Lindner Uri, Ramon Jacob, Mor Yoram
Department of Urology, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Harefuah. 2007 Jan;146(1):53-6, 77.
The incidence of adolescent varicocele is 15% and it might cause damage to the developing testis and subsequently even impair fertility. Adolescent varicocele is usually asymptomatic and the diagnosis is often made during routine physical examination. The precise etiology of varicocele or the mechanism by which varicocele impairs fertility is not totally elucidated. The indications for interventional treatment are still controversial, though there appears to be a consensus that treatment should be offered to adolescents suffering from meaningful reduction of the ipsilateral testicular volume. There is also an ongoing controversy regarding the preferred surgical approach and the advantages of radiographic occlusion of the spermatic veins via venography. Eventually, in adolescents who receive timely treatment, there is a recovery in testicular volume, an up-rise in serum FSH, better response to gonadotropin stimulation and ultimately improved spermatograms. Herein, we review the current relevant literature with special focus upon the controversial issues.
青少年精索静脉曲张的发病率为15%，它可能会对发育中的睾丸造成损害，进而甚至损害生育能力。青少年精索静脉曲张通常无症状，诊断往往在常规体格检查时作出。精索静脉曲张的确切病因或其损害生育能力的机制尚未完全阐明。尽管似乎已达成共识，即应对患侧睾丸体积有明显缩小的青少年进行治疗，但介入治疗的指征仍存在争议。关于首选的手术方法以及通过静脉造影对精索静脉进行放射学闭塞的优势也存在持续的争议。最终，在接受及时治疗的青少年中，睾丸体积会恢复，血清促卵泡激素升高，对促性腺激素刺激的反应更好，最终改善精液检查结果。在此，我们回顾当前的相关文献，特别关注有争议的问题。
