血管性顽固性血精临床特点与治疗经验及预后分析  

Clinical characteristics,treatment experience and prognostic analysis of vascular refractory hemospermia

作　　者：韩虎[1] 尹航[1] 李家兴 黄山 田龙[1] HAN Hu;YIN Hang;LI Jiaxing;HUANG Shan;TIAN Long(Department of Urology,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,北京100020

出　　处：《中国性科学》2025年第2期8-11,共4页Chinese Journal of Human Sexuality

基　　金：北京市自然科学基金面上项目(7222066)。

摘　　要：目的探讨血管性顽固性血精临床特点、治疗经验及预后。方法选取2014年3月至2023年8月首都医科大学附属北京朝阳医院收治的40例血管性顽固性血精患者作为研究对象。后尿道静脉曲张采用经尿道双极等离子电凝术治疗,后尿道血管瘤采用经尿道双极等离子电切术治疗。比较不同血管性顽固性血精患者临床症状、并发症及预后情况。结果40例患者中后尿道血管瘤患者19例、后尿道静脉曲张患者21例。血管性顽固性血精主要临床症状为性生活相关性血尿,常同时伴有血凝块;后尿道血管瘤和后尿道静脉曲张的症状相似。后尿道血管瘤患者症状消失平均时间短于后尿道静脉曲张患者(P<0.05)。术后出现尿道狭窄1例,其余患者未出现并发症。随访期间有4例后尿道静脉曲张患者出现复发。结论血管性顽固性血精通常是一种良性疾病。对于超声和(或)磁共振成像(MRI)等辅助检查阴性并伴有性刺激相关性血尿的顽固性血精患者应高度怀疑为血管性血精,可通过经尿道膀胱镜检查明确诊断,采用经尿道双极等离子电切术或电凝术治疗。Objective To explore the clinical characteristics,treatment experiences,and prognosis of vascular refractory hematospermia.Methods A total of forty patients with vascular refractory hematospermia who were treated at Beijing Chaoyang Hospital,Capital Medical University from March 2014 to August 2023,were selected as study objects.Posterior urethral varices were treated with transurethral bipolar plasma coagulation,and posterior urethral hemangiomas were treated with transurethral bipolar plasma resection.Clinical symptoms,complications,and prognosis status were compared among different types of vascular refractory hematospermia patients.Results A total of nineteen patients had posterior urethral hemangiomas,and twenty-one patients had posterior urethral varices.The main symptoms of vascular refractory hematospermia included sexually-related hematuria,often accompanied by blood clots at the same time.Clinical manifestations of posterior urethral hemangiomas were similar to those of posterior urethral varices,but the average time for symptom disappearance in posterior urethral hemangioma patients was shorter than that in posterior urethral varices patients(P<0.05).One case of urethral stricture occurred postoperatively,and no other complications were observed in other patients.During follow-up,four patients with posterior urethral varices had relapses.Conclusions Vascular refractory hematospermia is usually a benign condition.For patients with sexually stimulated-related hematuria and refractory hematospermia,with negative results from auxiliary examinations such as ultrasound and/or magnetic resonance imaging(MRI),vascular hemospermia should be highly suspected.Diagnosis can be confirmed through transurethral cystoscopy,and treatment can be performed using transurethral bipolar plasma resection or coagulation.

关 键 词：血管性顽固性血精 后尿道血管瘤 后尿道静脉曲张 

分 类 号：R697[医药卫生—泌尿科学]