[1]肖恒军 闫卫鑫 陆敏华 陈俊 李小华 陈晓波 李茂胤 张浩 庞俊 高新.精囊镜技术治疗射精管梗阻性无精子症:附36例报告[J].中华腔镜泌尿外科杂志(电子版),2016,10(05):348-352.[doi:10.3877/cma.j.issn.1674-3253.2016.05.013 ]
　Xiao Hengjun,Yan Weixin,Lu Minhua,et al.Transurethral seminal vesiculoscopyfor treatment of azoospermia secondary toejaculatory duct obstruction: report of 36 cases[J].,2016,10(05):348-352.[doi:10.3877/cma.j.issn.1674-3253.2016.05.013 ]
点击复制

精囊镜技术治疗射精管梗阻性无精子症:附36例报告()
分享到：

中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
10
期数:
2016年05期
页码:
348-352
栏目:
临床研究
出版日期:
2016-11-05

文章信息/Info

Title:
Transurethral seminal vesiculoscopyfor treatment of azoospermia secondary toejaculatory duct obstruction: report of 36 cases
作者:
肖恒军 1闫卫鑫 1陆敏华 1陈俊 2李小华 3陈晓波 1李茂胤 1张浩 1庞俊 1高新 1
510630广州，中山大学附属第三医院泌尿外科 1，不育与性医学科 2；518116深圳市龙岗中心医院泌尿外科 3
Author(s):
Xiao Hengjun1;  Yan Weixin1;  Lu Minhua1;  Chen Jun2;  Li Xiaohua3;  Chen Xiaobo1; Li Maoyin1;  Zhang Hao1;  Pang Jun1;  Gao Xin1.
Department of Urology, 2Department of infertility & sexual medicine, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; 3Department of Urology, Longgang Distric Central Hospital of Shenzhen, Shenzhen 518116, China
关键词:
精囊镜; 无精子症; 射精管梗阻
DOI:
10.3877/cma.j.issn.1674-3253.2016.05.013
摘要:
目的探讨精囊镜技术治疗射精管梗阻性无精子症的可行性和疗效。方法回顾性分析 2009年 12月至 2015年 11月中山大学附属第三医院采用精囊镜射精管扩张技术治疗 36例射精管梗阻性无精子症患者临床资料。患者年龄 23~39岁，平均 28岁。术前常规行精液分析、精浆果糖测定和经直肠超声检查等检查明确诊断为射精管梗阻性无精子症。36例无精症患者，精液量 0.1~1.8ml，pH值 6.0~7.2，精液常规和离心均未检出精子。结果单纯精囊镜扩张射精管治疗射精管梗阻 23例，精囊镜技术联合射精管口切开治疗 13例。手术时间 12~60min，平均 25min。33例获得随访，随访时间 2~48个月，平均 12个月， 25例患者在术后 1~3个月复查精液常规或离心可找到精子，其中 17例精子密度和活力接近正常， 7例获得妊娠。8例患者术后复查精液仍未见精子。结论精囊镜射精管扩张治疗射精管梗阻性无精子症技术可行，对于精囊镜技术经验丰富的术者，该方法是治疗射精管梗阻性无精子症安全有效的手段。

参考文献/References:

[1] Pace G, Galatioto GP, GualàL, et al. Ejaculatory duct obstruction caused by a right giant seminal vesicle with an ipsilateral upper urinary tract agenesia: an embryologic malformation [J]. Fertil Steril, 2008, 89(2): 390-394.
[2] Han WK, Lee SR, Rha KH, et al. Transutricular seminal vesiculoscopy in hematospermia: technical considerations and outcomes[J]. Urology, 2009, 73(6): 1377-1382.
[3] Liu ZY, Sun YH, Xu CL, et al. Transurethral seminal vesiculoscopy in the diagnosis and treatment of persistent or recurrent hemospermia: a single-institution experience [J]. Asian J Androl 2009, 11(5): 566-570.
[4] 肖恒军, 黄文涛, 刘小彭, 等. 精囊镜检诊治顽固性血精[J]. 中华腔镜泌尿外科杂志:电子版, 2011, 5(2): 119-122.
[5] Song T, Zhang X, Zhang L, et al. Transurethral seminal vesiculoscopy in the diagnosis and treatment of seminal vesicle stones[J]. Chin Med J (Engl), 2012, 125(8): 1475-1478.
[6] Xiao HJ, Huang WT, Liu XP, et al. A novel diagnostic and therapeutic technique for persistent and recurrent hemospermia:transurethral seminal vesiculoscopy with a ureteroscope [J]. J Endourol,2011, 25(Suppl 1): 301.
[7] 肖恒军, 刘小彭, 张炎, 等. 顽固性血精症原因分析和治疗对策[J/CD]. 中华腔镜泌尿外科杂志:电子版, 2012, 6(5): 49-52.
[8] 肖恒军, 高新. 精囊镜技术诊治顽固性血精症[M] . 北京: 人民卫生出版社, 2014: 210-218.
[9] Fisch H, Lambert SM, Goluboff ET. Management of ejaculatory duct obstruction: etiology, diagnosis, and treatment [J]. World J Urol, 2006, 24(6): 604-610.
[10] Galosi AB, Montironi R, Fabiani A, et al. Cystic lesions of the prostate gland: an ultrasound classification with pathological correlation[J]. J Urol, 2009, 181(2): 647-657.
[11] Smith JF, Walsh TJ, Turek PJ. Ejaculatory duct obstruction [J].Urol Clin North Am, 2008, 35(2): 221-227.
[12] 李权. 射精管梗阻的研究进展[J]. 国际泌尿系统杂志, 2012, 32(1): 82-87.
[13] Paick J, Kim SH, Kim SW. Ejaculatory duct obstruction in infertile men[J]. BJU Int, 2000, 85(6): 720-724.
[14] Engin G, Kadio?lu A, Orhan I, et al. Transrectal US and endorectal Mr imaging in partial and complete obstruction of the seminal duct system. A comparative study [J]. Acta Radiol, 2000, 41(3):288-295.
[15] 刘智勇, 王磊, 孙颖浩, 等. 经尿道精囊镜技术- 一种治疗射精管梗阻性无精子症的新方法[J]. 中国男科学杂志, 2010, 24(9):18-20
[16] Meacham RB, Townsend RR, Drose JA. Ejaculatory duct obstruction: diagnosis and treatment with transrectal sonography [J]. AJR Am J Roentgenol, 1995, 165(6): 1463-1466.
[17] Turek PJ, Magana JO, Lipshultz LI. Semen parameters before and after transurethral surgery for ejaculatory duct obstruction [J]. J Urol, 1996, 155(4): 1291-1293.
[18] 涂响安, 赵良运, 赵亮, 等. 经尿道射精管切开术治疗射精管梗阻的效果(附60 例报告)[J]. 北京大学学报:医学版, 2011, 43(4):559-561.

相似文献/References:

[1]胡国栋,王秀,王平,等.经尿道精囊镜第4代气压弹道联合超声吸附碎石系统治疗精囊结石[J].中华腔镜泌尿外科杂志(电子版),2012,(03):221.
　HU Guo-dong,WANG Xiu,WANG Ping,et al.Transurethral seminal vesiculoscopy combine with the 4th EMS for the treatment of seminal stones[J].,2012,(05):221.
[2]肖恒军,刘小彭,张炎,等.顽固性血精症原因分析和治疗对策[J].中华腔镜泌尿外科杂志(电子版),2012,(05):49.
　XIAO Heng-jun,LIU Xiao-peng,ZHANG Yan,et al.Aetiology and therapeutic procedures for persistent and recurrent hemospermia[J].,2012,(05):49.
[3]张志宏 董永良 张凯 郝斌 孟军.软性输尿管镜精囊检查在顽固性血精诊治中的应用价值[J].中华腔镜泌尿外科杂志(电子版),2015,(06):443.[doi:10.3877/cma.j.issn.1674-3253.2015.06.014 ]
　Zhang Zhihong,Dong Yongliang,Zhang Kai,et al.The value of flexible ureteroscope seminal vesicle examination for diagnosing and treating refractory hemospermia[J].,2015,(05):443.[doi:10.3877/cma.j.issn.1674-3253.2015.06.014 ]
[4]郭欢仪 陈军 张滨 陈俊 张炎.阴囊及直肠腔内彩色多普勒超声在无精子症诊断分型中的价值[J].中华腔镜泌尿外科杂志(电子版),2015,(01):55.[doi:10.3877/cma.j.issn.1674-3253.2015.01.014 ]
　Guo Huanyi,Chen Jun,Zhang Bin,et al.Classification of azoospermia with scrotal and transrectal ultrasonography[J].,2015,(05):55.[doi:10.3877/cma.j.issn.1674-3253.2015.01.014 ]

备注/Memo

备注/Memo:
基金项目：广东省科技计划项目(2011B060300003，2013B022000045）；高校基本科研业务费中山大学青年教师培育项目(12ykpy40)
通讯作者：肖恒军，Email：hjxiao555@126.com
更新日期/Last Update: 2016-10-30