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精索静脉曲张手术治疗对精索静脉曲张患者血清激素和抑制素 B 水平的影响：系统评价和荟萃分析。

Effects of Varicocele Surgical Repair on Serum Hormone and Inhibin B Levels for Patients With Varicocele: A Systematic Review and Meta-Analysis.

机构信息

Department of Urology, Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.

Department of Urology, Tengzhou Central People's Hospital, Tengzhou, China.

出版信息

Am J Mens Health. 2023 Sep-Oct;17(5):15579883231199400. doi: 10.1177/15579883231199400.

DOI:10.1177/15579883231199400
PMID:37694823
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10496478/
Abstract

Varicocele surgical repair can improve the function of the testis for patients with varicocele. We carried out a systematic review and meta-analysis to assess the effects of varicocele surgical repair on serum hormones and inhibin B levels in patients with varicocele. A literature search was performed in August 2022, and no language or geographic region restrictions were applied. The search included the following databases: PubMed, Embase, and Medline. A literature review was performed to identify all published clinical trials assessing serum hormone and inhibin B levels before and after varicocele surgical repair. The reference lists of retrieved studies were also investigated. A systematic review and meta-analysis were conducted. Eight articles were selected from 162 articles, including 452 patients. The combined analysis showed that after surgical treatment, mean serum testosterone, inhibin B, and sperm concentration levels increased compared with preoperative levels ( .05). After surgical treatment, mean serum follicle-stimulating hormon (FSH), and Luteinizing hormone (LH) levels decreased compared with preoperative levels ( .05). This meta-analysis demonstrates that varicocele surgical repair can improve testicular function, increase serum testosterone, and inhibin B levels and decrease serum FSH and LH levels in patients with varicocele. This might be related to the improvement of infertility. A large-scale multicenter randomized controlled study is needed for further confirmation.

摘要

精索静脉曲张手术修复可改善精索静脉曲张患者的睾丸功能。我们进行了系统评价和荟萃分析，以评估精索静脉曲张手术修复对精索静脉曲张患者血清激素和抑制素 B 水平的影响。2022 年 8 月进行了文献检索，未对语言或地理区域进行限制。检索包括以下数据库：PubMed、Embase 和 Medline。进行文献综述以确定所有评估精索静脉曲张手术修复前后血清激素和抑制素 B 水平的已发表临床试验。还调查了检索研究的参考文献列表。进行了系统评价和荟萃分析。从 162 篇文章中选择了 8 篇文章，包括 452 名患者。联合分析表明，与术前水平相比，手术后平均血清睾酮、抑制素 B 和精子浓度水平升高（ .05）。与术前水平相比，手术后平均血清卵泡刺激素（FSH）和黄体生成素（LH）水平降低（ .05）。这项荟萃分析表明，精索静脉曲张手术修复可以改善睾丸功能，增加血清睾酮和抑制素 B 水平，降低血清 FSH 和 LH 水平，这可能与改善不育有关。需要进行大规模多中心随机对照研究进一步证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/c839060c953b/10.1177_15579883231199400-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/4f6e5eaf9bc9/10.1177_15579883231199400-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/2e62dde396e6/10.1177_15579883231199400-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/259b82a4fb3d/10.1177_15579883231199400-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/df4ee5a02efc/10.1177_15579883231199400-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/c839060c953b/10.1177_15579883231199400-fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/4f6e5eaf9bc9/10.1177_15579883231199400-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/2e62dde396e6/10.1177_15579883231199400-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/259b82a4fb3d/10.1177_15579883231199400-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/df4ee5a02efc/10.1177_15579883231199400-fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baaa/10496478/c839060c953b/10.1177_15579883231199400-fig5.jpg

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本文引用的文献

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Effect of varicoceles on spermatogenesis.精索静脉曲张对精子发生的影响。
Semin Cell Dev Biol. 2022 Jan;121:114-124. doi: 10.1016/j.semcdb.2021.04.005. Epub 2021 May 6.
2
Chronic scrotal pain in young adults.青年男性的慢性阴囊疼痛。
BMC Res Notes. 2017 Jul 4;10(1):241. doi: 10.1186/s13104-017-2590-0.
3
Varicocele and male infertility.精索静脉曲张与男性不育。
Nat Rev Urol. 2017 Sep;14(9):523-533. doi: 10.1038/nrurol.2017.98. Epub 2017 Jul 4.
4
Clinical Outcomes of Varicocele Repair in Infertile Men: A Review.精索静脉曲张修复术治疗不育男性的临床结果：综述
World J Mens Health. 2016 Aug;34(2):101-9. doi: 10.5534/wjmh.2016.34.2.101. Epub 2016 Aug 23.
5
Varicocele: tissue stress in the etiology.精索静脉曲张：病因中的组织压力。
Turk J Med Sci. 2016 Jun 23;46(4):1014-7. doi: 10.3906/sag-1411-70.
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Testosterone and Varicocele.睾酮与精索静脉曲张
Urol Clin North Am. 2016 May;43(2):223-32. doi: 10.1016/j.ucl.2016.01.009. Epub 2016 Mar 21.
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Summary evidence on the effects of varicocele treatment to improve natural fertility in subfertile men.关于精索静脉曲张治疗对改善不育男性自然生育能力影响的汇总证据。
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