Baek Seung Ryong, Park Hyun Jun, Park Nam Cheol
Department of Urology, Pusan National University School of Medicine, Busan, Korea.
Medical Research Institute of Pusan National University Hospital, Busan, Korea.
Andrologia. 2019 Mar;51(2):e13187. doi: 10.1111/and.13187. Epub 2018 Oct 25.
We investigated the clinical characteristics of patients with varicocele according to the presence or absence of scrotal pain. We retrospectively reviewed the records of patients who underwent varicocelectomy. The age, body mass index, grade, laterality of varicocele, testicular volume difference, time to hospital visit, serum testosterone level and semen parameters were evaluated. A total of 954 patients were included. The painful group had lower mean age, lower BMI, higher grade of varicocele, smaller testicular volume difference and shorter time to hospital visit than the painless group. In addition, the median serum total testosterone level and total sperm count, concentration and motility were higher in the painful group than in the painless group. In multivariate analysis, there were significant differences between the two groups in age, grade of varicocele, testis volume difference, time to hospital visit, total sperm count and concentration. Patients with painful varicocele visited hospital earlier because of the pain and tended to start treatment sooner. They were also younger, had smaller testis atrophy and had higher sperm concentration, even though they had a higher grade of varicocele than patients without pain. Although scrotal pain in varicocele patients is difficult to treat, it leads to early diagnosis and treatment.
我们根据是否存在阴囊疼痛调查了精索静脉曲张患者的临床特征。我们回顾性分析了接受精索静脉结扎术患者的记录。评估了患者的年龄、体重指数、精索静脉曲张分级、侧别、睾丸体积差异、就诊时间、血清睾酮水平和精液参数。共纳入954例患者。与无痛组相比，疼痛组的平均年龄更低、体重指数更低、精索静脉曲张分级更高、睾丸体积差异更小且就诊时间更短。此外，疼痛组的血清总睾酮水平中位数以及总精子计数、浓度和活力均高于无痛组。多因素分析显示，两组在年龄、精索静脉曲张分级、睾丸体积差异、就诊时间、总精子计数和浓度方面存在显著差异。有疼痛的精索静脉曲张患者因疼痛更早就诊，且倾向于更早开始治疗。他们年龄也更小，睾丸萎缩更小，精子浓度更高，尽管他们的精索静脉曲张分级高于无疼痛的患者。虽然精索静脉曲张患者的阴囊疼痛难以治疗，但它能促使早期诊断和治疗。
