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目的探讨经尿道精囊镜技术在男科疾病诊治中的应用价值。方法入选28例男科疾病患者,其中顽固性血精18例、不育症5例、会阴部疼痛2例、射精后下腹部疼痛1例、射精无力伴精液量少1例、性交后血尿1例。年龄18~63岁,平均(38±13)岁。采用麻醉下经尿道置入F7/8.5、F8/9.8输尿管硬镜,检查精囊及输精管壶腹部,并直视下行冲洗、钬激光碎石取石及广谱抗菌素保留灌注。术后定期随访患者主观症状、精液性状或配偶妊娠情况。结果本组病例手术时间30~140 min,平均(59±29)min。随访1~50个月,平均(8±10)个月。治愈12例,好转7例,未愈9例,治愈好转率67.9%。所有病例术后均未出现附睾炎、逆行射精、尿失禁和直肠损伤,偶有射精管梗阻复发或性交时精液自溢等并发症。结论精囊炎症或结石、射精管囊肿或梗阻是导致顽固性血精、射精疼痛、性交后血尿、不育症等男科疾病难治的重要原因,利用腔镜技术行精囊内检查及治疗具有诊断明确、创伤小、效果好、并发症少等优点,是治疗顽固性血精、射精疼痛、性交后血尿、不育症的有效方法。
Objective To investigate the value of transurethral seminal vesicle mirror technique in the diagnosis and treatment of male diseases. Methods 28 cases of male diseases were selected, including 18 cases of intractable semen, 5 cases of infertility, 2 cases of perineal pain, 1 case of lower abdominal pain after ejaculation, 1 case of ejaculation weakness with less semen, 1 case of post-intercourse hematuria . Age 18 to 63 years, mean (38 ± 13) years. Under anesthesia transurethral placement of F7 / 8.5, F8 / 9.8 ureteroscopy, check the seminal vesicle and vasectomy abdomen, and direct down the flush, holmium laser lithotripsy and broad spectrum antibiotics retention perfusion. Regular follow-up after the patient’s subjective symptoms, semen or spouse pregnancy. Results The operation time of this group was 30 to 140 minutes (mean, 59 ± 29) min. Followed up for 1 to 50 months, with an average of (8 ± 10) months. 12 cases were cured, 7 cases improved, 9 cases were unhealed, the improvement rate was 67.9%. No cases of postoperative epididymitis, retrograde ejaculation, urinary incontinence and rectal injury, occasional recurrent ejaculatory duct obstruction or sexual intercourse when the spit from the overflow and other complications. Conclusion Seminal vesicle inflammation or stones, ejaculatory duct cysts or obstruction is the leading cause of intractable semen, ejaculation pain, post-intercourse hematuria, infertility and other male diseases refractory to the use of endoscopic seminal vesicle examination and treatment with a clear diagnosis , Trauma, good effect, fewer complications, etc., is the treatment of intractable semen, ejaculation pain, hematuria after sexual intercourse, an effective method of infertility.