Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Cell-gene Therapy Translational Medicine Research Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Andrology. 2018 Nov;6(6):936-942. doi: 10.1111/andr.12534. Epub 2018 Aug 5.
Low-intensity extracorporeal shock wave therapy (Li-ESWT) has been introduced as a treatment for penile diseases. Its impact on testicular function during treatment remains unknown.
To clarify whether Li-ESWT impairs testicular function during the treatment of penile diseases by investigating the impact of Li-ESWT on testosterone synthesis and spermatogenesis in adult rats.
Twenty-four male Sprague-Dawley rats were equally divided into the following three groups: control group, 1.6 BAR group, and 3.2 BAR group. Rats in the experimental groups were treated with Li-ESWT at different energy levels (300 shocks at 1.6 BAR or 3.2 BAR, 2 Hz frequency) three times a week for 3 weeks. The control group did not receive any treatment during the same period of time. One day after the last shock wave treatment, serum and testicular tissue testosterone concentrations were measured, and sperm quality was assayed. Histologic examination of the testes and quantitative real-time PCR were performed.
Testosterone levels in both the serum and testicular tissue did not change after Li-ESWT exposure. The expression levels of steroidogenic enzymes (steroidogenic acute regulatory protein (StAR), cytochrome P450 cholesterol side-chain cleavage enzyme (P450scc), and 3β-hydroxysteroid dehydrogenase (3β-HSD)) were not impacted by Li-ESWT. The 3.2 BAR group showed a significantly lower sperm count and lower expression of synaptonemal complex protein 3 (SYCP3) in testicular tissue than the control group. No significant differences in sperm quality or SYCP3 expression were observed between the control group and the 1.6 BAR group.
Li-ESWT exposure at 3.2 BAR inhibited spermatogenesis and decreased sperm quality, which indicated that male patients with a desire to preserve fertility should undergo low-energy Li-ESWT or other treatment modalities.
低强度体外冲击波疗法（Li-ESWT）已被引入治疗阴茎疾病。其在治疗过程中对睾丸功能的影响尚不清楚。
通过研究 Li-ESWT 对成年大鼠睾丸睾酮合成和生精的影响，明确 Li-ESWT 是否会在治疗阴茎疾病期间损害睾丸功能。
将 24 只雄性 Sprague-Dawley 大鼠等分为以下三组：对照组、1.6 BAR 组和 3.2 BAR 组。实验组大鼠分别采用不同能量水平（300 次 1.6 BAR 或 3.2 BAR，2 Hz 频率）的 Li-ESWT 每周 3 次治疗 3 周。同期对照组大鼠不接受任何治疗。末次冲击波治疗后 1 天，检测血清和睾丸组织中睾酮浓度，评估精子质量。对睾丸进行组织学检查和实时定量 PCR 检测。
Li-ESWT 暴露后血清和睾丸组织中的睾酮水平没有变化。类固醇生成酶（类固醇急性调节蛋白（StAR）、细胞色素 P450 胆固醇侧链裂解酶（P450scc）和 3β-羟甾脱氢酶（3β-HSD））的表达水平不受 Li-ESWT 影响。3.2 BAR 组的精子计数明显低于对照组，睾丸组织中联会复合体蛋白 3（SYCP3）的表达水平也明显低于对照组。对照组和 1.6 BAR 组之间的精子质量或 SYCP3 表达无显著差异。
3.2 BAR 的 Li-ESWT 暴露抑制了精子发生并降低了精子质量，这表明有生育力保护需求的男性患者应接受低能量 Li-ESWT 或其他治疗方式。
