精道异位开口于扩大的前列腺囊(附22例报告)  

Ectopic seminal tract opening in enlarged prostatic utricle: A report of 22 cases

作　　者：胡昕[1] 林建中[1] 吴宏飞[1] 李久明[1] 吴伟力[1] 于洪波[1] HU Xin;LIN Jian-zhong;WU Hong-fei;LI Jiu-ming;WU Wei-li;YU Hong-bo(Department of Urology,Nanjing BenQ Hospital Affiliated to Nanjing Medical University,Nanjing,Jiangsu 21009,China)

机构地区：[1]南京医科大学附属明基医院泌尿外科,江苏南京210019

出　　处：《中华男科学杂志》2020年第10期911-916,共6页National Journal of Andrology

摘　　要：目的:探讨精道异位开口于扩大的前列腺囊(EPU)的诊断、治疗和分类,以提高对本病的诊治水平。方法:回顾性分析1985年10月至2017年10月诊治的22例精道异位开口于EPU患者的临床资料;经精道造影,EPU开口插管造影或术中穿剌输精管造影以明确诊断。分别经尿道行EPU开口冷刀内切开或电切EPU前壁、开放手术或腹腔镜下手术切除囊肿等治疗。结果:诊断为输精管异位开口于EPU 5例,射精管异位开口于EPU 17例。予相应治疗,经3~48个月随访,症状消失,不育者精液质量改善,2例通过ICSI获生育。结论:精道异位开口于EPU罕见,精道造影是诊断本病的可靠方法。治疗应结合分类分型,以恢复精液流出道通畅为目的。Objective: To explore the diagnosis, classification and treatment of ectopic seminal tract opening in enlarged prostatic utricle(EPU). Methods: We retrospectively analyzed the clinical data on 22 cases of ectopic seminal tract opening in EPU confirmed by spermography, EPU open cannula angiography or intraoperative puncture of the vas deferens and treated by transurethral incision of EPU, cold-knife incision or electric incision of EPU, full drainage of the anteriorwal, and open or laparoscopic surgery from October 1985 to October 2017. Results: Five of the patients were diagnosed with ectopic opening of the vas deferens and the other 17 with ectopic opening of the ejaculatory duct in EPU. During the 3-48 months of postoperative follow-up, symptoms disappeared in all the cases, semen quality was improved in those with infertility, and 2 of the infertile patients achieved pregnancy via ICSI. Conclusion: Ectopic seminal tract opening in EPU is rare clinically. Spermography is a reliable method for the diagnosis of the disease, and its treatment should be aimed at restoring the smooth flow of semen based on proper classification and typing of the disease. Natl J Androl, 2020, 26(10): 911-916.

关 键 词：输精管 射精管 异位开口 扩大的前列腺囊 苗勒管囊肿 先天性畸形 

分 类 号：R697.3[医药卫生—泌尿科学]