Tsampoukas Georgios, Dellis Athanasios, Papatsoris Athanasios
Urologist, General Hospital of Patras, Patras, Greece.
Urology, National and Kapodistrian University of Athens, Aretaieion Academic Hospital, Athens, Greece.
Arab J Urol. 2019 Aug 1;17(4):298-304. doi: 10.1080/2090598X.2019.1647676. eCollection 2019.
: To study scrotal ultrasonographic characteristics in patients with subclinical varicocele (SV) and investigate their relationship with semen parameters. : In all, 56 men with SV were recruited and divided into two groups, according to their semen characteristics. Group A, comprised 34 men with normal semen analysis; and Group B, comprised 22 men who carried at least one abnormality, regarding sperm concentration, motility and morphology. Between the two groups we compared: age; body mass index (BMI); semen pH and semen volume; total testicular volume (TTV); maximal vein diameter (MVD) and degree of reflux; mean values of peak-systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) of the intratesticular arteries; whether bilateral SV; and serum testosterone and follicle-stimulating hormone (FSH) levels. : Asthenospermia was present in all patients in Group B; 10 patients had asthenospermia only, six patients were astheno-oligospermic and six patients had astheno-oligo-teratospermia. Age, BMI, semen pH and volume, TTV, MVD and degree of reflux did not differ significantly between the two groups ( > 0.05). However, EDV, PSV and RI were significantly different ( < 0.05). Bilateral SV was significantly more frequent in patients in Group B ( < 0.05). Finally, FSH was elevated in Group B ( < 0.05), whereas testosterone was normal in both groups, albeit significantly lower in men with abnormal semen analyses ( < 0.05). : Classic ultrasonographic characteristics in men with SV, such as venous size or degree of reflux, were insufficient to distinguish patients with abnormal semen analysis. However, bilateral disease and intratesticular haemodynamics differed significantly in patients with SV and abnormal semen analysis. : BMI: body mass index; CDU: colour Doppler ultrasonography; EDV: end-diastolic velocity; MVD: maximal vein diameter; PSV: peak-systolic velocity; RI: resistive index; SV: subclinical varicocele; TTV: total testicular volume; US: ultrasonography.
研究亚临床型精索静脉曲张（SV）患者的阴囊超声特征，并探讨其与精液参数的关系。
共招募了56例SV患者，根据精液特征将其分为两组。A组由34例精液分析正常的男性组成；B组由22例精子浓度、活力和形态至少有一项异常的男性组成。我们比较了两组之间的以下指标：年龄；体重指数（BMI）；精液pH值和精液量；总睾丸体积（TTV）；最大静脉直径（MVD）和反流程度；睾丸内动脉的收缩期峰值速度（PSV）、舒张末期速度（EDV）和阻力指数（RI）的平均值；是否为双侧SV；以及血清睾酮和卵泡刺激素（FSH）水平。
B组所有患者均存在弱精子症；10例患者仅为弱精子症，6例患者为弱精子少精子症，6例患者为弱精子少精子畸形精子症。两组之间的年龄、BMI、精液pH值和体积、TTV、MVD和反流程度无显著差异（P>0.05）。然而，EDV、PSV和RI有显著差异（P<0.05）。B组患者双侧SV更为常见（P<0.05）。最后，B组FSH升高（P<0.05），而两组睾酮均正常，尽管精液分析异常的男性睾酮水平显著较低（P<0.05）。
SV男性的经典超声特征，如静脉大小或反流程度，不足以区分精液分析异常的患者。然而，SV且精液分析异常的患者双侧病变和睾丸内血流动力学有显著差异。
体重指数；CDU：彩色多普勒超声；EDV：舒张末期速度；MVD：最大静脉直径；PSV：收缩期峰值速度；RI：阻力指数；SV：亚临床型精索静脉曲张；TTV：总睾丸体积；US：超声检查
