Witt M A, Lipshultz L I
Department of Surgery, Emory University, Atlanta, Georgia.
Urology. 1993 Nov;42(5):541-3. doi: 10.1016/0090-4295(93)90268-f.
Varicoceles are associated with ipsilateral testicular atrophy in the adolescent. To determine if varicoceles are capable of causing progressive loss of fertility, we conducted a date-matched, retrospective study. We reviewed 2,989 patients evaluated for infertility at our institution from 1985 to 1990. A total of 285 (8.5%) patients were diagnosed with secondary infertility. A varicocele was identified as the cause of the patient's infertility in 177 (69%) men with secondary infertility. When matched by date to an identical number of men with primary infertility in whom 128 (50%) were infertile on the basis of a varicocele effect, the difference was significant (p < 0.0001). We conclude that a varicocele in some men is a progressive and not a static lesion resulting in the loss of previously established fertility. In addition, varicoceles are not only the leading cause of infertility in men with secondary infertility, but also occur with a greater frequency than in men with primary infertility.
精索静脉曲张与青少年同侧睾丸萎缩有关。为了确定精索静脉曲张是否能够导致生育能力的逐渐丧失，我们进行了一项日期匹配的回顾性研究。我们回顾了1985年至1990年在我们机构接受不育评估的2989例患者。共有285例（8.5%）患者被诊断为继发性不育。在177例（69%）继发性不育男性中，精索静脉曲张被确定为患者不育的原因。当按日期与相同数量的原发性不育男性匹配时，其中128例（50%）因精索静脉曲张效应而不育，差异具有统计学意义（p < 0.0001）。我们得出结论，在一些男性中，精索静脉曲张是一种进行性而非静态的病变，会导致先前已有的生育能力丧失。此外，精索静脉曲张不仅是继发性不育男性不育的主要原因，而且其发生率高于原发性不育男性。
