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目的探讨前列腺囊肿所致梗阻性无精子症的诊断及其微创治疗的疗效和安全性评价。方法回顾性分析2007年3月至2007年10月间诊治的7例前列腺囊肿所致梗阻性无精子症的临床资料。根据病史、体检、血清性激素、精液分析、精浆果糖测定和经直肠超声(TRUS)检查对其进行诊断,运用经直肠超声引导下前列腺囊肿穿刺引流术治疗,术后随访至少3个月以上。结果7例患者精液量0.5～1.8ml,pH值5.5～7.0,精浆果糖阴性。TRUS检查:前列腺囊肿均位于两侧射精管之间,单发,大小不等。所有患者均一次穿刺成功,6例术后查见精子,其中2例妊娠,其余病例精液质量有所恢复,妊娠情况在观察中。结论病史、体检、精液分析、精浆果糖测定和TRUS是前列腺囊肿所致梗阻性无精子症的基本诊断手段,经直肠前列腺囊肿穿刺引流术治疗梗阻性无精子症安全、有效、经济、微创。
Objective To investigate the diagnosis of obstructive azoospermia caused by prostatic cyst and the evaluation of the curative effect and safety of its minimally invasive treatment. Methods The clinical data of 7 cases of obstructive azoospermia due to prostatic cyst diagnosed from March 2007 to October 2007 were analyzed retrospectively. The patients were diagnosed according to their medical history, physical examination, serum sex hormones, semen analysis, fructose determination and transrectal ultrasound (TRUS). Prostate cyst was punctured and drainage guided by transrectal ultrasound. The patients were followed up for at least 3 months. Results Semen volume of 7 patients was 0.5 ~ 1.8ml, pH value was 5.5 ~ 7.0, and the fructose of the seminal plasma was negative. TRUS examination: Prostate cysts are located on both sides of the ejaculatory ducts, single hair, the size range. All patients were successfully punctured, and 6 cases were found sperm after surgery, of which 2 cases of pregnancy, the rest of the semen quality has been restored, pregnancy observed. Conclusion The history, physical examination, semen analysis, determination of fructose and TRUS are the basic diagnostic methods of obstructive azoospermia induced by prostatic cysts. The treatment of obstructive azoospermia by transrectal prostatic cyst drainage is safe, effective, economical and minimally invasive .