Wang Lihong, Huang Xiaoqi, Ding Yinman
Department of Urology, Xuancheng People's Hospital, Xuancheng, 242000, China.
Basic Clin Androl. 2025 Aug 26;35(1):32. doi: 10.1186/s12610-025-00282-1.
Varicocele (VC) is a significant contributor to both primary and secondary male infertility. VC can lead to progressive, time-dependent damage to testicular function, as demonstrated in both animal and human studies. To assess testicular tissue alterations, we conducted the first systematic review and meta-analysis on the effects of VC on testicular stiffness and volume. A literature search was conducted in June 2024 without language or geographic restrictions. The search included the databases PubMed, Embase, and Medline. We reviewed the literature to identify all published clinical trials using shear wave elastography (SWE) to evaluate the stiffness and volume of varicocele-affected and normal testes. The reference lists of the retrieved studies were examined. We conducted a systematic review and meta-analysis.
Seven articles, encompassing 1118 testes, were selected from a pool of eighty-seven. The analysis revealed that the stiffness of varicocele-affected ipsilateral testes was higher than that of normal testes (p < 0.05), and the stiffness of normal testes was higher than that of contralateral testes (p < 0.05). Regarding volume, the varicocele-affected ipsilateral testes were smaller than the contralateral testes (p < 0.05), with no significant difference between the contralateral and normal testes (p > 0.05).
This meta-analysis indicates that VC impacts the stiffness and volume of both testes. SWE is an effective technique for assessing testes affected by VC, but a large-scale, multicenter randomized controlled study is needed for further confirmation.
精索静脉曲张（VC）是导致男性原发性和继发性不育的重要因素。动物和人体研究均表明，VC可导致睾丸功能进行性、时间依赖性损害。为评估睾丸组织的改变，我们首次对VC对睾丸硬度和体积的影响进行了系统评价和荟萃分析。2024年6月进行了文献检索，无语言或地理限制。检索数据库包括PubMed、Embase和Medline。我们回顾文献以识别所有已发表的使用剪切波弹性成像（SWE）评估精索静脉曲张患侧和正常睾丸硬度及体积的临床试验。检查了检索到的研究的参考文献列表。我们进行了系统评价和荟萃分析。
从87篇文献中筛选出7篇文章，共涉及1118个睾丸。分析显示，精索静脉曲张患侧同侧睾丸的硬度高于正常睾丸（p<0.05），正常睾丸的硬度高于对侧睾丸（p<0.05）。关于体积，精索静脉曲张患侧同侧睾丸小于对侧睾丸（p<0.05），对侧睾丸与正常睾丸之间无显著差异（p>0.05）。
这项荟萃分析表明，VC会影响双侧睾丸的硬度和体积。SWE是评估受VC影响睾丸的有效技术，但需要大规模、多中心随机对照研究进行进一步证实。
