CAJ | 학술논문

目的比较经尿道射精管口切开术(Transurethral resection of ejaculatory ducts,TURED)与精囊腺镜下射精管内切开术治疗射精管梗阻引起的无精子症临床疗效.方法系统性回访我院于2009年7月至2012年6月住院行手术治疗并完成随访的射精管梗阻病人59人,其中 A组27人,行经尿道射精管口电切术(TURED);B组32人,行精囊腺镜下射精管内切开术.术前体检双侧睾丸正常,附睾穿刺可见成熟精子.经直肠彩超(TURS)提示双侧精囊腺均存在,同时合并射精管扩张、精囊腺囊肿等射精管梗阻的证据.精液常规均未发现精子,pH<7.1,精浆生化结果提示果糖含量明显减少.术后2~3月回访复查精液分析及并发症状况.结果在附睾炎的发生率、并发症的总发生率方面,B组较A组明显降低,差异具统计学意义(P<0.05).两者术后复查精液分析各项指标及受孕率,差异无统计学意义.结论精囊镜技术是一种安全、有效的治疗射精管梗阻的手术方式.
목적비교경뇨도사정관구절개술(Transurethral resection of ejaculatory ducts,TURED)여정낭선경하사정관내절개술치료사정관경조인기적무정자증림상료효.방법계통성회방아원우2009년7월지2012년6월주원행수술치료병완성수방적사정관경조병인59인,기중 A조27인,행경뇨도사정관구전절술(TURED);B조32인,행정낭선경하사정관내절개술.술전체검쌍측고환정상,부고천자가견성숙정자.경직장채초(TURS)제시쌍측정낭선균존재,동시합병사정관확장、정낭선낭종등사정관경조적증거.정액상규균미발현정자,pH<7.1,정장생화결과제시과당함량명현감소.술후2~3월회방복사정액분석급병발증상황.결과재부고염적발생솔、병발증적총발생솔방면,B조교A조명현강저,차이구통계학의의(P<0.05).량자술후복사정액분석각항지표급수잉솔,차이무통계학의의.결론정낭경기술시일충안전、유효적치료사정관경조적수술방식.
Objective To evaluate the clinical efficacy of two operation methods, such as the Transurethral resection of ejaculatory ducts (TURED) and inner resection of Ejaculatory duct with the resseminal vesiculoscopy, in treatment of patients with ejaculatory duct obstruction. Methods Total of 59 patients with ejaculatory duct obstruction in our hospital from July 2009 to June 2012 were enrolled in the study. Of them, 27 patients underwent TURED(group A) and the other patients(32) received inner resection of Ejaculatory duct in the resseminal vesiculoscopy(group B). They all had normal testis before operation.Puncture of epididymis showed that mature spermatozoon existed in it. Transrectal ultrasonography showed they all had seminal vesicle, but had evidences of ejaculatory duct obstruction like ejaculatory duct cysts, ejaculatory duct expansion. Semen tests showed azoonspermia and pH<7.1, seminal plasma test revealed a decrease of fructose.The semen test and complications were recorded in 2~3 months after operation. Results Compared to that of groupA, the incidence of epididymitis and the number of complication people in group B decreased obviously. The index of semen test and the rates of becoming pregnants had no difference between two groups. Conclution The resseminal vesiculoscopy was a safty and effective method in the treatment of ejaculatory duct obstruction