目的:探讨耻骨上膀胱抽吸术(SBA)在射精后尿液(PEU)精子观察诊断逆行射精(RE)中的作用。然而,在几名受试者中,在尿道中保留的射精被洗掉并排出尿液后,在PEU中也观察到精子。因此,在RE的诊断中检测PEU中的精子存在问题,需要一种更好的方法来克服PEU阳性的歧义,并确定哪个患者经历了真正的RE。
方法:一组患者在一个专科中心接受了为期两年的RE检查。所有患者均行SBA和精液分析。在从膀胱抽吸的尿液和PEU中研究了精子。
结果:32名患者(年龄范围18-62岁)接受了SBA和PEU的RE调查。19例患者在SBA和PEU中均检测到精子,而5例患者仅在PEU中显示精子。在所有19名患者中,SBA中发现的精子平均数少于在PEU中观察到的精子平均数。
结论:SBA是诊断RE的一种可靠可行的方法,可以区分精子向后流入膀胱的真实RE和尿道中残留的射精。整个射精不太可能逆行流动,RE可能是射精部分泄漏到膀胱中。
OBJECTIVE: To investigate the role of suprapubic bladder aspiration (SBA) in the diagnosis of retrograde ejaculation (RE) which is diagnosed with the observation of sperm in post-ejaculatory urine (PEU). However, sperm is also observed in PEU after the wash out of the retained ejaculate in the urethra with the expulsion of urine in several subjects. Therefore, detection of sperm in PEU in the diagnosis of RE is problematic and a better method is needed to overcome the ambiguity of positive PEU and to identify which patient experience true RE.
METHODS: A cohort of patients underwent an examination for RE over a two-year period at a single specialist centre. All patients underwent SBA and semen analysis. Sperm was investigated in urine aspirated from the bladder and in PEU.
RESULTS: Thirty-two patients (age range 18-62 years) underwent SBA and PEU for investigation of RE. Sperm was detected both in SBA and PEU in 19 patients, while 5 patients revealed sperm only in PEU. The mean number of sperm found in SBA was less than the mean number of sperm observed in PEU in all 19 patients.
CONCLUSIONS: SBA is a reliable and feasible method in the diagnosis of RE and can distinguish the true RE in which sperm flows backward into the bladder from the retained ejaculate in the urethra. The whole ejaculate does not likely flow retrogradely and RE could be a partial leakage of the ejaculate into the bladder.