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[生育及睾丸内分泌功能的小睾丸症症状]

[Symptom of micro-orchism for fertility and endocrine testicular function].

作者信息

Schreiber G, Hipler U C

机构信息

Universitätshautklinik Jena, Erfurter Strasse 35, 07740 Jena.

出版信息

Hautarzt. 2000 Nov;51(11):833-7. doi: 10.1007/s001050051226.

Abstract

BACKGROUND AND OBJECTIVE

There are no reliable findings regarding the frequency and etiology of the spermatogenetic and endocrine functional restrictions in the small testicle (microorchidism). This information is needed to properly assess the risk when multiple testicular biopsies for assisted reproduction techniques lead to further volume reduction.

PATIENTS/METHODS: 535 patients consulting our andrological clinic were included into the study. Orchidometric findings were corelated to spermatological data. Furthermore, FSH, Inhibin B, LH, testosterone and 17 estradiol were analysed. In 116 cases extended andrological studies clarified the etiology of the microorchidism.

RESULTS

26.5% of the patients had a testicular volume < or = 12 ml, 67.1% were in the normal area, 6.4% show a testicular volume > 25 ml. Patients with small testicles had azoospermia in 44.6%, OAT-syndrome in 20.2% and endocrine hypogonadism in 19.8%. The most frequent causes were Klinefelter-syndrome, maldescensus testis, varicocele, secondary atrophies and idiopathic clinical pictures.

CONCLUSIONS

Microorchidism is understood as a one-sided testicular volume < or = 12 ml in adult men. We consider the risky taking of tissue out of the small testicle as avoidable, if predictive diagnostic factors for the discovering of spermatozoa via operation are analysed. An androgen-substitution in microorchidism may be carried out in selected individuals.

摘要

背景与目的

关于小睾丸(小睾症)生精和内分泌功能受限的频率及病因,目前尚无可靠的研究结果。在为辅助生殖技术进行多次睾丸活检导致睾丸体积进一步缩小时,需要这些信息来正确评估风险。

患者/方法:535名到我们男科门诊咨询的患者被纳入研究。睾丸测量结果与精液学数据相关。此外,还分析了卵泡刺激素(FSH)、抑制素B、黄体生成素(LH)、睾酮和雌二醇。在116例患者中,进一步的男科研究明确了小睾症的病因。

结果

26.5%的患者睾丸体积≤12毫升,67.1%处于正常范围,6.4%的患者睾丸体积>25毫升。小睾丸患者中,无精子症占44.6%,少精子、畸形精子、无精子综合征(OAT综合征)占20.2%,内分泌性腺功能减退占19.8%。最常见的病因是克氏综合征、睾丸未降、精索静脉曲张、继发性萎缩和特发性临床表现。

结论

小睾症被认为是成年男性单侧睾丸体积≤12毫升。如果分析通过手术发现精子的预测诊断因素,我们认为从小睾丸中获取组织的风险是可以避免的。对于小睾症患者,可对选定个体进行雄激素替代治疗。

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