前列腺尿道囊肿导致梗阻性无精子症的罕见病例

Madhur Anand, Bhupendra Pal Singh, Ujjawal Jain, Nitish Dev, Mayank Kesharwani
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引用次数: 0

摘要

男性不育是一个令人担忧的问题,影响着全球约8%的夫妇,而射精管梗阻约占男性不育病例的5%。前列腺子宫囊肿是射精管梗阻的一种罕见病因,但可通过手术矫正。虽然这些囊肿通常没有症状,但可表现为无精子症和射精量少,因此有必要进行干预以恢复生育能力。我们介绍了一例 22 岁新婚男性的病例,他患有无精子症,其他病史均无异常。临床检查显示双侧输精管和附睾正常,但射精量少。睾丸大小、卵泡刺激素和睾酮水平均在正常范围内。经腹超声波检查发现前列腺内有一个中线囊性结构。双侧睾丸细针穿刺证实存在处于不同发育阶段的精子。患者接受了尿道镜检查、双侧逆行精囊造影和经尿道前列腺中线囊肿切除术。3 个月后,随访结果显示精液分析正常。经尿道前列腺中线囊肿顶端切除术可有效恢复射精管梗阻患者的生育能力。精确的切除技术对防止尿道括约肌受损和随后的尿失禁至关重要。这种方法为前列腺子宫囊肿和相关无精子症患者恢复生育能力提供了良好的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Rare Case of Prostatic Utricle Cyst Causing Obstructive Azoospermia
Male infertility is a concern affecting approximately 8% of couples worldwide, with ejaculatory duct obstruction contributing to about 5% of male infertility cases. Prostatic utricle cysts are a rare but surgically correctable cause of ejaculatory duct obstruction. While often asymptomatic, these cysts can manifest as azoospermia with low ejaculate volume, necessitating intervention for fertility restoration. We present the case of a 22-year-old newly married male with azoospermia and otherwise unremarkable medical history. Clinical examination revealed normal bilateral vas deferens and epididymis, along with low ejaculate volume. Testicular size, follicle-stimulating hormone, and testosterone levels were within the normal range. Transabdominal ultrasound uncovered a midline cystic structure within the prostate. Bilateral testicular fine-needle aspiration confirmed the presence of spermatozoa at various stages of development. The patient underwent urethroscopy, bilateral retrograde seminal vesiculography, and transurethral resection of the midline prostatic cyst. At 3 months, the follow-up revealed normal semen analysis. Transurethral resection of the roof of the midline prostatic cyst can effectively restore fertility in cases of ejaculatory duct obstruction. Precise resection technique is crucial to prevent damage to the urethral sphincter and subsequent incontinence. This approach offers a favorable prognosis for fertility restoration in patients with prostatic utricle cysts and associated azoospermia.
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