Yoshida K, Kitahara S, Chiba K, Horiuchi S, Horimi H, Sumi S, Moriguchi H
Department of Urology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan.
Int J Fertil Womens Med. 2000 Jul-Aug;45(4):279-84.
We sought predictive indicators of functionally successful repair in 168 infertile Japanese males who underwent high ligation of a varicocele via a retroperitoneal approach.
Possible indicators evaluated included age at marriage, duration of infertility, testicular volume, varicocele grade, seminal analysis findings, and serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and testosterone. All patients had palpable or visible unilateral left varicoceles. Success in conception was evaluated in all subjects 1 year after varicocele repair.
No associations were observed between outcome and mean age at marriage, infertility duration, varicocele grade, seminal volume, or serum PRL and testosterone concentrations, but testicular volume, sperm count, percentage of motile sperm, and serum FSH and LH concentrations were significantly associated with outcome. Multiple regression analysis of dependence of outcome revealed testicular volume and serum FSH concentrations to be independent predictors.
Varicocele repair is likely to accomplish fertility in patients with a combined testicular volume of at least 30 mL or serum FSH concentrations lower than 11.7 mIU/mL.
我们在168例通过腹膜后途径行精索静脉曲张高位结扎术的日本不育男性中寻找功能修复成功的预测指标。
评估的可能指标包括结婚年龄、不孕持续时间、睾丸体积、精索静脉曲张分级、精液分析结果以及促卵泡生成素（FSH）、促黄体生成素（LH）、催乳素（PRL）和睾酮的血清浓度。所有患者均有可触及或可见的单侧左侧精索静脉曲张。在精索静脉曲张修复术后1年对所有受试者的受孕成功情况进行评估。
未观察到结局与平均结婚年龄、不孕持续时间、精索静脉曲张分级、精液量或血清PRL和睾酮浓度之间存在关联，但睾丸体积、精子计数、活动精子百分比以及血清FSH和LH浓度与结局显著相关。对结局依赖性的多元回归分析显示睾丸体积和血清FSH浓度是独立的预测指标。
对于合并睾丸体积至少30 mL或血清FSH浓度低于11.7 mIU/mL的患者，精索静脉曲张修复术可能实现生育。
