Weintraub M P, De Mouy E, Hellstrom W J
Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana.
J Urol. 1993 Oct;150(4):1150-4. doi: 10.1016/s0022-5347(17)35711-7.
In this study, 8 patients were diagnosed as having ejaculatory duct obstruction. The complaints included infertility, painful ejaculation, hematospermia, and perineal and/or testicular pain. Preoperative diagnostics included transrectal ultrasonic scanning and magnetic resonance imaging. A body coil and an endorectal coil using fast spin-echo techniques were used. The diagnosis of ejaculatory duct obstruction in each patient was confirmed by vasography with a combined iodinated contrast medium and methylene blue solution for radiological and direct visualization. A resectoscope was used for careful unroofing of the involved ejaculatory duct orifice. Patency was confirmed radiographically and by direct vision. In terms of presenting complaints, 7 of 8 patients improved symptomatically and/or objectively. Ejaculatory duct obstruction, a more prevalent condition than is currently appreciated, should be thoroughly investigated and actively treated in cases of infertility or complaints referable to ejaculatory dysfunction. Magnetic resonance imaging using an endorectal coil is a valuable adjunct in the diagnosis and therapy of this disorder.
在本研究中，8例患者被诊断为射精管梗阻。主诉包括不孕、射精疼痛、血精以及会阴和/或睾丸疼痛。术前诊断包括经直肠超声扫描和磁共振成像。使用体部线圈和直肠内线圈，采用快速自旋回波技术。通过使用碘化造影剂和亚甲蓝溶液联合进行输精管造影以进行放射学和直接可视化，从而确诊每位患者的射精管梗阻。使用电切镜小心地打开受累射精管口。通过放射学检查和直接观察确认通畅情况。就主诉而言，8例患者中有7例在症状和/或客观方面有所改善。射精管梗阻是一种比目前所认识到的更为普遍的病症，在不孕或涉及射精功能障碍的主诉病例中应进行彻底检查并积极治疗。使用直肠内线圈的磁共振成像在该疾病的诊断和治疗中是一种有价值的辅助手段。
