Gottschalk-Sabag S, Bar-On E, Weiss D B
Institute of Pathology and Cytology, Shaare Zedek Medical Center, Jerusalem.
Harefuah. 1994 Jul;127(1-2):3-5, 64.
Epididymal fine needle aspirations (EFNA) were performed on 29 epididymides of 17 infertile, azoospermic men in whom testicular cytology revealed adequate spermatogenesis. Sonograms confirmed the presence of all the excretory male organs. EFNA was performed to diagnose and locate the site of genital tract occlusion. The presence of cuboidal epithelial cells in the aspirate was the sole indication that epididymal content was aspirated. In 10 (34%) of the 29 aspirates there were only cuboidal epithelial cells and no spermatozoa, indicating proximal occlusion in the rete testis, in the canaliculi efferents or in the most proximal segment of the epididymis itself. Occlusion in the distal segments of the epididymis or in the vas deferens was diagnosed in 13 epididymal aspirates (45%) which contained both cuboidal cells and spermatozoa. In 6 epididymides (21%) no conclusion could be reached because of failed aspirations. There are a variety of treatment modalities available for male genital tract obstruction, such as reconstructive surgery or IVF. The success rate of treatment is mainly dependent on the site of obstruction. Since vasography has its own limitations and hazards, diagnostic EFNA should be performed before treatment in men in whom genital obstruction is suspected.
对17名不育无精子症男性的29个附睾进行了附睾细针穿刺抽吸术（EFNA），这些男性的睾丸细胞学检查显示有足够的精子发生。超声检查证实了所有男性排泄器官的存在。进行EFNA是为了诊断和定位生殖道梗阻的部位。抽吸物中存在立方上皮细胞是抽吸到附睾内容物的唯一指征。在29次抽吸物中，有10次（34%）仅含有立方上皮细胞而无精子，表明睾丸网、输出小管或附睾最近端部分存在近端梗阻。13次附睾抽吸物（45%）中同时含有立方上皮细胞和精子，诊断为附睾远端或输精管梗阻。有6个附睾（21%）因抽吸失败而无法得出结论。男性生殖道梗阻有多种治疗方式，如重建手术或体外受精。治疗成功率主要取决于梗阻部位。由于输精管造影有其自身的局限性和风险，对于怀疑有生殖道梗阻的男性，应在治疗前进行诊断性EFNA。
