Saypol D C, Howards S S, Turner T T, Miller E D
J Clin Invest. 1981 Jul;68(1):39-45. doi: 10.1172/jci110252.
Varicocele had been repeatedly implicated as a cause of infertility in selected men, although neither a causal relationship nor a mechanism has been documented. The purpose of this investigation was to create a varicocele model in animals and to study the subsequent alterations in testicular physiology. Secondary dilatation of the left internal spermatic vein was achieved either by partial ligation of the left renal vein in rats and dogs or by surgical destruction of the valve of the left testicular vein in a second group of dogs. 1 mo after partial ligation in the rats and 3 mo after partial ligation or valve destruction in the dogs, testicular blood flow was measured using Strontium 85 (SR-85)-labeled microspheres (15 +/- 1.1 micrometer). Intratesticular temperature was measured with a Bailey needle probe thermometer and biopsies were obtained for histologic sections. Mean testicular blood flow in milliliters per minute per 100 g was significantly greater in the partially ligated rats; right testis control 26 +/- 2, left testis control 24 +/- 2 compared to right testis experimental 35 +/- 3, left testis experimental 35 +/- 4 (p less than 0.02). Dogs undergoing either partial vein ligation or valve destruction showed similar increases in mean testicular blood flow; right testis control 8 +/- 1, left testis control 8 +/- 1 vs. right testis experimental 16 +/- 3, left testis experimental 18 +/- 4 (p less than 0.01). The mean difference between intratesticular and intraperitoneal temperature in control rats was significantly higher (4.02 +/- 0.25 degrees C right testis, 3.77 +/- 0.14 degrees C left testis), than rats who underwent partial vein ligation (right testis 2.14 +/- 0.09 degrees C, left testis 2.34 +/- 0.12 degrees C) (p less than 0.001). Control dogs also had a significantly higher mean difference between intratesticular and rectal temperatures; (right testis control 3.61 +/- 0.42 degrees C, left testis control 3.60 +/- 0.40 degrees C) than the partially ligated or valve destruction dogs (right testis 2.31 +/- 0.17 degrees C, left testis 2.67 +/- 0.32 degrees C) (p less than 0.05). In addition, histologic evaluation revealed abnormalities in spermatogenesis in some of the animals. Thus, venous dilatation secondary to partial vein ligation or testicular vein valve obliteration is followed by large bilateral increases in testicular blood flow in these two species. A consequence of this increased flow is an elevation in bilateral testicular temperature, which it is postulated, leads to impaired spermatogenesis in some of the animals. In selected men varicocele may impair spermatogenesis by a similar physiologic mechanism.
精索静脉曲张一直被反复认为是某些男性不育的原因,尽管尚未证实其因果关系和作用机制。本研究的目的是建立动物精索静脉曲张模型,并研究随后睾丸生理功能的变化。通过部分结扎大鼠和犬的左肾静脉,或在另一组犬中手术破坏左睾丸静脉瓣膜,实现左精索内静脉的继发性扩张。在大鼠部分结扎后1个月,以及犬部分结扎或瓣膜破坏后3个月,使用锶85(SR - 85)标记的微球(15±1.1微米)测量睾丸血流量。用贝利针式探针温度计测量睾丸内温度,并取活检组织制作组织切片。每100克每分钟的平均睾丸血流量,部分结扎的大鼠显著增加;右侧睾丸对照组为26±2,左侧睾丸对照组为24±2,而右侧睾丸实验组为35±3,左侧睾丸实验组为35±4(p<0.02)。接受部分静脉结扎或瓣膜破坏的犬,平均睾丸血流量也有类似增加;右侧睾丸对照组为8±1,左侧睾丸对照组为8±1,而右侧睾丸实验组为16±3,左侧睾丸实验组为18±4(p<0.01)。对照大鼠睾丸内温度与腹腔内温度的平均差值显著高于部分静脉结扎的大鼠(右侧睾丸4.02±0.25℃,左侧睾丸3.77±0.14℃)(右侧睾丸2.14±0.09℃,左侧睾丸2.34±0.12℃)(p<0.001)。对照犬睾丸内温度与直肠温度的平均差值也显著高于部分结扎或瓣膜破坏的犬(右侧睾丸对照组3.61±0.42℃,左侧睾丸对照组