多普勒超声检查——精索静脉曲张和继发性不育患者管理的重要工具。

Doppler Ultrasonography - An Important Tool in Managing Patients With Varicocele and Secondary Infertility.

机构信息

Department of Urology, "Colentina" Clinical Hospital, Bucharest, Romania.

Department of Urology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

出版信息

In Vivo. 2022 Sep-Oct;36(5):2392-2399. doi: 10.21873/invivo.12972.

DOI:10.21873/invivo.12972

PMID:36099105

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9463887/

Abstract

BACKGROUND/AIM: Doppler ultrasound was successfully implemented as part of the diagnostic plan of medical emergencies in scrotal pathology. This study aimed to investigate whether it could play an important role in managing not only varicocele, but patients with secondary infertility as well.

PATIENTS AND METHODS

The current study included 135 patients with varicocele and infertility. Surgery was performed in 18 cases with painful varicocele, 15 cases with testicular hypotrophy, and 48 cases with infertility.

RESULTS

Among cases with infertility who underwent surgery, aged between 19 and 36 years old, 80% showed a significant improvement in the spermogram after curing the varicocele. In patients over 36 years of age, only 42% had some improvement in the spermogram after surgery. In addition, after surgery, antispermatic antibodies showed a significant decrease in all patients.

CONCLUSION

Varicocele and secondary infertility are a well-known pathology. While the role of Doppler ultrasonography is established in varicocele diagnosis, we found an important pool of patients with secondary infertility and asymptomatic varicocele that would not have been diagnosed in the absence of Doppler ultrasound investigations. Since the best results in fertility were observed in patients younger than 36 years of age, we reiterate the importance of Doppler ultrasonography in addressing infertility.

摘要

背景/目的：多普勒超声已成功应用于阴囊病理学中的医学急症诊断计划。本研究旨在探讨其是否不仅对精索静脉曲张，而且对继发性不育症患者的管理也能发挥重要作用。

患者与方法

本研究纳入了 135 例精索静脉曲张和不育症患者。手术适用于 18 例疼痛性精索静脉曲张、15 例睾丸萎缩和 48 例不育症患者。

结果

在接受手术的不育症患者中，年龄在 19 至 36 岁之间的患者，80%在治愈精索静脉曲张后精子计数明显改善。对于年龄超过 36 岁的患者，手术后精子计数仅有 42%有所改善。此外，手术后抗精子抗体在所有患者中均显著下降。

结论

精索静脉曲张和继发性不育症是一种众所周知的病理学。虽然多普勒超声在精索静脉曲张诊断中的作用已确立，但我们发现存在一大群患有继发性不育症和无症状精索静脉曲张的患者，如果没有多普勒超声检查，这些患者将无法被诊断。由于在年龄小于 36 岁的患者中观察到最佳的生育效果，因此我们再次强调多普勒超声在解决不育症方面的重要性。