不育男性前列腺中线囊肿经直肠超声检查及精液特点分析

Transrectal ultrasonographic features of midline prostatic cysts in infertile men and their semen analysis

目的分析男性不育患者前列腺中线囊肿经直肠超声表现和精液特点。方法对2013年11月至2014年10月在南京医科大学附属苏州医院超声中心就诊的34例男性不育患者经直肠超声表现及精液特点进行分析。结果 34例男性不育超声显示前列腺中线囊肿的患者声像图均表现为前列腺内无回声区,其中射精管囊肿17例,囊肿一侧与同侧精囊相连,纵切面声像图示囊肿呈倒置水滴状尖端指向精阜;苗勒管囊肿11例,囊肿位于前列腺基底部、尿道后上方中线处,纵切面声像图呈水滴状或类圆形;真性前列腺囊肿6例,囊肿位于前列腺内部或前列腺包膜下,横切面及纵切面声像图呈圆形或类圆形,根据囊肿的解剖位置及形态可加以鉴别。精液检测分析提示射精管囊肿患者中无精子症13例,少精子症2例;苗勒管囊肿患者中无精子症4例,少精子症6例;真性前列腺囊肿患者中无精子症1例,少精子症2例。结论经直肠超声检查可对前列腺中线囊肿解剖位置及形态做出准确诊断,与精液分析相结合可为临床治疗提供可靠的依据。

Objective To investigate the transrectal ultrasonographic （TRUS） features of midline prostatic cysts and the semen analysis in infertile men. Methods The ultrasonographic characteristics of midline prostatic cysts were retrospectively analyzed in 34 infertile men, who underwent transrectal ultrasound and semen analysis in Suzhou Hospitial Affiliated to Nanjing Medical University from November 2013 to October 2014. Results Thirty-four patients were detected by transrectal ultrasound with anechoic areas in their prostates. Among them, the cysts could be divided into 3 groups： 17 ejaculatory duct cyst, 11 mullerian duct cyst and 6 true prostatic cyst. Ejaculatory duct cysts was connected with ipsilateral seminal vesicle and pointed to seminal hillock showing a water-drop shape on longitudinal view of ultrasound. Mullerian dust cysts were located at the base of the prostates behind the urethra with a water-drop shape on longitudinal view. True prostatic cysts were inside the prostates or under the prostate capsules with a round or oval shape either on longitudinal view or transverse view of ultrasound. Therefore, these midline prostate cysts could be differentiated by their anatomical position and shape. These patients then underwent semen analysis. By semen analysis, there were 13, 4, 1 aspermia and 2, 6, 2 oligospermia in patients with ejaculatory dust cysts, mullerian duct cysts, and true prostatic cysts, respectively. Conclusions Transrectal ultrasound can provide accurate information about the anatomical position and shape of midline prostatic cysts in infertile men. Combined with semen analysis, transrectal ultrasound can provide a reliable evidence for clinical treatment.