Han Fei, Wu Hong-Fei, Yu Hong-Bo
Department of Urology, BenQ Medical Center / The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu 210019, China.
Zhonghua Nan Ke Xue. 2022 Apr;28(4):321-325.
To explore the diagnosis and treatment of ectopic seminal duct opening into the urethra.
We reviewed the literature and retrospectively analyzed the clinical data on a case of sex development abnormality. The patient was a 16-year-old gender female seeking medical improvement of female signs, admitted to hospital with "clitoris hypertrophy, no menstruation and chromosome karyotype 46XY", treated by bilateral orchiectomy, and simultaneously examined by seminal vesiculography and cystoscopy.
Seminal vesiculography showed the ectopic opening of the right ejaculatory duct into the urethra accompanied by dysplasia of the seminal vesicle. Cystoscopy exhibited a fissrure-like opening in the right wall of the urethra but no verumontanum. Postoperative pathology revealed bilateral undeveloped testes and epididymides.
Ectopic opening of the seminal duct into the urethra is extremely rare and often complicated by many malformations, for the diagnosis of which the most reliable options are seminal vesiculography and retrograde radiography through the ectopic orifice under the cystoscope. The treatment of the disease should follow the principles of timeliness, individualization and consideration of associated malformations.
探讨尿道内异位开口精囊的诊断与治疗。
我们查阅了文献，并回顾性分析了1例性发育异常病例的临床资料。患者为16岁女性，因女性体征改善需求就诊，因“阴蒂肥大、无月经且染色体核型为46XY”入院，接受双侧睾丸切除术，并同时进行精囊造影和膀胱镜检查。
精囊造影显示右侧射精管异位开口于尿道，伴有精囊发育不良。膀胱镜检查显示尿道右壁有裂隙样开口，但无精阜。术后病理显示双侧睾丸及附睾未发育。
精囊异位开口于尿道极为罕见，且常伴有多种畸形，对于其诊断，最可靠的方法是精囊造影和膀胱镜下经异位开口逆行造影。该病的治疗应遵循及时、个体化及考虑相关畸形的原则。
