假性重复输精管畸形(附1例报告及文献复习)

Pseudo duplication of the vas deferens(report of a case and review of literatures)

目的探讨假性重复输精管畸形的发病机制、临床特点和诊治方法。方法分析1例患者的临床诊治资料,复习相关文献。患者表现为右侧先天性输尿管(假性输精管)与精道汇合,合并同侧肾缺如、精囊囊肿。手术切除病变输尿管和精囊,同侧盆腔段输精管结扎。结果术后患者痊愈出院。病理检查提示与精道汇合的右输尿管在组织学上具有与输精管相同的特点。结论胚胎早期,输尿管芽从输精管前体近端发出可能是导致假性输精管畸形的原因。精道造影在本病诊断中具有重要价值。治疗宜行盆腔段输精管结扎、病变精囊切除．并根据患例肾功能状况决定是否行上尿路重建术。

Objective To investigate the embryogenesis, clinical features, diagnosis, and treatment of pseudo duplication of the vas deferens. Methods Clinical data of a patient were studied, and correlated literatures were reviewed. The patient presented as right ureterovasal communication, associated with ipsilateral renal agenesis and seminal vesicle cyst. Open excision of the affected ureter and seminal vesicle was performed, and the pelvic vas deferens was ligated. Results The patient recovered uneventfully. Pathological examination revealed the ureter histologically simulated the vas deferens. Conclusion Embryologically, the ＂accessary vas＂ is a vasated ureter that buds ectopically from the proximal vas precursor （PVP）. Vasography plays an important role in the diagnosis. Ligation of the pelvic vas deferens and removal of the affected seminal vesicle is necessary, and the necessity of reconstruction of the upper urinary tract is determined by the status of renal function.