Maimaitiming Abulaiti, Muhemaiti Aidibai, Mulati Yelisudan, Li Xiaodong
Urology Department, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Clinical Research Center for Genitourinary System, Urumqi, China.
Ultrasound Department, Medical Imaging Center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
Eur Urol Open Sci. 2023 Dec 20;59:40-48. doi: 10.1016/j.euros.2023.11.008. eCollection 2024 Jan.
Varicocele is a condition that seriously affects male fertility. It can cause pathological changes in the testicles and affect their spermatogenesis and endocrine function.
To formulate nomograms to predict sperm improvements after microscopic varicocelectomy.
A retrospective analysis was conducted on varicocele patients who met the research criteria and were enrolled from March 2020 to June 2022. They were divided into a development and a validation cohort in a 2:1 ratio.
Data on preoperative testicular atrophy index, bilateral testicular elastic modulus, testosterone, pre- and postoperative 6-mo total sperm count, sperm concentration, and sperm vitality were collected. An increase of ≥25% is considered a postoperative improvement in sperm parameters. Predictive nomograms were constructed through forward stepwise LR regression, based on independent risk factors filtered by univariate and multivariate logistic regression analyses. Receiver operating characteristic curve analysis, calibration curve, and decision curve analysis were employed to assess the performance of the models.
The areas under the curve of nomograms for predicting the postoperative improvement of total sperm count, sperm concentration, and sperm vitality were 0.915, 0.986, and 0.924 respectively. The nomogram models demonstrated good predictive performance. The single-center sample size was a limitation of this study.
In this study, we developed effective predictive nomogram models for anticipating postoperative improvements in sperm quality among varicocele patients. These models offer a significant value in providing accurate predictions of surgical outcomes. However, it is crucial to conduct further external validation.
In this study, a predictive nomogram model was constructed for assessing the improvement of sperm quality in varicocele patients after surgery. The model offered satisfactory results.
精索静脉曲张是一种严重影响男性生育能力的疾病。它可导致睾丸发生病理变化，影响其精子发生及内分泌功能。
制定列线图以预测显微镜下精索静脉结扎术后精子改善情况。
设计、设置与参与者：对2020年3月至2022年6月符合研究标准并纳入的精索静脉曲张患者进行回顾性分析。他们按2:1的比例被分为开发队列和验证队列。
收集术前睾丸萎缩指数、双侧睾丸弹性模量、睾酮、术前及术后6个月的总精子计数、精子浓度和精子活力数据。精子参数术后增加≥25%被视为术后改善。基于单因素和多因素逻辑回归分析筛选出的独立危险因素，通过向前逐步LR回归构建预测列线图。采用受试者工作特征曲线分析、校准曲线和决策曲线分析来评估模型的性能。
预测总精子计数、精子浓度和精子活力术后改善的列线图曲线下面积分别为0.915、0.986和0.924。列线图模型显示出良好的预测性能。本研究的局限性在于单中心样本量。
在本研究中，我们开发了有效的预测列线图模型，用于预测精索静脉曲张患者术后精子质量的改善情况。这些模型在准确预测手术结果方面具有重要价值。然而，进行进一步的外部验证至关重要。
在本研究中，构建了一个预测列线图模型，用于评估精索静脉曲张患者术后精子质量的改善情况。该模型结果令人满意。
