Centola G M, Lee K, Cockett A T
Department of Urology, University of Rochester Medical Center, New York.
Urology. 1987 Nov;30(5):479-81. doi: 10.1016/0090-4295(87)90386-4.
The varicocele, present in many of the male partners of infertile couples continues to generate controversy, particularly as related to its diagnosis and pathophysiology. The purpose of our study was to determine the relationship between testicular volume and the presence or absence of a varicocele. Testicular volume was determined by the use of an orchiometer; the presence of a varicocele was determined by palpation during a Valsalva maneuver. The patients utilized in the study were those seen in our Andrology and General Urology Clinics; 291 patients with varicoceles and 83 control patients (no evidence of varicocele) were used. The left (mean = 21.4 mL) and right (mean = 23.4 mL) testicular volumes of patients with a varicocele were significantly reduced compared with that of the control group (left, mean = 23.4 mL; right, mean = 26.2 mL; p = 0.0041 and p = 0.002, respectively). The testicular volume corrected on the basis of the body mass (V/m2) also was significantly reduced in the varicocele group compared with controls (left p = 0.007; right p = 0.001). Reduced testicular volume relative to body size may be detected prior to actual demonstration of the stress pattern and the presence of a varicocele, and may be useful in early diagnosis. It is suggested that measurement of testicular volume may be a useful adjunct to routine examination of the infertile male.
精索静脉曲张在许多不育夫妇的男性伴侣中存在，这一情况仍存在争议，尤其是在其诊断和病理生理学方面。我们研究的目的是确定睾丸体积与精索静脉曲张的有无之间的关系。睾丸体积通过使用睾丸测量器来确定；精索静脉曲张的存在通过瓦尔萨尔瓦动作时的触诊来确定。本研究中使用的患者是在我们男科和普通泌尿外科诊所就诊的患者；使用了291例精索静脉曲张患者和83例对照患者（无精索静脉曲张证据）。精索静脉曲张患者的左侧睾丸体积（平均 = 21.4 mL）和右侧睾丸体积（平均 = 23.4 mL）与对照组相比显著减小（左侧，平均 = 23.4 mL；右侧，平均 = 26.2 mL；p分别为0.0041和0.002）。与对照组相比，精索静脉曲张组基于体重校正后的睾丸体积（V/m²）也显著减小（左侧p = 0.007；右侧p = 0.001）。在实际显示压力模式和精索静脉曲张存在之前，可能检测到相对于身体大小而言睾丸体积减小，这可能有助于早期诊断。建议睾丸体积测量可能是不育男性常规检查的有用辅助手段。
