遠坂 顕¹, 吉田 謙一郎²

Akira TOSAKA¹, Ken-Ichiro YOSHIDA²

¹埼玉医科大学総合医療センター泌尿器科, ²獨協医科大学泌尿器科

¹Department of Urology Saitama Medical Center of Saitama Medical School, ²Department of Urology Dokkyo University School of Medicine

キーワード : Azoospermia, Ejaculatory duct, Male infertility, Seminal vesicle, Ultrasonography

We used transrectal ultrasonography (TRUS) to look for obstruction of the genital duct in eight azoospermic patients with associated normal-sized testes and compared the results with those obtained with vasoseminal vesiculography (VG), testicular biopsy, or both. TRUS showed abnormal findings suggesting obstruction of the genital duct in five cases and normal findings in the other three. Subsequent VG and testicular biopsy identified three cases of obstruction of the genital duct (two cases of absence of the vas deferens and seminal vesicle and one case of obstruction of the ejaculatory duct) from the five patients with abnormal TRUS findings, and one case of genial-duct obstruction (obstruction of the vas deferens caused by previous bilateral inguinal herniorrhaphy) from the three patients with normal TRUS findings. The patient with obstruction of the ejaculatory duct recieved transurethral resection of the prostatic urethra, resulting in production of semen with a high sperm count (30-50×10⁶/ml). TRUS thus appears to be useful for detecting obstruction of the genital duct in azoospermic patients with associated normal-sized tests.