Nabi G, Asterlings S, Greene D R, Marsh R L
Academic Unit of Urology, Department of Surgery, University of Aberdeen, Foresterhill, Scotland, United Kingdom.
Urology. 2004 Feb;63(2):359-63. doi: 10.1016/j.urology.2003.09.026.
To assess the technical feasibility and compare the semen quality in men with or without pregnancy after percutaneous embolization of varicoceles in the management of infertility.
The records of 102 patients who underwent retrograde varicocele embolization between January 1997 and January 2002 were reviewed through the Hospital Information Support System. Infertility was the indication for embolization in 71 cases. The present study consisted of this group of patients. The size of the varicoceles, the size of the testis, the pre-embolization semen analysis parameters, the technical details of embolization procedure, any anomalous vessels seen on venography, and, if unsuccessful, the reason for failure of the procedure were noted. A record of postembolization semen parameters (at least two) was made. Patients were divided into four groups depending on the pre-embolization semen density, and a correlation of this was assessed with improvements in morphology and motility. Follow-up was performed using a questionnaire to evaluate the success rate of the procedure, complications, and any treatment for infertility by the patient or his partner after the procedure. Patients who had a successful pregnancy were compared with those who did not to determine the correlation between the changes in semen quality and pregnancy rate.
Between January 1997 and January 2002, 71 patients underwent retrograde varicocele embolization, using an embolizing coil, for infertility. In 68 (95.7%), it was technically successful. Nineteen patients (26.7%) had various anomalous vessels on venography. A statistically significant improvement (P = 0.002) was noted in the motility parameters in patients with a pre-embolization semen density between 10 and 30 million/mL. All patients were followed up by questionnaire. Follow-up was possible in 51 patients (75%). One patient had varicocele recurrence and underwent open inguinal surgical ligation. Of 45 patients, the partners of 18 (40%) had a successful pregnancy. A comparison of the postembolization semen quality between those with and without a successful pregnancy found no correlation between the changes in the semen parameters and the pregnancy rate.
Varicocele embolization is a technically feasible, minimally invasive, outpatient procedure that improves semen quality significantly in patients with a pre-embolization semen density of 10 to 30 million/mL. However, no correlation was found between the improvements in semen quality and the pregnancy rate.
评估经皮栓塞精索静脉曲张治疗不孕症时，男性患者进行该操作的技术可行性，并比较有或无妊娠男性的精液质量。
通过医院信息支持系统回顾了1997年1月至2002年1月期间接受逆行精索静脉曲张栓塞术的102例患者的记录。71例患者因不孕症接受栓塞治疗。本研究即由这组患者组成。记录精索静脉曲张的大小、睾丸大小、栓塞前精液分析参数、栓塞操作的技术细节、静脉造影中发现的任何异常血管，若操作失败，记录失败原因。记录栓塞后精液参数（至少两项）。根据栓塞前精液密度将患者分为四组，并评估其与形态和活力改善之间的相关性。采用问卷调查进行随访，以评估该操作的成功率、并发症以及患者或其伴侣术后针对不孕症采取的任何治疗措施。将成功妊娠的患者与未成功妊娠的患者进行比较，以确定精液质量变化与妊娠率之间的相关性。
1997年1月至2002年1月期间，71例患者因不孕症接受了使用栓塞线圈的逆行精索静脉曲张栓塞术。其中68例（95.7%）技术成功。19例患者（26.7%）在静脉造影中有各种异常血管。栓塞前精液密度在1000万至3000万/mL之间的患者，其活力参数有统计学意义的改善（P = 0.002）。所有患者均通过问卷调查进行随访。51例患者（75%）得以随访。1例患者精索静脉曲张复发，接受了开放腹股沟手术结扎。45例患者中，18例（40%）的伴侣成功妊娠。比较成功妊娠和未成功妊娠患者栓塞后的精液质量，发现精液参数变化与妊娠率之间无相关性。
精索静脉曲张栓塞术是一种技术可行、微创的门诊手术，可显著改善栓塞前精液密度为1000万至3000万/mL患者的精液质量。然而，精液质量的改善与妊娠率之间未发现相关性。
