Turner T T
Department of Urology, University of Virginia School of Medicine, Charlottesville 22908, USA.
Hum Reprod Update. 2001 Jan-Feb;7(1):78-84. doi: 10.1093/humupd/7.1.78.
The pathophysiology of the varicocele has received considerable study, both in humans and in animal models. Mechanistic information is difficult to obtain from human subjects because study designs must not be invasive and the subject population is variable in the status of the varicocele, patient age, fertility or other health-related issues. Because of these limitations, animal models of varicocele have been developed in several species, the most common being the rat. Surgery to establish the varicocele involves partial obstruction of the left renal vein, causing a varicosity of the left spermatic vein, including the pampiniform plexus. Studies using this model have shown that experimental left varicocele induces bilateral increases in testicular blood flow and temperature contemporaneous with decreases in intratesticular testosterone and testicular sperm output. Spermatic vein reflux is not related to the pathophysiological consequences of experimental varicocele. Many questions remain regarding the mechanism by which varicocele induces testicular dysfunction, chief among them being how the unilateral varicocele causes a bilateral testicular response in the first place.
精索静脉曲张的病理生理学已经在人类和动物模型中得到了大量研究。由于研究设计不能具有侵入性，且研究对象群体在精索静脉曲张的状态、患者年龄、生育能力或其他健康相关问题方面存在差异，因此很难从人类受试者那里获得机制方面的信息。由于这些限制，已经在多个物种中建立了精索静脉曲张的动物模型，最常见的是大鼠。建立精索静脉曲张的手术包括部分阻塞左肾静脉，导致左精索静脉（包括蔓状静脉丛）曲张。使用该模型的研究表明，实验性左侧精索静脉曲张会导致双侧睾丸血流和温度升高，同时睾丸内睾酮和睾丸精子输出减少。精索静脉反流与实验性精索静脉曲张的病理生理后果无关。关于精索静脉曲张诱发睾丸功能障碍的机制仍有许多问题，其中最主要的是单侧精索静脉曲张最初是如何引起双侧睾丸反应的。
