Objectives:To explore effect of resectoscope combined with seminal vesiculoscopy in treating patients with ejaculatory duct obstruction azoospermia.Methods:Clinical data of 1 9 patients with ejaculatory duct obstruction azoospermia from March 201 3 to March 201 4 was analyzed.Preoperative sperm or masturbation get se-men was examined as azoospermia.By transrectal prostate,seminal vesicle and testicular ultrasound,CT examina-tion of the prostate gland and seminal vesicles,the diagnosis of ejaculatory duct obstruction azoospermia was con-firmed.One month after the operation,continuous examinations on the semen were done.Results:Under lumbar spinal anesthesia,the Storz F4.8 /6 ureteroscopy with the resectoscope through the prostate capsule seminal vesicu-loscopy was done.Operations for 1 8 patients were successfully completed.Operation for a patient was not completed because of failures on finding ejaculatory duct.The operation time was 30 -50 min.During the operation 7 cases of ejaculatory duct cysts,1 2 cases of ejaculatory duct stenosis or/and obstruction,1 1 cases of seminal vesiculoscopy seminal vesicle mucosal inflammation hyperaemia and scattered bleeding points and 2 cases of seminal vesicle muco-sal inflammatory changing into intraluminal stones were found.All the patients were treated accordingly.Follow -up was done from a month to 1 2 months after the operation,except for two cases,whose semen was found no sperm af-ter 1 2 months.The semen of remaining patients was found sperm in varying degrees at the beginning of the first month.No complications such as epididymitis,retrograde ejaculation,urinary serious injury,rectal injury oc-curred.Conclusions:For resectoscope with seminal vesiculoscopy through the prostate capsule in the treatment of ejaculatory duct obstruction azoospermia,the process is resection of ejaculatory duct cyst and incision occlusion of the ejaculatory duct opening,expansion in the seminal vesiculoscopy,then seminal vesiculoscopy examination in se-minal vesicle cavity under direct vision,removing the obstruction,rinse the deposition of seminal vesicle lumen, which clearly confirms the etiology of azoospermia,before removing obstruction and dredging seminal ductal system. The operation combined resectoscope with seminal vesiculoscopy technology has important clinical value for the treat-ment of ejaculatory duct obstruction azoospermia.%目的：探讨精囊镜联合电切镜在射精管梗阻性无精子症中的应用。方法：分析作者2013年3月至2014年3月间收治的19例射精管梗阻性无精子症患者的临床资料，术前经取精器或手淫获得精液进行检查，示无精子症，经直肠前列腺、精囊腺及睾丸彩超检查，前列腺及精囊腺的 CT 检查，确诊为射精管梗阻性无精子症，腰麻下，利用 Storz F4.8／6输尿管镜，配合电切镜行经前列腺小囊精囊镜检查。术后1个月起，连续复查精液常规。结果：18例患者顺利完成手术，1例因反复寻找射精管开口失败致手术无法完成。手术时间30～50min。术中发现射精管囊肿7例，射精管狭窄和或梗阻12例，精囊镜下精囊壁黏膜炎症性充血、散在出血点11例，精囊黏膜炎症性改变并腔内结石2例，均进行对症治疗。术后1个月起开始随访至术后12个月，除2例患者术后12个月精液常规未发现精子，其余患者在第1个月开始精液中均有不同程度精子的发现。19例患者术后均未出现附睾炎、逆行射精、尿道严重损伤、直肠损伤等并发症。结论：电切镜结合精囊镜经前列腺小囊治疗射精管梗阻性无精子症，先切除射精管囊肿及切开闭塞的射精管开口，经精囊镜扩张，在直视下通过精囊镜检查精囊腔内情况，解除了梗阻，冲洗了淤积的精囊内腔，既明确了无精子症的病因，又解除了梗阻，疏通了精道，该术式将电切镜和精囊镜技术有利结合，对射精管梗阻性无精子症的治疗具有重要的临床价值。
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