精囊炎伴精囊结石患者病因初步分析

Etiological factors for calculus-associated seminal vesiculitis: Analysis of calculus composition in 6 cases

目的:通过对精囊结石标本进行成分分析,初步探讨精囊结石患者的致病因素。方法:回顾性分析6例反复血精且盆腔CT平扫提示精囊结石患者的临床资料。患者年龄28~69岁,持续或反复血精3个月至6年。6例中5例有急性尿道炎史。所有患者均接受精囊镜检查治疗术,术中证实精囊炎合并精囊结石,并以套石篮套取结石标本。利用第二代红外光谱结石成分分析仪分析6例精囊结石成分。随访患者2周至3个月,复查盆腔CT平扫观察有无生殖道结石复发。结果:CT平扫结果提示术后3个月有3例患者精囊结石复发,其中2例血精复发,其复发时间均在手术后1个月。6例精囊结石中有5例含有感染性结石成分——六水磷酸镁铵,仅有1例结石成分为二水草酸钙、一水草酸钙以及碳酸磷灰石的混合性结石。结论:6例精囊结石以六水磷酸镁铵结石最常见,推测精囊结石合并精囊炎可能的致病因素主要为感染。

Objective： To explore the etiological factors for calculus-associated seminal vesiculitis by analyzing the composition of seminal vesicle calculus samples. Methods： This retrospective study included 6 cases of recurrent hematospermia diagdosed with seminal vesicle calculus by non-contrast pelvic CT. The patients were aged 28 to 69 years, with persistent or recurrent hematospermia for 3 months to 6 years, and 5 of them with a history of acute urcthritis. All the patients underwent seminal vesiculoscopy, which con- limned calculus-associated seminal vesiculitis. The calculus samples were obtained with a spiral dislodge and their composition was de- termined with a second-generation infrared calculus composition analyzer. The patients were followed up for 2 to 12 weeks postopera- tively, during which non-contrast pelvic CT was employed for observation of recurrent calculus in the reproductive tract. Results ： Pel- vic CT scanning indicated recurrence of seminal vesicle calculus in 3 cases at 12 weeks postoperatively, of which, 2 were accompanied with recurrent hematospermia, both observed at 4 weeks after operation. As for the composition of the calculus, the infrared calculus composition analyzer revealed struvite （magnesium ammonium phosphate hcxahydrate） in 5 cases and a mixture of calcium oxalate dihydrate, calcium oxalate monohydrate, and carbonate apatite in the other one. Conclusion： Seminal vesicle calculi are most commonly composed of struvite, and infection is the main etiological factor for calculus-associated seminal vesiculitis.