超音波法による前立腺と精嚢の嚢胞性変化の診断

Abstract

前立腺とりわけ射精管の拡張は決して稀ではなく, 血精液症, 前立腺肥大症, 前立腺癌の症例にしばしば合併し, 時に, 前立腺, 射精管などの嚢胞性変化が不妊症の原因となりうることがわかった。特に血精液症の原因の一つとして, 射精管の構造異常が深くかかわっている可能性が示唆された

Transrectal ultrasonography (TRUS) has been used extensively to evaluate the lower urinary tract in males, including the prostate gland, seminal vesicles and ejaculatory ducts. Of 475 males who underwent TRUS at Kitasato University Hospital, 43 (9.1%) were found to have cystic changes of these structures. Most of these cystic changes could be identified as being of prostate origin, Wolffian duct origin or Mullerian duct origin by their sonographic appearance and location. Although most patients were asymptomatic, 8 of the 30 men with a complaint of hematospermia had a sonographic finding of cystic changes in the prostate (3 patients) or ejaculatory ducts (5 patients). Inflammation and allergic reaction have been suggested to be related to hematospermia, however, their mechanism remains to unclear. These findings suggest that cystic changes in the ejaculatory duct contribute to hematospermia.