Seminal vesicle examination

Each of the seminal vesicles is located on the outer side of the ampulla of the vas deferens. It has a long elliptical sac shape and is about 3 to 5 cm long. It looks like a milky white transparent state. It secretes seminal fluid, which accounts for about 70% of the semen volume. The lower end of the seminal vesicle is a thin discharge tube, which is combined with the end of the ampulla of the vas deferens to form an ejaculatory duct. The ejaculation tube is about 2 cm long and penetrates the prostate from the base of the prostate. It is open to the fine sputum and is also a channel for transporting semen. The seminal vesicle examination is the examination of semen, including sperm acrosome integrity rate examination, sperm trajectory analysis, and biochemical examination of seminal plasma. Basic Information Specialist classification: male examination check classification: semen and prostatic fluid examination Applicable gender: whether the male is fasting: not fasting Including items: sperm climbing test, sperm agglutination test, sperm acrosome integrity rate check Tip: Before leaving semen, the patient should stop sexual intercourse for 4 to 7 days. Normal value 1. The normal reference value of the acrosome integrity rate of normal males is >75%. 2, fine in the normal movement track. 3. Biochemical examination of seminal plasma (1) The measurement of fructose is generally carried out by the resorcinol method, and the normal value is 256 ± 104 mg/dl. (2) Trace elements play an important role in male reproductive and reproductive endocrine functions. Zinc in normal semen is 130±56μg/ml, copper is 1.85±0.15μg/ml, and iron is 0.81±004μg/ml. (3) Citric acid was determined by furthherrmann reaction, and the normal value was 56±2.0 mg/dl. (4) Protein was measured by the double urinary method. The normal person is 3.6 ± 0.8 g / dl. (5) Acid phosphatase was measured by the β-glycerol phosphate method. The normal value is 882 ± 412 Brine units / ml. The test result was normal and negative. Clinical significance Abnormal result 1, sperm acrosome integrity rate <75%, suggesting male infertility. 2. Abnormal sperm movement speed indicates abnormal sperm. 3. Determination of refined berry sugar content The concentration of refined berry sugar is greater than 8.3 mmol/L or 13 mmol/primary ejaculation. Reduced berry sugar is found in androgen secretion and seminal vesiculitis; sperm berry sugar is also found in congenital seminal vesicle absence, azoospermia or seminal vesicle dysplasia caused by azoospermia and retrograde ejaculation; and simple vas deferens obstructive azoospermia The fructose content is normal. 4, seminal plasma acid phosphatase determination of prostatitis, the acid phosphatase content in the seminal plasma decreased, when the acid phosphatase increased, the prostate disease (early prostate cancer or benign prostatic hypertrophy) has diagnostic value. Positive results may be diseases: testicular hydrocele, male infertility, blood syndrome considerations Forbidden before examination: Before leaving semen, the patient should stop sexual intercourse for 4 to 7 days. Testosterone propionate, testosterone phenylacetate, and nantrolone phenylpropionate could not be used 1 week before the test. Drinking should be stopped within 1 month before the test. This must be done. Requirements for inspection: 1. When taking semen, you can use soft soap or paraffin oil for penile massage, collect the specimens in sterile test tubes; use condoms (wash clean, no spermicides) or use semen interruption method to collect semen, but this way The amount collected is often small. 2. If the semen is not obtained by the above method, the seminal vesicle and the end of the vas deferens can be massaged through the rectum, and the urine can be collected to check whether there is sperm in the sediment. 3. Do not expose semen to overheated and cold conditions. Hand it to the doctor for reference, no more than 30 minutes. Keep warm in cold weather, and keep it in your underwear pocket when you send it. 4. If bacterial culture is to be carried out, the urethral opening should be rinsed and disinfected, and the semen should be collected in a sterile test tube. 5. If you are not giving birth, both husband and wife must go to check. Inspection process First, the sperm acrosome integrity rate check Analysis of sperm acrosome integrity requires smearing and staining of sperm and analysis of sperm morphology. According to the shape and damage of the acrosome, the sperm acrosome is divided into four types. Type I: The acrosome is intact, the sperm morphology is normal, the coloration is uniform, the acrosome edge is neat, and sometimes the clear equatorial plate is visible. Type II: The acrosome is slightly inflated, and the sperm plasma membrane (acrosomal membrane) is loosely enlarged. Type III: Acrosome destruction, the sperm plasma membrane is severely expanded and destroyed, the coloration is shallow, and the edges are not neat. Type IV: The acrosome is completely detached and the sperm nuclei are bare. Types II, III, and IV are all acrosomal incomplete sperm. When calculating the acrosome integrity rate, 200 sperms are generally counted, and the percentage of spermatozoa of type I acrosome is counted. Acrosome integrity rate (%) = acrosome intact sperm count / total sperm count × 100%. Second, sperm trajectory analysis The semen is placed in the semen automatic analysis system. The semen automatic analysis system can record the sperm trajectory for 3 seconds in real time, and its trajectory map reflects the real movement of the sperm. It can provide a variety of parameters that describe the state of sperm movement, and the image output shows the movement of the sperm to determine the fertilization of the sperm. Third, the biochemical examination of seminal plasma When performing biochemical examination of semen, the semen specimen should be placed in a water bath at 35 ° C ~ 37 ° C. After liquefaction, centrifuge at 1.2 ~ 1.5 ml for 15 minutes, and take the upper layer of seminal plasma for biochemical determination. Most of the tests currently carried out are fructose, trace elements, citric acid, protein, acid phosphatase, lactate dehydrogenase x and so on. (1) Determination of fructose: The resorcinol method is generally used, and the normal value is 256 ± 104 mg/dl. Fructose is mainly secreted by the seminal vesicle, which is the main source of sperm energy metabolism and is related to sperm motility. Fructose is zero, and the absence of seminal vesicles should be considered. When the seminal vesicle has inflammation, the fructose content decreases. In addition, the androgen deficiency and the fructose content in the elderly are reduced, and the amount of fructose in the seminal plasma is higher in diabetes. (2) Trace elements: play an important role in male reproductive and reproductive endocrine function. The zinc in normal semen was 130±56 μg/ml, copper: 1.85±0.15 μg/ml, and iron: 0.81±004 μg/ml. Zinc in semen can affect sperm metabolism, and is directly proportional to sperm motility and density, and can affect the gonads indirectly by affecting the pituitary gland. When zinc is insufficient, the secretion of pituitary gonadotropin is reduced, making gonadal dysplasia, or The reproductive and endocrine functions of the gonads are impaired. Copper can affect sperm survival and activity, copper concentration in semen is high, and sperm activity is poor. (3) Citric acid: measured by furthherrmann reaction, the normal value is 56±2.0mg/dl, mainly from the prostate, regulating the concentration of calcium in semen, affecting the liquefaction of semen, and having the action of prostatic acid phosphatase activator, thus affecting sperm motility . When the prostate has inflammation, the citric acid content is significantly reduced. (4) Protein: Determined by the double urine method. The normal person is 3.6 ± 0.8 g / dl. The protein in semen is mainly from the seminal vesicle and prostate, which can promote sperm motility and protect sperm from environmental harmful effects. (5) Acid phosphatase: measured by the method of β-glycerophosphate. The normal value is 882 ± 412 Brine units / ml. The enzyme is mainly from the prostate. It is related to the vitality and metabolism of sperm. In prostatitis, the content of acid phosphatase in seminal plasma decreases; early prostate cancer or benign prostatic hypertrophy, acid phosphate enzyme content often increases. (6) Sperm-specific enzyme-Lactate dehydrogenase isozyme has relative tissue specificity and has a certain relationship with spermatogenic function. Not suitable for the crowd There are no specific taboos for this check. Adverse reactions and risks This test is less invasive and generally does not cause serious complications or other hazards.