Holt B, Pryor J P, Hendry W F
Department of Urology, St Bartholomew's Hospital, London, England.
J Pediatr Surg. 1995 Dec;30(12):1677-9. doi: 10.1016/0022-3468(95)90450-6.
Congenital abnormalities of the genitourinary tract often coexist, and cryptorchidism is common in patients who have had imperforate anus. Twenty men who had pull-through procedures for imperforate anus in infancy have been evaluated for infertility. Seven had coexisting renal abnormalities, 4 had had recurrent epididymitis, 3 had had bilateral orchidopexies (at age 7 to 12), 2 had spina bifida, and 1 had a pituitary adenoma. Seven had no ejaculate (aspermia), 11 were azoospermic, 1 was severely oligozoospermic, and 1 had a normal sperm concentration in a small volume of ejaculate. Both vasa were blocked in 5 men, and this appeared to be a result of the original operative procedure. One vas was blocked in another 7 patients who had abnormalities on the contralateral side; three had epididymal blocks after epididymitis, and four had congenital malformations associated with an absent or ectopic kidney. After reconstruction (4), insertion of sperm reservoirs (4), microscopic epididymal sperm aspiration (2), or artificial insemination (1), sperm were retrieved from 9 men (ejaculated by 4) 2 pregnancies occurred. Male infertility after treatment of imperforate anus in infancy can be related to a wide variety of cause, some of which are amenable to treatment.
先天性泌尿生殖道异常常同时存在，隐睾症在肛门闭锁患者中很常见。对20名婴儿期因肛门闭锁接受拖出术的男性进行了不育评估。7人存在肾脏合并异常，4人曾患复发性附睾炎，3人（7至12岁时）接受过双侧睾丸固定术，2人患有脊柱裂，1人患有垂体腺瘤。7人无射精（无精子症），11人无精子，1人严重少精子症，1人少量射精中精子浓度正常。5名男性双侧输精管均堵塞，这似乎是原手术操作的结果。另外7名对侧有异常的患者中1人输精管堵塞；3人附睾炎后附睾堵塞，4人存在与肾缺如或异位相关的先天性畸形。经过重建（4例）、植入储精囊（4例）、显微附睾精子抽吸（2例）或人工授精（1例）后，9名男性（4例射精）获取到精子，发生了2次妊娠。婴儿期肛门闭锁治疗后的男性不育可能与多种原因有关，其中一些原因可进行治疗。
