摘要
目的探讨苗勒管囊肿的诊断和治疗方法。方法回顾性分析1993年1月至2007年12月诊治的48例苗勒管囊肿患者资料。1993年1月至1997年12月共诊治8例，多因慢性前列腺炎症状就诊并行经直肠超声（TRUS）检查。7例较小囊肿行TRUS引导下经会阴穿刺抽吸囊液，1例较大囊肿行开放手术切除囊肿。2002年1月至2007年12月共诊治40例，多因梗阻性无精子症就诊，均行TRUS检查，其中12例行MRI检查。39例较小囊肿行经尿道囊肿切开引流，1例较大囊肿行腹腔镜下苗勒管囊肿切除。结果1993年1月至1997年12月所诊治的8例患者术后6个月随访只有1例复发，再次行经尿道囊肿切开引流后治愈。2002年1月至2007年12月所诊治的40例患者术后3个月复查TRUS，未见有囊肿复发。术后6个月随访，39例梗阻性无精子症患者中，10例配偶顺利怀孕，其余29例中9例精液中出现精子。1例19岁患者术后症状消失。结论苗勒管囊肿多因慢性前列腺炎症状和梗阻性无精子症就诊。TRUS是诊断苗勒管囊肿的首选检查，MRI则能提供更精确的信息。经尿道苗勒管囊肿切开引流术为苗勒管囊肿的有效治疗手段，对于较大的囊肿腹腔镜下囊肿切除是较好的选择。
Objective To study the diagnosis and treatment methods of Mullerian duct cyst. Methods The records of 48 patients with Mullerian duct cyst were reviewed and the diagnosis and treatment methods were compared. From January 1993 to December 1997, eight patients visited the clinic, most of whom complained of the chronic prostatitis symptom. They all underwent the transrectal ultrasonography （TRUS）. Seven patients were treated by transperineal TRUS-guided aspiration therapy. One patient with the large Mullerian duct cyst was extirpated by open operation. From January 2002 to December 2007, we treated forty patients. Most of them visited us complained of the obstructive azoospermia. All patients were diagnosed by the TRUS and twelve patients underwent MRI examine. Thirty-nine patients with smaller Mnllerian duct cyst were treated by transurethral cyst incision therapy. One patient with large Mullerian duct cyst was extirpated by laparoscopic operation. Results One of the eight patients, recurrence was detected at the half-year＇s follow-up and cured by transurethral cyst incision. All the 40 patients underwent TRUS at three months postoperative follow-up, no cysts recurrence. At the six months postoperative follow-up, ten of thirty-nine patients obstructive azoospermia patients had made their wiles pregnant successfully. Nine patients of the other twenty-nine patients had sperms in semen. One 19 years old patient＇s symptom disappeared. Conclusions The patient with Mullerian duct cyst often complained of chronic prostatitis symptom and the obstructive azoospermia. TURS was the preferred examine method in the diagnosis of the Mullerian duct cyst. And MRI could offer more exact informations. Transurethral cyst incision was effective methods for Mullerian duct cyst. Laparoscopic Mullerian duct cyst resection was a good choice for the large cysts.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2009年第23期1805-1808,共4页
Chinese Journal of Surgery
