Hall S, Oates R D
New England Male Reproductive Center, Boston University School of Medicine/University Hospital, Massachusetts 02118.
J Urol. 1993 Oct;150(4):1161-4. doi: 10.1016/s0022-5347(17)35714-2.
Ten patients who presented for infertility had unilateral absence of the scrotal vas deferens and a contralateral mesonephric duct anomaly, including contralateral ejaculatory duct or epididymal/vasal obstruction. The details of the physical examination, semen analysis and transrectal ultrasound led to an accurate preoperative diagnosis in each case. Therapeutic manipulations appropriate in this group included transurethral resection of the ejaculatory duct, microscopic vasoepididymostomy and microsurgical sperm aspiration coupled with in vitro fertilization. Only 3 patients had ipsilateral renal agenesis or ectopia (30%), which is well below the stated percentage for patients with unilateral vasal agenesis (90%). An aberration in the proper sequence of mesonephric embryological development may partly explain this bilateral constellation of abnormalities.
10例因不育前来就诊的患者存在单侧阴囊输精管缺如及对侧中肾管异常，包括对侧射精管或附睾/输精管梗阻。体格检查、精液分析及经直肠超声检查的细节使得每例患者均能获得准确的术前诊断。该组患者适宜的治疗手段包括经尿道射精管切除术、显微镜下输精管附睾吻合术及显微外科精子抽吸术联合体外受精。仅3例患者存在同侧肾缺如或异位（30%），这远低于单侧输精管缺如患者所述的比例（90%）。中肾胚胎发育正常顺序的异常可能部分解释了这种双侧异常的情况。
