先天性精囊缺如的临床特点和诊断分析

目的 探讨先天性精囊缺如的临床特点，提高其诊断水平。方法 分析21例患者的临床资料。经超声检查、盆腔CT或精道造影检查确诊。6例行睾丸穿刺活检或附睾穿刺检查。结果 双侧精囊缺如14例，单侧精囊缺如7例。合并先天性双侧输精管缺如（CBAVD）者13例，合并单侧输精管缺如（CUA-VD）者5例，合并双侧输精管异位开口于苗勒管囊肿者1例，同时合并单侧输精管缺如及对侧输精管异位开口于苗勒管囊肿者2例。6例行睾丸或附睾穿刺者均生精功能正常。结论 先天性精囊缺如不会单独出现，常合并输精管缺如或输精管末端异位开口。双侧精囊缺如者无生育能力，单侧精囊缺如者临床表现复杂多变。仔细检查阴囊内容物多可提供重要信息；超声、盆腔CT和精道造影检查可确诊。

Clinical characteritics and diagnosis of congenital agenesis of seminal vesicle

Objective To investigate the clinical features and diagnosis of congenital agenesis of seminal vesicle (CASV).Methods Clinical data of 21 patients were studied.The diagnosis was confirmed by ultrasonography,pelvic computed tomography(CT),and vasography.Six patients received testicular or epididymal puncture.Results Fourteen patients were confirmed with bilateral agenesis of seminal vesicle,and 7 with unilateral agenesis of seminal vesicle.Thirteen patients were associated with congenital bilateral absence of the vas deferens (CBAVD),5 patients were associated with congenital unilateral absence of the vas deferens (CUAVD),1 patient was associated with bilateral vas deferens ectopic into a mullerian duct cyst,2 patients were associated with CUAVD and ectopia of the contralateral vas into mullerian duct cyst simultaneously.Spermatogenesis was potent in those 6 patients who received testicular or epididymal puncture.Conclusion CASV is not an independent abnormity which is frequently associated with congenital absence of the vas deferens or ipsilateral ectopia of the vas deferens.CASV may be present as infertility,azoospermia,low volume,low pH,hematospermia,and so on.Careful examination of the scrotum may reveal absence of the vas deferens,and the diagnosis of CASV should be confirmed by sonography,pelvic CT or vasography.