Improvement of sperm count and motility after ligation of varicoceles detected with colour Doppler ultrasonography.
Improvement of sperm count and motility after ligation of varicoceles detected with colour Doppler ultrasonography.
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彩色多普勒超声检测精索静脉结扎后精子数量和活力的改善。
DOI：
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发表时间：
2002
影响因子：
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通讯作者：
Weber
中科院分区：
文献类型：
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作者：
F. Pierik;Vreeburg;Stijnen;J. V. Roijen;G. Dohle;Laméris;Timmers;Weber
关于精索静脉曲张结扎术改善精液参数和妊娠率的有效性的争论仍在继续。此外，对于亚临床精索静脉曲张的治疗益处也没有达成共识。本研究的目的是回顾性调查亚临床和临床精索静脉曲张高位结扎对精子计数和活动力的影响。本文分析了病史和体格检查中的几个因素对精索静脉曲张手术成功的预测价值。共139例患者，手术单侧精索静脉曲张的左侧，进行了研究。根据彩色多普勒超声检查，73例患者的精索静脉曲张为亚临床型，根据触诊和超声检查，66例患者的精索静脉曲张为临床型。手术前后精液参数的比较显示了显着的改善。亚临床和临床精索静脉曲张患者的精子数中位数分别从10.0增加到14.7，从18.2增加到28.6百万/射精（p < 0.001）。亚临床精索静脉曲张患者中位精子计数的改善百分比与临床精索静脉曲张患者的改善百分比无统计学差异。结扎后平均前向运动显著改善（p < 0.001）。亚临床精索静脉曲张的运动改善，从16%到23%，明显大于临床精索静脉曲张的24%到27%的改善。术前精子数增加与睾丸体积呈正相关（P < 0.05）。有隐睾病史的患者精子活力的增加明显较低（n = 22，p < 0.05）。目前的数据表明，结扎精索静脉曲张检测多普勒超声，无论是否可触及，结果在精子浓度和活力的增加。
The debate regarding the efficacy of varicocele ligation for improvement of semen parameters and pregnancy rates is ongoing. In addition, no consensus exists as to the benefit of treatment of subclinical varicoceles. The aim of this study was to investigate, retrospectively, the effect of high ligation of both subclinical and clinical varicoceles on sperm count and motility. The value of several factors from history-taking and physical examination for the prediction of successful varicocelectomy was analysed. A total of 139 patients, operated on for a unilateral varicocele on the left side, were studied. Varicoceles were subclinical in 73 patients, based on colour Doppler ultrasonography, and 66 varicoceles were clinical, based on palpation in addition to ultrasonography. Comparison of semen parameters before and after surgery revealed a significant improvement. The median sperm count increased from 10.0 to 14.7, and from 18.2 to 28.6 million/ejaculate, in patients with subclinical and clinical varicoceles, respectively (p < 0.001). The percentage improvement in median sperm count in subclinical varicoceles was not statistically different from the improvement in clinical varicoceles. Mean progressive motility improved significantly after ligation (p < 0.001). The improvement in motility in subclinical varicoceles, from 16 to 23%, was significantly larger than the 24 to 27% improvement in clinical varicoceles. The increase in sperm count was related positively to testicular volume before surgery (p < 0.05). The increase in sperm motility was significantly lower in patients with a history of cryptorchidism (n = 22, p < 0.05). The present data show that ligation of varicoceles detected using Doppler ultrasonography, whether palpable or not, results in an increase in sperm concentration and motility.