University Department of Growth and Reproduction, Rigshospitalet, and International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Fertility, Rigshospitalet, Copenhagen, Denmark.
Eur Urol. 2016 Dec;70(6):1019-1029. doi: 10.1016/j.eururo.2016.06.044. Epub 2016 Jul 14.
Present knowledge on the impact of varicoceles on testicular function is largely based on studies of subfertile and infertile men, making it difficult to extrapolate the impact of varicocele on the general population.
To describe associations between varicocele and testicular function assessed by semen analysis and reproductive hormones in men from the general population.
DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional multicentre study of 7035 young men, median age 19 yr, from the general population in six European countries (Denmark, Finland, Germany, Estonia, Latvia, and Lithuania) were investigated from 1996 to 2010.
We analysed results from physical examination, conventional semen variables, and serum reproductive hormones using multivariable regression analyses.
A total of 1102 (15.7%) had grade 1-3 varicocele. Increasing varicocele grade was associated with poorer semen quality, even in grade 1 varicocele. In grade 3 varicocele, sperm concentration was less than half of that in men with no varicocele. Presence of varicocele was also associated with higher serum levels of follicle-stimulating hormone, lower inhibin B, and higher levels of luteinising hormone; testosterone and free testosterone were not significantly different between men with and without varicocele. This study cannot draw a conclusion on the progressiveness of varicocele or the effect of treatment.
We demonstrated an adverse effect of increasing grade of varicocele on testicular function in men not selected due to fertility status.
The presence and increasing grade of varicocele is adversely associated with semen quality and reproductive hormone levels in young men from the general population.
目前关于精索静脉曲张对睾丸功能影响的知识主要基于对不育和不孕男性的研究，因此难以推断精索静脉曲张对一般人群的影响。
描述普通人群中精索静脉曲张与精液分析和生殖激素评估的睾丸功能之间的关系。
设计、地点和参与者：这是一项横断面多中心研究，共纳入了来自丹麦、芬兰、德国、爱沙尼亚、拉脱维亚和立陶宛等六个欧洲国家的 7035 名年龄中位数为 19 岁的普通人群中的年轻男性，研究于 1996 年至 2010 年进行。
我们使用多变量回归分析方法分析了体格检查、常规精液变量和血清生殖激素的结果。
共有 1102 名（15.7%）男性患有 1-3 级精索静脉曲张。精索静脉曲张程度的增加与精液质量下降相关，即使在 1 级精索静脉曲张中也是如此。在 3 级精索静脉曲张中，精子浓度不到无精索静脉曲张男性的一半。精索静脉曲张的存在也与血清卵泡刺激素水平升高、抑制素 B 水平降低和黄体生成素水平升高相关；精索静脉曲张男性和非精索静脉曲张男性的睾酮和游离睾酮水平无显著差异。本研究无法确定精索静脉曲张的进展性或治疗效果。
我们在未因生育状况而选择的男性中发现，精索静脉曲张程度的增加与睾丸功能下降相关。
普通人群中精索静脉曲张的存在和程度的增加与年轻男性的精液质量和生殖激素水平呈负相关。
