Greenberg S H, Lipshultz L I, Wein A J
J Reprod Med. 1979 Feb;22(2):77-81.
Two hundred sixteen consecutive infertility patients were examined with the Doppler ultrasonic stethoscope to detect incompetence of the gonadal vein valves, the precursor of frank varicocele. All 75 men with clinically palpable varicoceles had positive Doppler findings. In 33 cases varicocele could not be definitely excluded because of unsatisfactory physical examinations; the Doppler findings were negative in 13, positive in 13 and equivocal in 7 of these men. Eighty-nine men had no evidence of varicocele on physical examination and negative Doppler findings. However, 19, patients with no palpable varicocele had positive Doppler examinations. With respect to testicular size and semen quality, this subclinical varicocele group could not be clearly distinguished from patients with idiopathic semen quality depression. Nevertheless, five men with subclinical varicocele and oligoasthenospermia underwent internal spermatic vein ligation. Postoperatively, four had negative Doppler examinations. Two patients showed a significant improvement in semen quality, and both men fathered children after several months. We believe that these preliminary results justify further investigation of "subclinical varicocele".
对216例连续的不孕症患者使用多普勒超声听诊器进行检查，以检测性腺静脉瓣膜功能不全，这是明显精索静脉曲张的先兆。所有75例临床上可触及精索静脉曲张的男性多普勒检查结果均为阳性。在33例因体格检查结果不理想而无法明确排除精索静脉曲张的病例中，13例男性的多普勒检查结果为阴性，13例为阳性，7例为可疑。89例男性体格检查未发现精索静脉曲张迹象，多普勒检查结果为阴性。然而，19例未触及精索静脉曲张的患者多普勒检查结果为阳性。就睾丸大小和精液质量而言，这一亚临床精索静脉曲张组与特发性精液质量下降患者无法明确区分。尽管如此，5例患有亚临床精索静脉曲张和少弱精子症的男性接受了精索内静脉结扎术。术后，4例多普勒检查结果为阴性。2例患者精液质量有显著改善，两人在几个月后均使配偶受孕。我们认为这些初步结果证明有必要对“亚临床精索静脉曲张”进行进一步研究。
