摘要
目的 研究经前列腺小囊进镜技术联合经直肠超声(TRUS)辅助进镜的临床效果。方法 回顾性分析2016年4月至2022年4月于本院收治的82例射精管梗阻引发无精子症状患者,经药物治疗无效后,均采用精囊镜手术治疗。观察临床效果、并发症及患者配偶妊娠率情况。结果 82例精囊镜手术患者,手术时间(45.63±10.63) min,术中出血量(17.82±4.52) mL。TRUS引导下经前列腺小囊进镜成功率>经前列腺小囊进镜>经射精管口进镜(均P<0.05)。患者术后3个月、6个月、10个月、术前的精液量、PH值、精浆果糖水平相比具有差异性,即术后10个月>术后6个月>术后3个月>术前(P<0.05)。82例患者配偶术后妊娠例数75例,占比为91.46%。并发症发生率为9.76%(8/82)。结论 经前列腺小囊进镜技术联合TRUS辅助进镜应用于射精管梗阻患者中,可有效提高进镜成功率,进而改善精液质量,弥补了单纯经射精管口、前列腺小囊进镜手术的不足,具有更高的安全性,值得推广。
Objective To study the clinical effect of transprostatic capsular laparoscopy combined with real-time rectal ultrasound(TRUS).Methods A retrospective analysis of 82 cases of azoospermia caused by ejaculatory duct obstruction admitted to our hospital from April 2016 to April 2022 was performed after ineffective drug treatment.The clinical effect,complications and the pregnancy rate of spouses were observed.Results The average operation time and intraoperative blood loss were(45.63±10.63)min and(17.82±4.52)mL.The success rate of TRUS-guided transprostatic vesicular entry was more than that of transprostatic vesicular entry and more than that of transejaculatory ductal entry(all P<0.05).There were differences in semen volume,PH value and sugar level at 3,6 and 10 months after surgery,that is,10 months after surgery greater than 6 months after surgery and greater than 3 months after surgery and greater than before surgery(P<0.05).Of the 82 patients,there were 75 cases of postoperative pregnancy,the pregnancy rate of spouses rate was 91.46%.The complication rate was 9.76%(8/82).Conclusion The application of transvesicular laparoscopy combined with TRUS assisted laparoscopy in patients with ejaculatory duct obstruction can effectively improve the success rate of endoscopic surgery,and then improve semen quality,and make up for the shortcomings of simple transvesicular laparoscopy and prostatic sac surgery,which has higher safety and is worth promoting.
作者
许凯杰
胡俊彪
张春霆
吴慧玲
XU Kaijie;HU Junbiao;ZHANG Chunting(Jinhua People's Hospital,Zhejiang 321000,China)
出处
《浙江创伤外科》
2023年第9期1612-1614,1618,共4页
Zhejiang Journal of Traumatic Surgery
基金
金华市科技局项目(2021-3-109)。
关键词
精囊镜术
射精管梗阻
微创
TRUS
经前列腺小囊进镜术
Seminal vesicoscopy
Obstruction of the ejaculatory duct
Minimally invasive
TRUS
Transprostatic capsular laparoscopy
