ミュラー管嚢胞による閉塞性無精子症

A CASE OF OBSTRUCTIVE AZOOSPERMIA TRIGGERED BY MULLERIAN DUCT CYST, FOR WHICH PREGNANCY WAS DONE WITH SPERMATOZOA COLLECTION BY EPIDIDYMAL MICROPUNCTURE DUE TO INEFFECTIVE TRANSURETHRAL OPERATION

　30歳男性。無精子症。精巣生検で造精機能正常。精管，精嚢造影にて，左右の精嚢は正常大であるが，その中央に嚢胞が造影され，尿道，膀胱は造影されない。両側精管のミュラー管嚢胞への開口，およびこれに伴う閉塞性無精子症と診断。経尿道的手術により，尿道とミュラー管嚢胞を交通させたが，その後も精液検査では無精子症が持続。精巣上体での閉塞合併が考えられ，精巣上体微小穿刺による精子採取，顕微授精を施行し，双子の妊娠に成功した。

A 30-year old male, without child for 4 years after marriage was diagnosed as azoospermia after semen analysis. A testis biopsy showed normal spermatozoa. Vasoseminal vesiculography also showed that rigt and left seminal vesicles were normal in size, but at its center had a cyst without the communication to the urethra and the urinary bladder. This finding with transrectal ultra-sound, CT, and MRI examinations led to the diagnosis of the Mullerian duct cyst with abnormal opening of seminal ducts which caused obstructive azoosperm.