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精索静脉曲张修复术中保留睾丸动脉。

Preserved testicular artery at varicocele repair.

作者信息

Salem H K, Mostafa T

机构信息

Urology Departments, Faculty of Medicine, Cairo University, Cairo 11562, Egypt.

出版信息

Andrologia. 2009 Aug;41(4):241-5. doi: 10.1111/j.1439-0272.2009.00926.x.

DOI:10.1111/j.1439-0272.2009.00926.x
PMID:19601936
Abstract

Whether or not varicocele causes infertility is a contentiously debated issue. This study aimed to compare semen parameters and pregnancy rate in infertile males who underwent varicocelectomy with preserved or accidentally ligated testicular artery. Ninety-five infertile oligoasthenozoospermic patients with left-sided varicocele were subjected to subinguinal varicocelectomy with trial of preserving testicular artery. According to absence or presence of testicular artery in the histological excised pedicle the cases were divided into two groups; group 1 (n = 60) with preserved testicular artery and group 2 (n = 35) where the artery was accidentally ligated being not defined or injured. Semen analysis was carried out after 4, 8 and 12 months and post-operative pregnancy rate was assessed after 1 year. Serum follicle-stimulating hormone (FSH), luteinising hormone (LH) and total testosterone (T) were estimated pre- and post-operatively. Semen parameters (total sperm count, sperm concentration and sperm motility) showed significant increase post-operatively compared with pre-operative parameters but were comparable in both groups with no significant difference. Serum FSH, LH, T hormones and pregnancy rate (23.3% versus 22.9%) 1 year post-operatively showed no significant difference. It is concluded that accidental ligation of testicular artery has no deleterious effect on semen parameters during primary varicocele repair if the testicular arterial supply was not compromised.

摘要

精索静脉曲张是否会导致不育是一个备受争议的问题。本研究旨在比较接受精索静脉结扎术时保留或意外结扎睾丸动脉的不育男性的精液参数和妊娠率。95例左侧精索静脉曲张的不育少弱精子症患者接受了腹股沟下精索静脉结扎术,并尝试保留睾丸动脉。根据组织学切除蒂部中睾丸动脉的有无,将病例分为两组;第1组(n = 60)保留睾丸动脉,第2组(n = 35)动脉意外结扎,未明确或受损。术后4、8和12个月进行精液分析,术后1年评估妊娠率。术前和术后测定血清促卵泡激素(FSH)、黄体生成素(LH)和总睾酮(T)。精液参数(总精子数、精子浓度和精子活力)术后与术前参数相比有显著增加,但两组之间具有可比性,无显著差异。术后1年血清FSH、LH、T激素和妊娠率(23.3%对22.9%)无显著差异。得出的结论是,如果睾丸动脉供应未受影响,在原发性精索静脉曲张修复过程中意外结扎睾丸动脉对精液参数没有有害影响。

相似文献

1
Preserved testicular artery at varicocele repair.精索静脉曲张修复术中保留睾丸动脉。
Andrologia. 2009 Aug;41(4):241-5. doi: 10.1111/j.1439-0272.2009.00926.x.
2
Predictive indicators of successful varicocele repair in men with infertility.不育男性精索静脉曲张修复成功的预测指标。
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3
[Laparoscopic varicocele ligation. The comparative assessment of artery-ligating and artery-preserving varicocelectomy].[腹腔镜精索静脉曲张结扎术。动脉结扎与保留动脉的精索静脉切除术的对比评估]
Wiad Lek. 2001;54(11-12):621-31.
4
Bilateral is superior to unilateral varicocelectomy in infertile males with left clinical and right subclinical varicocele: a prospective randomized controlled study.对于患有左侧临床型和右侧亚临床型精索静脉曲张的不育男性,双侧精索静脉曲张切除术优于单侧:一项前瞻性随机对照研究。
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5
Should the testicular artery be preserved at varicocelectomy?精索静脉曲张手术时是否应保留睾丸动脉?
J Urol. 1993 May;149(5 Pt 2):1357-60. doi: 10.1016/s0022-5347(17)36391-7.
6
Microsurgical inguinal varicocelectomy with and without testicular delivery.有和没有睾丸提出的显微外科腹股沟精索静脉曲张切除术。
Urology. 2006 Dec;68(6):1323-6. doi: 10.1016/j.urology.2006.08.1113.
7
Effect of varicocelectomy on sperm parameters and pregnancy rate in patients with subclinical varicocele: a randomized prospective controlled study.精索静脉曲张切除术对亚临床精索静脉曲张患者精子参数及妊娠率的影响:一项随机前瞻性对照研究。
J Urol. 1996 May;155(5):1636-8.
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[The value of pre-operative semen analysis as a restore index of fertilizing capacity after varicocelectomy].[术前精液分析作为精索静脉曲张切除术后受精能力恢复指标的价值]
Zhonghua Nan Ke Xue. 2006 Feb;12(2):145-7.
9
The varicocele and male infertility.精索静脉曲张与男性不育症。
Urol Clin North Am. 1981 Feb;8(1):41-51.
10
Predictors of improved seminal characteristics by varicocele repair.精索静脉曲张修复术后精液特征改善的预测因素
Andrologia. 2009 Feb;41(1):20-3. doi: 10.1111/j.1439-0272.2008.00882.x.

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Preserving one artery shortens the surgical time and does not affect the efficacy of microsurgical subinguinal varicocelectomy: preliminary findings from a retrospective study.保留一条动脉可缩短手术时间且不影响显微镜下腹股沟下精索静脉高位结扎术的疗效:一项回顾性研究的初步结果
BMC Urol. 2024 Dec 21;24(1):277. doi: 10.1186/s12894-024-01670-x.
2
Effects of Varicocele Surgical Repair on Serum Hormone and Inhibin B Levels for Patients With Varicocele: A Systematic Review and Meta-Analysis.精索静脉曲张手术治疗对精索静脉曲张患者血清激素和抑制素 B 水平的影响:系统评价和荟萃分析。
Am J Mens Health. 2023 Sep-Oct;17(5):15579883231199400. doi: 10.1177/15579883231199400.
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Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data.
精索静脉曲张修复术能否改善传统精液参数?一项前后数据的荟萃分析研究。
World J Mens Health. 2024 Jan;42(1):92-132. doi: 10.5534/wjmh.230034. Epub 2023 Jun 22.
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Novel method of using angioembolization for treating testicular hemorrhage after blunt trauma.使用血管栓塞术治疗钝性创伤后睾丸出血的新方法。
Radiol Case Rep. 2022 Mar 21;17(5):1692-1695. doi: 10.1016/j.radcr.2022.02.043. eCollection 2022 May.
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Effect of Varicocelectomy on Serum FSH and LH Levels for Patients with Varicocele: a Systematic Review and Meta-analysis.精索静脉曲张切除术对精索静脉曲张患者血清促卵泡生成素和促黄体生成素水平的影响:一项系统评价和Meta分析
Indian J Surg. 2018 Jun;80(3):233-238. doi: 10.1007/s12262-016-1571-1. Epub 2016 Dec 23.
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Anatomical factors affecting the time required for microsurgical subinguinal varicocelectomy.影响显微外科腹股沟下精索静脉曲张切除术所需时间的解剖学因素。
Springerplus. 2016 Jul 8;5(1):1031. doi: 10.1186/s40064-016-2689-0. eCollection 2016.
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The role of testicular artery in laparoscopic varicocelectomy: a systematic review and meta-analysis.睾丸动脉在腹腔镜精索静脉曲张结扎术中的作用:一项系统评价和荟萃分析。
Int Urol Nephrol. 2016 Jun;48(6):955-65. doi: 10.1007/s11255-016-1254-7. Epub 2016 Mar 12.
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Varicocele repair in severe oligozoospermia: A case report of post-operative azoospermia.重度少精子症患者的精索静脉曲张修复术:术后无精子症病例报告
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