Department of Experimental Medicine, Sapienza University of Rome, Rome 00161, Italy.
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome 00161, Italy.
Asian J Androl. 2019 Jul-Aug;21(4):408-412. doi: 10.4103/aja.aja_102_18.
Varicocele is a common finding in men. Varicocele correction has been advocated for young patients with testicular hypotrophy, but there is a lack of morphofunctional follow-up data. We assessed whether percutaneous treatment of left varicocele is associated with testicular "catch-up growth" in the following 12 months by retrospectively reviewing data from an electronic database of 10 656 patients followed up in our clinic between 2006 and 2016. We selected all young adults (<35 years) with left varicocele who underwent percutaneous treatment, had a minimum of 12 months' ultrasound imaging follow-up, and had no other conditions affecting testicular volume. One hundred and fourteen men (mean±standard deviation [s.d.] of age: 22.8 ± 5.4 years) met the inclusion and exclusion criteria. Left testicular hypotrophy (LTH), defined as a ≥20% difference between left and right testicular volume at baseline, was observed in 26 (22.8%) men. Participants with LTH (mean±s.d.: 14.5 ± 2.7 ml) had lower baseline testicular volume compared to those without LTH (mean±s.d.: 15.7 ± 3.8 ml; P = 0.032). Repeated measures mixed models showed a significant interaction between LTH and time posttreatment when correcting for baseline left testicular volume (β = 0.114, 95% confidence interval [CI]: 0.018-0.210, P = 0.020), resulting in a catch-up growth of up to 1.37 ml per year (95% CI: 0.221-2.516). Age at intervention was also associated with reduced testicular volume (-0.072 ml per year, 95% CI: -0.135--0.009; P = 0.024). Percutaneous treatment of left varicocele in young adults with LTH can result in catch-up growth over 1 year of follow-up. The reproductive and psychological implications of these findings need to be confirmed in longer and larger prospective studies.
精索静脉曲张在男性中较为常见。精索静脉曲张矫正术已被提倡用于睾丸萎缩的年轻患者，但缺乏形态功能的随访数据。我们通过回顾 2006 年至 2016 年间在我们诊所接受随访的 10656 例患者的电子数据库数据，评估了经皮治疗左侧精索静脉曲张是否与接下来 12 个月睾丸“追赶生长”有关。我们选择了所有接受经皮治疗、至少有 12 个月超声影像学随访且无其他影响睾丸体积的条件的年轻成年男性（<35 岁）。114 名男性（年龄的平均值±标准差[SD]：22.8±5.4 岁）符合纳入和排除标准。观察到 26 名（22.8%）男性存在左侧睾丸萎缩（LTH），定义为基线时左、右侧睾丸体积相差≥20%。与无 LTH 的患者相比（平均值±SD：14.5±2.7 ml），有 LTH 的患者的基线睾丸体积较小（平均值±SD：15.7±3.8 ml；P=0.032）。当校正基线左侧睾丸体积时，重复测量混合模型显示 LTH 与治疗后时间之间存在显著交互作用（β=0.114，95%置信区间[CI]：0.018-0.210，P=0.020），导致每年追赶生长高达 1.37 ml（95%CI：0.221-2.516）。干预时的年龄也与睾丸体积减少有关（每年减少 0.072 ml，95%CI：-0.135--0.009；P=0.024）。在存在 LTH 的年轻成年男性中经皮治疗左侧精索静脉曲张可导致 1 年以上的随访中出现追赶生长。这些发现的生殖和心理影响需要在更长和更大的前瞻性研究中得到证实。
