Lin Jian-Zhong, Shi Guang-Dong, Wu Hong-Fei, Yu Hong-Bo, Zhou He-Tong, Hu Xin, Wang Hao
Department of Urology, Nanjing BenQ Hospital, Nanjing Medical University, Nanjing, Jiangsu 210019, China.
Department of Surgery, Gaogang Hospital of Traditional Chinese Medicine, Taizhou, Jiangsu 225300, China.
Zhonghua Nan Ke Xue. 2018 Mar;24(3):236-240.
To investigate the diagnosis and treatment of ejaculatory duct cyst.
This study included 2 male patients present at the hospital for hemospermia and abnormal sensation in the perineal region in July and August 2014. Both underwent transrectal ultrasonography, routine semen examination, CT, MRI, cystoscopy, and vesiculography before transurethral fenestration of the cysts and pathological examination of the cyst wall specimens. Analyses were made on the clinical presentations, imaging features, pathological characteristics, differential diagnosis and treatment of ejaculatory duct cyst and relevant literature was reviewed.
The cyst wall was mainly composed of smooth muscle, the inner wall lined with pseudostratified ciliated columnar epithelia, and with positive expressions of CD10 and Muc6 proteins on immunohistochemical staining, which indicated renal iatrogenic ejaculatory duct cyst. The patients were followed up for 18 and 20 months, respectively. All symptoms disappeared and no recurrence occurred after surgery. Routine semen examination for the two patients showed the semen volumes to be 3.5 and 3.1 ml, sperm concentrations 35 and 32 ×10⁶/ml, grade a sperm 32.0 and 26.0%, grade b sperm 18.0 and 31.0%, and semen liquidation time 30 and 34 minutes, respectively.
Pelvic cystic masses can be detected by transrectal ultrasonography, CT and MRI, but definite diagnosis relies on vesiculography, pathological examination and immunohistochemical staining. Transurethral fenestration is safe and effective for the treatment of ejaculation duct cyst.
探讨射精管囊肿的诊断与治疗。
本研究纳入2例男性患者，于2014年7月和8月因血精及会阴部异常感觉入院。2例患者在经尿道囊肿开窗及囊肿壁标本病理检查前均接受了经直肠超声检查、精液常规检查、CT、MRI、膀胱镜检查及精囊造影。对射精管囊肿的临床表现、影像学特征、病理特点、鉴别诊断及治疗进行分析，并复习相关文献。
囊肿壁主要由平滑肌组成，内壁衬以假复层纤毛柱状上皮，免疫组化染色CD10和Muc6蛋白呈阳性表达，提示为肾源性医源性射精管囊肿。2例患者分别随访18个月和20个月。术后所有症状消失，无复发。2例患者精液常规检查结果显示，精液量分别为3.5 ml和3.1 ml，精子浓度分别为35×10⁶/ml和32×10⁶/ml，a级精子分别为32.0%和26.0%，b级精子分别为18.0%和31.0%，精液液化时间分别为30分钟和34分钟。
经直肠超声检查、CT及MRI可发现盆腔囊性肿物，但明确诊断依赖于精囊造影、病理检查及免疫组化染色。经尿道囊肿开窗术治疗射精管囊肿安全有效。
