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目的探讨输精管内滤过装置(IVD)术后出现血精的原因及处理对策。方法对5例行IVD置入术后出现血精的患者进行检查和治疗:(1)阴囊检查3例。1例有附睾淤积症状者行单侧输精管IVD取出并输精管复通术,1例痛性结节症状者行双侧输精管结节切除并输精管复通术,1例行单侧输精管复通术。(2)行精囊镜检查1例。(3)给予抗炎止血等保守治疗1例。所有病例确定时间进行随访。结果3例复通术中2例在术后1个月至1年精液检查发现精子,1例复通后1个月精液复查发现少量精子,但其后多次复查精子消失,考虑吻合口堵塞。1例精囊镜检查术中双侧精囊内均未找到IVD。所有病例随访半年以上血精仍没有消失。结论 IVD术后长期的血精应该引起必要的重视,血精症状的反复发作及迁延不愈往往给患者造成巨大的心理压力。输精管节育术后应加强定期随访,及时发现身体异常情况,及时处理,减少IVD严重并发症发生,建议对于放置IVD的年限以及在取出IVD前定期随访都应有严格明确的规定。
Objective To investigate the causes of postoperative seminal stenosis after vasectomy (IVD) and the treatment strategies. Methods Five patients who underwent IVD after operation were examined and treated with hematoma: (1) scrotal examination in 3 cases. One patient with epididymitis symptoms underwent unilateral vas deferens IVD removal and vas deferens recanalization, and one patient with painful nodules underwent bilateral vasectomy and vas deferens regurgitation. One patient underwent unilateral vas deferens recanalization. (2) Seminal cystoscopy in 1 case. (3) given anti-inflammatory and other conservative treatment of hemostasis in 1 case. All cases were confirmed time for follow-up. Results 2 cases of 3 cases of recanalization were detected sperm 1 month to 1 year after sperm examination, 1 case of recanalization 1 month after sperm examination found a small amount of sperm, but after repeated sperm disappeared, consider the anastomotic blockage . One case of seminal vesicle examination did not find IVD in bilateral seminal vesicles. All cases of follow-up of more than six months blood serum has not disappeared. Conclusion Long-term blood serum after IVD should be given the necessary attention, recurrent seizures and prolonged unhealed often cause great psychological pressure on patients. Vet tube surgery should be strengthened after regular follow-up, timely detection of abnormalities in the body, timely treatment to reduce the serious complications of IVD, it is recommended for the placement of IVD and regular follow-up before IVD should be strictly defined.