Majzoub Ahmad, Esteves Sandro C, Gosálvez Jaime, Agarwal Ashok
Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Asian J Androl. 2016 Mar-Apr;18(2):205-12. doi: 10.4103/1008-682X.172642.
Varicocele is a common medical condition entangled with many controversies. Though it is highly prevalent in men with infertility, still it marks its presence in males who do have normal fertility. Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who benefitted the most from surgery. Since conventional semen analysis has been limited in its ability to evaluate the negative effects of varicocele on fertility, a multitude of specialized laboratory tests have emerged. In this review, we examine the role and significance of specialized sperm function tests with regards to varicocele. Among the various tests, analysis of sperm DNA fragmentation and measurements of oxidative stress markers provide an independent measure of fertility in men with varicocele. These diagnostic modalities have both diagnostic and prognostic information complementary to, but distinct from conventional sperm parameters. Test results can guide management and aid in monitoring intervention outcomes. Proteomics, metabolomics, and genomics are areas; though still developing, holding promise to revolutionize our understanding of reproductive physiology, including varicocele.
精索静脉曲张是一种存在诸多争议的常见病症。尽管它在不育男性中极为普遍，但在生育能力正常的男性中也有出现。确定哪些患者受到精索静脉曲张的负面影响，将使临床医生能够更好地挑选出那些从手术中获益最大的男性。由于传统的精液分析在评估精索静脉曲张对生育能力的负面影响方面能力有限，因此出现了许多专门的实验室检测方法。在本综述中，我们探讨了专门的精子功能检测对于精索静脉曲张的作用和意义。在各种检测中，精子DNA碎片分析和氧化应激标志物测量为精索静脉曲张男性的生育能力提供了独立的衡量指标。这些诊断方法具有与传统精子参数互补但又不同的诊断和预后信息。检测结果可指导治疗并有助于监测干预效果。蛋白质组学、代谢组学和基因组学领域虽然仍在发展，但有望彻底改变我们对包括精索静脉曲张在内的生殖生理学的理解。
