Pediatric and Adolescent Andrological Unit, Department of Pediatrics, San Paolo Hospital, ASST Santi Paolo e Carlo, Università degli Studi di Milano, Milan, Italy.
Department of Diagnostic and Interventional Radiology, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy.
Andrologia. 2019 Aug;51(7):e13286. doi: 10.1111/and.13286. Epub 2019 Apr 14.
Varicocele is a rather common andrological condition in adolescents, which can adversely affect testicular growth and seminal parameters, leading to infertility in about 20% of adults. The aim of this study was to investigate if treating varicocele before the age of 18 is a beneficial option to improve testicular hypotrophy and seminal parameters and if minimally invasive techniques could be an appropriate treatment choice for adolescent varicocele associated with spermatic vein reflux. A percutaneous scleroembolization was performed in sixty-four consecutive young patients (13-19 years old) with left varicocele, preceded by a fluoroscopy. In thirty-four of them, semen samples were also collected. We examined semen samples and testicles dimensions before and after percutaneous varicocelectomy, compared to a nonoperated control group, with a six-month follow-up. Total sperm count and sperm morphology were significantly increased in the intervention group. Left testicular volume significantly increased in both groups, while only correction of varicocele improved spermatozoa release per unit of testis volume. We conclude that early varicocelectomy by percutaneous scleroembolization significantly ameliorates seminiferous tubules activity in the critical adolescent phase of testicular growth. It is suggested that adolescents should be; offered varicocele repair as soon as possible in order to improve reproductive potential.
精索静脉曲张是青少年中一种相当常见的男科疾病,它可能会对睾丸生长和精液参数产生不利影响,导致约 20%的成年人不育。本研究旨在探讨在 18 岁之前治疗精索静脉曲张是否是改善睾丸萎缩和精液参数的有益选择,以及微创技术是否是精索静脉曲张伴精索静脉反流的青少年患者的合适治疗选择。我们对 64 例连续的左侧精索静脉曲张的年轻患者(13-19 岁)进行了经皮硬化栓塞术,之前进行了透视检查。其中 34 例还收集了精液样本。我们检查了经皮精索静脉结扎术前后的精液样本和睾丸大小,并与未手术的对照组进行比较,随访 6 个月。干预组的总精子数和精子形态显著增加。两组的左侧睾丸体积均显著增加,而只有精索静脉曲张的矫正才能改善单位睾丸体积的精子释放。我们的结论是,经皮硬化栓塞术的早期精索静脉结扎术可显著改善睾丸生长关键青少年期的生精小管活动。建议青少年应尽快接受精索静脉曲张修复,以提高生殖潜能。