Zampieri Nicola
Woman and Child Hospital, Azienda Ospedaliera Universitaria Integrata, Department of Surgery, Dentistry, Paediatrics and Gynaecology, Paediatric Fertility Lab, University of Verona, Piazzale A.Stefani 1, Verona Italy.
J Pediatr Urol. 2021 Feb;17(1):49.e1-49.e5. doi: 10.1016/j.jpurol.2020.11.024. Epub 2020 Nov 21.
Varicocele is one of the most frequent disease affecting the fertility potential; OBJECTIVE: the aim of this study is to assess the correlation between clinical and radiological grade of varicocele and hormonal values.
The data about adolescents with left unilateral varicocele aged between 13 and 16 years, with Tanner stage V, followed at the Authors' Institution between September 2016 and September 2019 were investigated; inclusion and exclusion criteria were created. Patients underwent standard visit, Ultrasound, Doppler velocimetry and hormonal tests (at T0 and T1). Those patients with testicular hypotrophy underwent surgery.
During the study period, 75 subjects with left unilateral varicocele were enrolled; 8 patients were excluded.A total of 67 patients were then studied. Among these patients, 37 had testicular hypotrophy, while the others had normal testicular volume. There was no correlation between grade of varicocele and testicular hypotrophy (p = 0.12); among those patients with testicular hypotrophy, there was a statistical correlation with the grade of spermatic vein reflux (grade 4 vs grades 1-2-3) (p = 0.03). Focusing on hormonal values, there was a statistical significant difference between FSH levels, clinical grades of varicocele and grade of spermatic vein reflux: FSH levels were higher in patients with clinical grade 3 varicocele respect to patients with grade 1-2 varicocele and, in particular, patients with grade 3 varicocele, testicular hypotrophy and grade 4 spermatic vein reflux (14 patients) had higher FSH level respect to others (p = 0.02). After surgery there was a significant FSH reduction.
Our results demonstrate that higher grade of spermatic vein reflux is associated with testicular hypotrophy and higher FSH levels.
精索静脉曲张是影响生育能力的最常见疾病之一;目的:本研究旨在评估精索静脉曲张的临床和放射学分级与激素值之间的相关性。
对2016年9月至2019年9月在作者所在机构随访的13至16岁、 Tanner分期为V期的左侧单侧精索静脉曲张青少年的数据进行了调查;制定了纳入和排除标准。患者接受了标准检查、超声、多普勒测速和激素检测(在T0和T1)。那些有睾丸萎缩的患者接受了手术。
在研究期间,纳入了75例左侧单侧精索静脉曲张患者;排除了8例患者。然后共研究了67例患者。在这些患者中,37例有睾丸萎缩,其余患者睾丸体积正常。精索静脉曲张分级与睾丸萎缩之间无相关性(p = 0.12);在那些有睾丸萎缩的患者中,与精索静脉反流分级(4级与1-2-3级)存在统计学相关性(p = 0.03)。关注激素值,卵泡刺激素(FSH)水平、精索静脉曲张临床分级和精索静脉反流分级之间存在统计学显著差异:临床3级精索静脉曲张患者的FSH水平高于1-2级患者,特别是,3级精索静脉曲张、睾丸萎缩和4级精索静脉反流的患者(14例)的FSH水平高于其他患者(p = 0.02)。手术后FSH有显著降低。
我们的结果表明,较高等级的精索静脉反流与睾丸萎缩和较高的FSH水平相关。