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患有精索静脉曲张疾病的无精子症患者应该接受手术来恢复生育能力吗?

Should azoospermic patients with varicocele disease undergo surgery to recover fertility?

作者信息

Alves Leonardo de Souza, Oliveira Francisco Batista de

机构信息

MD, Urologist, Faculdade de Ciências Médicas de Minas Gerais (FCM-MG). Director of Procriar - Instituto de Urologia e Andrologia. Full Member of the Sociedade Brasileira de Urologia (SBU), the American Urological Association (AUA), and the American Confederation of Urology (CAU). Full Member of the Colégio Brasileiro de Cirurgiões (CBC), Belo Horizonte, MG, Brazil.

MD, Gynecologist, Endocrinologist, FCM-MG, Belo Horizonte, MG, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2017 Apr;63(4):332-335. doi: 10.1590/1806-9282.63.04.332.

Abstract

INTRODUCTION

: Varicocele disease is well-known cause of infertility in men. The presence of spermatic varices veins create a hostile environment to spermatogenesis. It results in reduced quality of the sperm production and in some cases can determine a total absence of sperm. The varicocelectomy procedure in patients with non-obstructive azoospermia (NOA) can raise the rates of sperm in the semen analysis. A positive rate for sperm, even if very low, may be sufficient to enable the capture of sperm intended for in-vitro fertilization without the use of donor sperm.

OBJETIVE

: To evaluate the raise of sperm in NOA patients with varicocele disease who were submitted to a bilateral procedure to recovery sperm production.

METHOD

: We analized the sperm results of 25 NOA patients who undergone to a bilateral varicocelectomy procedure.

RESULTS

: From a total of 25 patients, three (12%) recovered sperm count four months after procedure. One year after the procedure, five (20%) patients recovered sperm production.

CONCLUSION

: Patients with varicocele disease and azoospermia, without genetic changes or obstruction of the spermatic tract, should undergo surgical procedure to recover sperm.

摘要

引言

精索静脉曲张疾病是男性不育的常见原因。精索静脉曲张的存在为精子发生创造了不利环境。这导致精子产生质量下降,在某些情况下可导致完全无精子。对于非梗阻性无精子症(NOA)患者,精索静脉结扎术可提高精液分析中的精子率。即使精子阳性率非常低,也可能足以在不使用供体精子的情况下获取用于体外受精的精子。

目的

评估接受双侧手术以恢复精子生成的患有精索静脉曲张疾病的NOA患者的精子增加情况。

方法

我们分析了25例接受双侧精索静脉结扎术的NOA患者的精子结果。

结果

在总共25例患者中,3例(12%)在术后四个月恢复了精子计数。术后一年,5例(20%)患者恢复了精子生成。

结论

患有精索静脉曲张疾病和无精子症、无基因改变或精索管道梗阻的患者应接受手术以恢复精子。

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