Martínez-Salamanca Juan I, Hernández Carlos, Jara José, Cabello Ramiro, Moncada Ignacio
Servicio de Urología y Unidad de Andrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Arch Esp Urol. 2004 Nov;57(9):1003-10.
Surgery has been largely indicated for varicocele with the aim of improving semen parameters in male patients with subfertility or infertility. However, the criteria for therapeutic success in which its usefulness has been based on have never been clear. Our objective was to analyze current criteria for therapeutic success after surgical treatment of varicocele, studying in depth the possible influence of varicocele on semen quality, its impact on fertility, and possible advantages of treatment.
We reviewed a group of original articles, systematic reviews, and metanalysis on the issue after MEDLINE search. We mainly focus on randomized placebo-controlled prospective studies the aim of which was to evaluate the improvement in semen quality and/or pregnancy rates in subfertile/infertile couples after treatment of varicocele.
There is great study heterogeneity, both in methods and possible interpretation of results. Although it seems treatment of varicocele may improve some semen quality parameters, it does not seem to represent an effective treatment for male subfertility.
手术治疗精索静脉曲张主要是为了改善患有亚生育力或不育症男性患者的精液参数。然而，其有效性所基于的治疗成功标准一直不明确。我们的目的是分析精索静脉曲张手术治疗后的当前治疗成功标准，深入研究精索静脉曲张对精液质量的可能影响、其对生育能力的影响以及治疗的可能优势。
我们在MEDLINE搜索后回顾了一组关于该问题的原始文章、系统评价和荟萃分析。我们主要关注随机安慰剂对照前瞻性研究，其目的是评估精索静脉曲张治疗后亚生育力/不育夫妇精液质量和/或妊娠率的改善情况。
在方法和结果的可能解释方面，研究存在很大的异质性。虽然精索静脉曲张的治疗似乎可以改善一些精液质量参数，但它似乎并不是男性亚生育力的有效治疗方法。
