经尿道电切术治疗射精管梗阻引起的无精子症

Transurethral electrotomy for the therapy of azoospermatism due to obstruction of ejaculatory duct

目的进一步探讨由于射精管梗阻(EDO)引起的无精子症的治疗。方法采用精液分析(包括精液的量、pH值、果糖的测定)、经直肠指检、B超检查精囊腺,手法检查和B超检查附睾的方法诊断。于2004年11月至2006年12月,20例患者临床上诊断为因射精管梗阻引起的无精子症,采用经尿道电切术切开、切除梗阻的射精管,直至见到有乳白色、褐色、黄褐色或暗红色精液排出。结果20例无精子症患者的精液量增多,精液中出现精子,1年内精液分析连续3次正常,其中4例其配偶怀孕。5例患者术后1年复查精囊腺明显缩小。本组没有发现明显的并发症。结论经尿道电切术治疗射精管梗阻的无精子症是一种简单、有效的方法。

Objective To investigate the therapy for azoospermatism due to obstruction of ejaculatory duct. Methods From November 2004 to December 2006, 20 cases of azoospermatism were diagnosed by semen analysis （including quantity of semen, pH and fructose）, transrectal palpation and ultrasonograph for seminal vesicle, palpation and ultrasonograph for epididymis. All cases were treated by transurethral incision or resection of the obstructive ejaculatory duct until milky semen discharged. Results For 20 cases of azoospermatism, quantity of semen increased and sperm can be found after operation. All of them had semen analysed for three times in twelve months postoperation, and the results were normal. 4 wives became pregnant after one year of operation. For 5 cases, seminal vesicle became smaller obviously and no complication can be found. Conclusion For treating azoospermatism due to obstruction of ejaculatory duct, transurethral electrotomy is a simple and effective method.