輸精管取精對於逆行性或無射精患者之經驗
樊樂威、黃靖崴、李威昌、張博誌、許毓昭、黃信介、陳煜、黃世聰、謝明里
林口長庚紀念醫院 外科部 泌尿科
The experience of vassal sperm aspiration on patients with an-ejaculation or retrograde ejaculation
Le-Wei Fan, Ching-Wei Huang, Wei-Chang Li, Po-Chih Chang, Yu-Chao Hsu, Hsin-Chieh Huang, Yu Chen, Shih-Tsung Huang, Ming-Li Hsieh
Divisions of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
Materials and Methods: We retrospectively reviewed vasal sperm aspirations on 10 patients with an-ejaculation or retrograde ejaculation during recent 3 years from 2015 to 2017. We collected pre-operative serum hormonal data (testosterone, follicle-stimulating hormone, luteinizing hormone and prolactin) and comorbidities of each patient. Every patient received standard procedure of vasal sperm
aspiration by single surgeon with immediately specimens interpreting and then was follow-up at clinics.
Results: Of all, 4 patients with retrograde ejaculation and 6 patients with an-ejaculation. There were 7 patients with controlled diabetes mellitus, one with ejaculating duct stone and one with unilateral testicular cancer status post orchiectomy and adjuvant chemotherapy, only one without any comorbidity. Aspirations were performed for use with assisted reproductive techniques in 9 cases and for cryopreservation alone in one. The average total sperm count was 178 × 106, with the motility between 9% and 66.7%. Three of the population had received open testis biopsy or microsurgical epididymal sperm aspiration (MESA) before vasal aspiration but prior result of semen analysis were poor quality for use in vitro fertilization (IVF). No complications have been observed to date.
Conclusions: Vasal sperm aspiration is a simple and effective method as alternative to sperm retrieval, considering its advantage of high successful rate while less invasive and destructive for reproductive system, it could be performed prior to retrieval from epididymis or testis.