青年男性输尿管下段结石行体外冲击波碎石治疗对其精液的影响分析

目的:探讨体外冲击波碎石(ESWL)治疗青年男性输尿管下段结石对精液的影响。方法:于2010年6月至2014年12月来我院门诊因输尿管下段结石行体外冲击波碎石治疗的青年男性患者340例中,取得同意并配合的患者106例,分别于碎石前及碎石治疗后1周和3个月进行常规精液分析,并将精液标本主要参数进行对比分析。结果:符合标准的患者共106例,失访14例,92例获得完整随访。92例患者中,术后7d精液中精子密度、精子畸形率及活率降低者分别为16例(17.3%)、26例(28.3%)和18例(19.6%),与术前比较均有统计学意义(P0.05);镜下血精有6例,术后3月则分别为2例(2.1%)、4例(4.3%)和6例(6.5%)与术前比较均无统计学意义(P0.05);无镜下血精。结论:体外冲击波碎石对青年男性输尿管下段结石是安全有效的方法,短期内可出现精子密度、精子活力降低,畸形精子率增加,镜下血精等,但随着时间推移,精液质量逐渐恢复。

Impact of extracorporeal shock wave lithotripsy on the semen of young men with distal ureteral stones

Objectives:To investigate the effect of extracorporeal shock wave lithotripsy (ESWL) on the semen of young men with distal ureteral stones.Methods:340 young male patients with distal ureteral stone treated with ESWL were in our hospital outpatient from June 2010 to December 2014.106 of them were recruited in the study.The semen of the 106 subjects were collected by masturbation for routine semen analysis before,1 week and 3 months after treatment respectively and the main parameters of semen samples were compared and analyzed.Results:14 patients were lost in the follow-up.In the other 92 patients,there were 16 cases (17.3％),26 cases (28.3％) and 18 cases (19.6％) with decreased sperm density,sperm deformity rate and activities rate respectively 7 days after treatment,with statistically significant difference compared with those before treatment (P ＜ 0.05),and there were 6 cases with hematospermia.In the postoperative 3 months,those with decreased sperm density,sperm deformity rate and activities rate were 2 cases (2.1％),4 cases (4.3％) and6 cases (6.5％) respectively,without statistically significant difference compared with those before treatment (P ＞ 0.05),and there were no hematospermia.Conclusion:ESWL is an effective treatment method for young male patient with distal ureteral stone,characterized with decreased sperm density and sperm motility,increased sperm malformation rate and hematospermia in the short term,but the semen quality can gradually recover over time.