Salem H K, Mostafa T
Urology Departments, Faculty of Medicine, Cairo University, Cairo 11562, Egypt.
Andrologia. 2009 Aug;41(4):241-5. doi: 10.1111/j.1439-0272.2009.00926.x.
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.
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。