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尿沉渣中出现精子的患者的临床背景

Clinical Background of Patients with Sperm in Their Urinary Sediment.

作者信息

Tomita Masuomi, Kikuchi Eiji, Maeda Takahiro, Kabeya Yusuke, Katsuki Takeshi, Oikawa Yoichi, Kato Kiyoe, Ohashi Masakazu, Nakamura So, Oya Mototsugu, Shimada Akira

机构信息

Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan.

Department of Urology, Keio University School of Medicine, Tokyo, Japan.

出版信息

PLoS One. 2015 Sep 11;10(9):e0136844. doi: 10.1371/journal.pone.0136844. eCollection 2015.

Abstract

INTRODUCTION

The detection rate and associated factors of at least one sperm in urinary sediment is not well-known in real clinical practice.

AIMS

The aim of the present study was to evaluate the clinical features associated with the presence of sperm in urinary sediment in a large number of samples.

METHODS

We conducted a cross-sectional study at Tokyo Saiseikai Central Hospital. We identified 5,005 males who were aged ≥20 years in whom urinary sedimentation had been performed at least twice between May 2011 and June 2012. The sperm group included patients in whom at least one urinary sediment test performed under a microscope had detected at least one sperm. We evaluated the associations between the presence of at least one sperm in urinary sediment and clinical parameters such as various diseases and the use of particular oral medicines.

MAIN OUTCOMES

In total, 1.6% (339/20,937) of urinary sediment samples contained at least one sperm. The sperm group consisted of 282 subjects (5.6%), and the no-sperm group included 4,723 subjects (94.3%).

RESULTS

Multivariate analysis demonstrated that younger age (<65) (odds ratio [OR]: 1.71, 95% confidence interval [CI]: 1.32-2.21), the total number of examinations (≥4) (OR: 1.46, 95%CI: 1.11-1.92), diabetes (OR: 1.72, 95%CI: 1.31-2.25), a history of pelvic surgery for colon cancer (OR: 4.89, 95%CI: 2.38-10.02), alpha-1 blocker use (OR: 1.55, 95%CI: 1.16-2.08), a history of trans-urethral resection of the prostate (OR: 2.77, 95%CI: 1.46-5.13), and selective serotonin reuptake inhibitor use (OR: 2.12, 95%CI: 1.07-4.19) were independent predictors of the presence of at least one sperm in urinary sediment.

CONCLUSION

There is considerable overlap between the factors associated with the presence of at least one sperm in urinary sediment and those that are strongly associated with ejaculatory disorders.

摘要

引言

在实际临床实践中,尿沉渣中至少发现一条精子的检出率及其相关因素尚不清楚。

目的

本研究旨在评估大量样本中尿沉渣中精子存在的相关临床特征。

方法

我们在东京济生会中央医院进行了一项横断面研究。我们确定了5005名年龄≥20岁的男性,他们在2011年5月至2012年6月期间至少进行了两次尿沉渣检查。精子组包括至少一次显微镜下尿沉渣检查发现至少一条精子的患者。我们评估了尿沉渣中至少一条精子的存在与各种疾病和特定口服药物使用等临床参数之间的关联。

主要结果

总共1.6%(339/20937)的尿沉渣样本含有至少一条精子。精子组由282名受试者(5.6%)组成,无精子组包括4723名受试者(94.3%)。

结果

多变量分析表明,年龄较小(<65岁)(比值比[OR]:1.71,95%置信区间[CI]:1.32 - 2.21)、检查总数(≥4次)(OR:1.46,95%CI:1.11 - 1.92)、糖尿病(OR:1.72,95%CI:1.31 - 2.25)、结肠癌盆腔手术史(OR:4.89,95%CI:2.38 - 10.02)、使用α-1阻滞剂(OR:1.55,95%CI:1.16 - 2.08)、经尿道前列腺切除术史(OR:2.77,95%CI:1.46 - 5.13)以及使用选择性5-羟色胺再摄取抑制剂(OR:2.12,95%CI:1.07 - 4.19)是尿沉渣中至少存在一条精子的独立预测因素。

结论

尿沉渣中至少存在一条精子的相关因素与射精障碍密切相关的因素之间存在相当大的重叠。

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