Zorgniotti A W
Urology. 1980 Jul;16(1):7-10. doi: 10.1016/0090-4295(80)90321-0.
The author presents arguments which favor elevated temperature of the testis and adnexae as an important factor in patients with poor semen seen in varicocele and "idiopathic" infertility. This appears to be primarily the result of disturbed thermoregulation due to internal spermatic vein retrograde blood flow. Elevated testis temperature without varicocele may be present in as high as 54% of all patients with "idiopathic" infertility. The prevailing theory in the United States is that the varicocele's bilateral effect is due to a substance noxious to spermatogeneis which is carried to both testes by retrograde internal spermatic vein blood flow and via crossover to the contralateral testis. A review of the published evidence for the crossover does not confirm its presence in the deep circulation of the contralateral testis, but rather its restriction to the superficial contralateral scrotal venous drainage. A simpler explanation for the bilateral effect of varicocele on spermatogenesis and sperm maturation by the epididymis is a gradient to the contralateral testis from the affected testis which results in demonstrable elevated temperature in both.
作者提出，对于精索静脉曲张和“特发性”不育症患者精液质量差的情况，睾丸及附件温度升高是一个重要因素。这似乎主要是由于精索内静脉血液逆流导致体温调节紊乱所致。在所有“特发性”不育症患者中，高达54%的人可能存在无精索静脉曲张的睾丸温度升高情况。美国流行的理论认为，精索静脉曲张的双侧影响是由于一种对精子发生有害的物质，该物质通过精索内静脉血液逆流以及交叉至对侧睾丸而被输送到双侧睾丸。对已发表的关于交叉情况的证据进行回顾后发现，并未证实其存在于对侧睾丸的深部循环中，而是局限于对侧阴囊的浅表静脉引流。精索静脉曲张对精子发生和附睾精子成熟产生双侧影响的一个更简单解释是，从受影响的睾丸到对侧睾丸存在一个梯度，这导致双侧睾丸温度明显升高。
