双侧显微外科腹股沟下精索静脉曲张切除术对弱精子症和少精子症的影响：109例报告

[Effect of bilateral microsurgical subinguinal varicocelectomy on asthenozoospermia and oligozoospermia: A report of 109 cases].

作者信息

Zhang Xing-Yuan, Shi Qing-Jing, Pan Lian-Jun, Pan Feng, Zhao Dan, Zhang Feng-Lei

机构信息

Department of Urology and Andrology, Women's Hospital of Nanjing Medical University / Nanjing Maternity and Child Health Hospital, Nanjing, Jiangsu 210002, China.

Department of Reproductive Health, Yixing Maternity and Child Health Hospital, Yixing, Jiangsu 214200, China.

出版信息

Zhonghua Nan Ke Xue. 2020 Aug;26(8):713-716.

PMID:33377732

Abstract

OBJECTIVE

To investigate the effects of bilateral microsurgical subinguinal varicocelectomy (BMSV) in patients with asthenozoospermia or oligozoospermia.

METHODS

Totally 147 patients with male infertility received BMSV from January 2018 to May 2019, of whom 109 had complete data recorded. We retrospectively analyzed the clinical data, including the total sperm count per ejeculate, sperm concentration and sperm motility before and after surgery, and the rate of natural conception achieved during the follow-up.

RESULTS

BMSV achieved a total effectiveness rate of 79.00% in improving the percentage of progressively motile sperm (a rise of ≥20%) and a marked effectiveness rate of 70.00% (a rise of ≥50%) in the 100 cases of asthenozoospermia as compared with the baseline, with a mean recovery time of (110.13 ± 37.43) days. Besides, a total effectiveness rate of 74.29% (an increase of ≥20%) and a marked effectiveness rate of 71.43% (an increase of ≥50%) were attained in the improvement of sperm concentration in the 35 cases of oligozoospermia, with a mean recovery time of (117.00 ± 48.79 ) days. A natural conception rate of 30.30% was observed during the follow-up. No severe adverse events occurred postoperatively.

CONCLUSIONS

BMSV is significantly effective for the treatment of asthenozoospermia and oligozoospermia.

摘要

目的

探讨双侧显微外科腹股沟下精索静脉结扎术（BMSV）对弱精子症或少精子症患者的影响。

方法

2018年1月至2019年5月，共有147例男性不育患者接受了BMSV手术，其中109例有完整的数据记录。我们回顾性分析了临床数据，包括每次射精的总精子数、手术前后的精子浓度和精子活力，以及随访期间的自然受孕率。

结果

与基线相比，在100例弱精子症患者中，BMSV提高前向运动精子百分比（上升≥20%）的总有效率为79.00%，显著有效率（上升≥50%）为70.00%，平均恢复时间为（110.13±37.43）天。此外，在35例少精子症患者中，提高精子浓度的总有效率为74.29%（增加≥20%），显著有效率为71.43%（增加≥50%），平均恢复时间为（117.00±48.79）天。随访期间自然受孕率为30.30%。术后未发生严重不良事件。