为术后6个月～13个月,平均受孕时间为8.6个月。术后阴囊无疼痛等不适。结论对于部分两侧输精管梗阻部位不同的梗阻性无精子症患者,通过显微镜下输精管交叉吻合,疗效满意。Objective To probe into effect and advantages of cross microsurgical vasovasostomy for the treatment of obstructive azoospermia. Methods The scrotal exploration were performed on 8 patients and found 3 patients with left deferent duct obstruction in pelvic and right epididymis obstruction, 2 patients with left long-seg- mentdeferent duct obstruction and right epididymis obstruction, a patient with left epididymis obstruction and right- pelvic segment deferent duct obstruction, and apatient with left epididymis obstruction and right long-segment deferent duct obstruction in scrotum and inguinal canal. All the patient received cross microsurgical vasovasostomy. Results Allthe patients were followed up from 9 to 22 months. Sperm were detected in the semen fluid of all the 8 patients,the recanalization rate of 100% and sperm density >20×10^6/ml. 4 patients' spouse conceived naturally (4/8) in 6 ~ 13 months after the operation, with the mean time of 8. 6 months. There was no pain or other discomfort in the scrotum after operation. Conclusions Cross microsurgical vasovasostomy is ofsatisfactory effect in the treatment ofobstructive azoospermia with different obstructive sites in both sides of the vas deferens.

关 键 词：输精管吻合术 无精子症 显微外科 

分 类 号：R697[医药卫生—泌尿科学]