Kang Caroline, Punjani Nahid, Lee Richard K, Li Philip S, Goldstein Marc
Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, 525 East 68th Street, Starr 900, New York, NY 10065, United States.
Semin Cell Dev Biol. 2022 Jan;121:114-124. doi: 10.1016/j.semcdb.2021.04.005. Epub 2021 May 6.
Varicoceles are dilated veins within the spermatic cord and a relatively common occurrence in men. Fortunately, the large majority of men are asymptomatic, however, a proportion of men with varicoceles can suffer from infertility and testosterone deficiency. Sperm and testosterone are produced within the testis, and any alteration to the testicular environment can negatively affect the cells responsible for these processes. The negative impact of varicoceles on testicular function occurs mainly due to increased oxidative stress within the testicular parenchyma which is thought to be caused by scrotal hyperthermia, testicular hypoxia, and blood-testis barrier disruption. Management of varicoceles involves ligation or percutaneous embolization of the dilated veins. Repair of varicoceles can improve semen parameters and fertility, along with serum testosterone concentration. In this review, we discuss the pathophysiology of varicoceles, their impact on testicular function, and management.
精索静脉曲张是精索内的扩张静脉,在男性中较为常见。幸运的是,绝大多数男性没有症状,然而,一部分患有精索静脉曲张的男性可能会出现不育和睾酮缺乏。精子和睾酮在睾丸内产生,睾丸环境的任何改变都会对负责这些过程的细胞产生负面影响。精索静脉曲张对睾丸功能的负面影响主要是由于睾丸实质内氧化应激增加,这被认为是由阴囊高温、睾丸缺氧和血睾屏障破坏引起的。精索静脉曲张的治疗包括对扩张静脉进行结扎或经皮栓塞。精索静脉曲张修复术可以改善精液参数和生育能力,以及血清睾酮浓度。在这篇综述中我们将讨论精索静脉曲张的病理生理学、其对睾丸功能的影响以及治疗方法。