先天性巨结肠术后射精功能障碍2例报告并文献复习  

Ejaculation dysfunction after Hirschsprung’s disease surgery:two cases report and literaturereview

作　　者：刘贵中[1,2] 吴宝军 白文俊 牛远杰[1] Liu Guizhong;Wu Baojun;Bai Wenjun;Niu Yuanjie(Department of Urology,Second Hospital of Tianjin Medical University,Tianjin 300211,China;Department of Urology,Tianjinjinnan Hospital,Tianjin 300350,China;Department of Urology,Peking University Peopled Hospital,Beijing,100044,China)

机构地区：[1]天津医科大学第二医院泌尿外科,天津300211 [2]天津市津南医院泌尿外科,天津300350 [3]北京大学人民医院泌尿外科,北京100044

出　　处：《中国男科学杂志》2021年第3期63-65,共3页Chinese Journal of Andrology

摘　　要：目的探讨先天性巨结肠术后射精功能障碍的发生机制与诊疗方案。方法通过总结近期我们收治的先天性巨结肠术后并射精功能障碍的患者2例,其中北京大学人民医院1例,天津医科大学第二医院1例,两例均以不育就诊,检查男性第二性征发育正常,性激素正常,1例精液量偏少,精液常规无精子,另1例射精后无精液,前列腺输精管壶腹按摩取精检查有精子,应用α-受体激动剂治疗。结果先天性巨结肠术后射精功能障碍的2例患者,考虑泌精功能障碍,给予米多君治疗后精液量均增多,其中1例检查精子浓度正常,自然妊娠,另1例合并性欲减退和逆行射精,米多君联合美多芭治疗,选择辅助生殖技术助孕。结论先天性巨结肠术后合并射精功能障碍存在精道动力性梗阻,与幼儿时期手术相关,首选前列腺输精管壶腹按摩取精检查明确,应用α-受体激动剂促进射精治疗有效。Objective To explore the mechanism and treatment of ejaculation dysfunction after Hirschsprung’s disease surgery.Methods Clinical data of two patients with ejaculation dysfunction after Hirschsprung’s disease surgery were analyzed.One case was from Peking University People’s Hospital,the other case from Second hospital of Tianjin Medical University,Both of patients were diagnosed as infertility,and their secondary sexual signs and sex hormone levels were normal.One case had a low semen volume,routine semen analysis showed azoospermia,the other case had no semen after ejaculation,prostate vas deferens and ampulla massage to take out the fluid to check for sperm,and receivedα-receptor agonist treatment.Results 2 patients with Hirschsprung’s disease after surgery and ejaculation dysfunction were considered to have emission failure,the semen volume increased after treatment with midodrine.One case had normal sperm concentration and spontaneous pregnancy,the other had decreased libido and retrograde ejaculation,midodrine combined with Madopar treatment,choose assisted reproductive technology to assist pregnancy.Conclusion The patients with ejaculation dysfunction after Hirschsprung’s disease surgeryhave seminal dynamic obstruction,which may be related to childhood surgery.Prostate vas deferens and ampulla massage-based sperm examinationis the first choice for diagnosis,andα-agonist is effective for promoting spermatogenesis.

关 键 词：HIRSCHSPRUNG病 射精功能障碍 泌精障碍 

分 类 号：R697.25[医药卫生—泌尿科学] R619.9[医药卫生—外科学]