Abdelwahab Khaled, Eliwa Ahmed M, Seleem Mohamed M, El Galaly Hazem, Ragab Ahmed, Desoky Esam A, Naguib Mohamed, Ali Maged M, Saber Sameh, Kamel Hussain
Urology Department, Zagazig University, Ash Sharqiyah, Egypt.
Urology Department, Zagazig University, Ash Sharqiyah, Egypt.
Urology. 2017 Sep;107:103-106. doi: 10.1016/j.urology.2017.04.026. Epub 2017 Apr 26.
To evaluate the role of preoperative testicular shear wave elastography (SWE) in the prediction of improvement of semen analysis parameters after subinguinal microsurgical varicocele ligation in patients with primary infertility and clinically detectable varicocele.
Testicular SWE before the surgical intervention was done. Forty-eight patients were scheduled for subinguinal microsurgical varicocele ligation as a treatment option. Computer-assisted semen analysis was repeated 6 months after the intervention.
At a cutoff value of 4.5 kPa, the stiffness index had a sensitivity of 86.4% and a specificity of 84.2% for semen parameter improvement after varicocelectomy. Correlation between different parameters of semen analysis and SWE showed a statistically significant negative correlation between SWE stiffness index and both sperm count (million/mL) and total motility. On the other hand, a nonsignificant negative correlation was found between SWE stiffness index and percentage of normal form.
Testicular SWE is a good test that can be used in the assessment of male infertility with clinically detectable varicocele, and its results may predict semen parameter improvement after varicocelectomy. Further studies on a larger number of patients are needed to verify our results.
评估术前睾丸剪切波弹性成像（SWE）在预测原发性不育且临床可检测到精索静脉曲张患者行腹股沟下显微外科精索静脉曲张结扎术后精液分析参数改善情况中的作用。
在手术干预前进行睾丸SWE检查。48例患者计划行腹股沟下显微外科精索静脉曲张结扎术作为治疗选择。干预6个月后重复进行计算机辅助精液分析。
在临界值为4.5 kPa时，硬度指数对精索静脉曲张切除术后精液参数改善的敏感性为86.4%，特异性为84.2%。精液分析不同参数与SWE之间的相关性显示，SWE硬度指数与精子计数（百万/毫升）和总活力均呈统计学显著负相关。另一方面，SWE硬度指数与正常形态百分比之间存在不显著的负相关。
睾丸SWE是一种可用于评估临床可检测到精索静脉曲张的男性不育症的良好检查方法，其结果可能预测精索静脉曲张切除术后精液参数的改善情况。需要对更多患者进行进一步研究以验证我们的结果。
