Bezold G, Gottlöber P, Gall H, Peter R U
Department of Dermatology, University of Ulm, Germany.
J Androl. 2000 May-Jun;21(3):403-8.
Seven Georgian male soldiers (19-25 years old) had accidentally been exposed to radiation by Cs-137 between April 1996 and May 1997. No information about the exact time and duration of exposure was available. All patients presented with the subacute stage of Cutaneous Radiation Syndrome with deep painful ulcers on different body sites, predominantly on the legs. Semen analyses showed complete azoospermia in 4 patients, with elevated follicle-stimulating hormone (FSH) in 3 and elevated luteinizing hormone (LH) in 2 of them. One patient had severe oligozoospermia of 7 million sperm per mL, with normal sperm motility and morphology; his FSH and LH levels were elevated. One patient had complete normozoospermia, and the seventh patient had polyzoospermia of 340 million per mL; both of these patients had normal serum hormone levels. Only the patient with oligozoospermia reported a history of delayed testicular descent; his physical examination showed relatively soft and small testicles and a varicocele with considerable reflux. The physical andrological examinations were normal in the other 6 patients. It is very likely that the azoospermia in the 4 patients can be attributed to the radiation accident. In conclusion, it is essential to perform andrological examinations in patients who have been exposed to radiation even if there are only cutaneous injuries detectable, as a high percentage of them can show azoospermia.
1996年4月至1997年5月期间，7名格鲁吉亚男性士兵（年龄在19至25岁之间）意外受到铯-137辐射。关于确切的暴露时间和持续时间没有相关信息。所有患者均表现为皮肤辐射综合征的亚急性期，身体不同部位出现深部疼痛性溃疡，主要集中在腿部。精液分析显示，4名患者完全无精子症，其中3名患者促卵泡生成素（FSH）升高，2名患者促黄体生成素（LH）升高。1名患者严重少精子症，每毫升精液中有700万个精子，精子活力和形态正常；其FSH和LH水平升高。1名患者精子完全正常，第7名患者每毫升精液中有3.4亿个精子，为多精子症；这两名患者血清激素水平均正常。只有少精子症患者有睾丸下降延迟的病史；其体格检查显示睾丸相对柔软且较小，伴有明显反流的精索静脉曲张。其他6名患者的体格和男科检查均正常。4名患者的无精子症很可能归因于辐射事故。总之，对于受辐射的患者，即使仅可检测到皮肤损伤，也必须进行男科检查，因为其中很大一部分可能会出现无精子症。
