Zhu ChangFu, Wang Cong
Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, China.
Ultrasound Department of the First Affiliated Hospital of Dalian Medical University, China.
Rev Int Androl. 2022 Jan-Mar;20(1):11-16. doi: 10.1016/j.androl.2020.05.009. Epub 2021 Jan 6.
To investigate the transrectal and scrotal ultrasonographic features of acquired obstructive azoospermia and evaluate the role of ultrasonography in the location diagnosis of acquired obstructive azoospermia patients.
Retrospectively analysis of 92 cases of acquired obstructive azoospermia in recent years. All the patients underwent transrectal and scrotal ultrasonography. The ultrasonographic features were observed of testis, epididymis, scrotal segment of vas deferens, seminal vesicle, ejaculatory duct and prostate. Eighty cases with normal semen were taken as control group.
Among the 92 cases of acquired obstructive azoospermia, 28 cases were prostate midline cyst, 32 cases were stone or calcification of the ejaculation duct and 21 cases were chronic seminal vesicle inflammation, which were found through transrectal ultrasonography; 27 cases were vas deferens dilation, 30 cases had abnormal mass of epididymis tail, 31 cases were epididymis thickness with reticular change, 8 cases were cystic dilatation of rete testis, which were found through scrotal ultrasonography. Compared with the control group, ultrasound examination increased the detection rate of distal seminal duct lesions and epididymal lesions in acquired obstructive azoospermia patients (p<.01). Comparison of testicular volume between case group and control group did not reveal significant difference (p>.05). The thickness of the head, body and tail of epididymis in case group was significantly bigger than that in control group (p<.01).
Transrectal and scrotal ultrasonography can find lesions in different parts of the seminal passage. Acquired obstructive azoospermia patients have increased rate of distal seminal duct lesions, epididymal lesions and epididymis volume. Transrectal and scrotum ultrasonography can provide reliable imaging evidence for the location diagnosis of acquired obstructive azoospermia.
探讨后天性梗阻性无精子症的经直肠及阴囊超声特征，评估超声检查在后天性梗阻性无精子症患者定位诊断中的作用。
回顾性分析近年来92例后天性梗阻性无精子症患者。所有患者均接受经直肠及阴囊超声检查。观察睾丸、附睾、输精管阴囊段、精囊、射精管及前列腺的超声特征。选取80例精液正常者作为对照组。
92例后天性梗阻性无精子症患者中，经直肠超声检查发现前列腺中线囊肿28例、射精管结石或钙化32例、慢性精囊炎21例；经阴囊超声检查发现输精管扩张27例、附睾尾部异常肿物30例、附睾增厚呈网状改变31例、睾丸网囊性扩张8例。与对照组比较，超声检查提高了后天性梗阻性无精子症患者输精管道远端病变及附睾病变的检出率（p<0.01）。病例组与对照组睾丸体积比较差异无统计学意义（p>0.05）。病例组附睾头、体、尾厚度均明显大于对照组（p<0.01）。
经直肠及阴囊超声检查可发现输精管道不同部位的病变。后天性梗阻性无精子症患者输精管道远端病变、附睾病变及附睾体积发生率增加。经直肠及阴囊超声检查可为后天性梗阻性无精子症的定位诊断提供可靠的影像学依据。
