Value of scrotal combined with transrectal ultrasound in the emplacement diagnosis of obstructive azoospermia
10.3760/cma.j.cn101441-20221026-00471
- VernacularTitle:经阴囊联合经直肠超声对梗阻性无精子症定位诊断的价值
- Author:
Rui YANG
1
;
Penglin ZOU
;
Yuchen TAO
;
Qiusheng SHI
;
Lianfang DU
;
Zheng LI
;
Xiaodong JIN
;
Fengbin ZHANG
Author Information
1. 上海交通大学医学院附属第一人民医院超声医学科，上海 201600
- Publication Type:Journal Article
- Keywords:
Microsurgery;
Scrotal ultrasonography;
Transrectal ultrasonography;
Obstructive azoospermia
- From:
Chinese Journal of Reproduction and Contraception
2023;43(10):1057-1061
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the accuracy of imaging findings on scrotal and transrectal ultrasonography in diagnosing the disease of obstructive azoospermia.Methods:Retrospective analysis of the data of 58 patients with azoospermia and infertility were performed who visited the Department of Andrology in the Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2015 to May 2020. Obstructive azoospermia was revealed by ultrasonography and confirmed by surgery. The qualitative and positional parameters on the sonogram were compared with the surgical results.Results:Among 58 patients with obstructive azoospermia diagnosed by ultrasonography, 3 patients with intratesticular obstruction performed microsurgical sperm extraction. In 21 patients with epididymal obstruction, 18 cases were treated by vasoepididymostomy. Six patients with vas deferens obstruction were treated by vasovasostomy. Two cases with low-level ejaculatory duct obstruction were treated by transurethral resection of the ejaculatrory duct, and 1 case with high-level ejaculatory duct obstruction was treated by microsurgical sperm extraction. A total of 25 patients with congenital absence of bilateral vas deferens performed scrotal exploration and sperm collection for assisted reproduction. Sperm was detected in epididymal fluid or testicular tissue in 57 cases. The accuracy of the diagnosis of obstructive azoospermia by ultrasound scan was 98.3% (57/58) with reference to the existence of sperm identified in the surgery. The intraoperative findings of 54 cases were consistent with the preoprerative ultrasound localization, and the coincidence rate of emplacement diagnosis was 93.1% (54/58).Conclusion:Scrotal and transrectal ultrasound can accurately diagnose obstructive azoospermia qualitatively and regionally, which is of great clinical significance for the correct diagnosis and treatment of the disease.
