D'Agostino S, Musi L, Colombo B, Belloli G
Divisione di Chirurgia Pediatrica, Ospedale Regionale di Vicenza, Italia.
Pediatr Med Chir. 1996 Sep-Oct;18(5 Suppl):27-30.
The varicocele is still the most common correctable cause of male infertility. The epidemiologic studies revealed a gradually increasing incidence of varicocele in patients 10 to 18 years old, as height at the end of puberty as that of the adult male population. The pediatric varicocele is often associated with smaller and hypotrophic testis which presents also histological and progressive changes. Surgical correction of a varicocele in the adult usually produces poor results. In order to improve the fertility rate in adulthood an early varicocelectomy has been suggested. On the basis of our own studies and after a review of the literature, we conclude that all grade III varicoceles and grade II associated with testicular hypotrophy must be early operated on. This hearing provides a higher fertility rate and can prevent the reduced fertility associated with delayed varicocelectomy.
精索静脉曲张仍是男性不育最常见的可纠正病因。流行病学研究显示，10至18岁患者中精索静脉曲张的发病率逐渐上升，青春期末期的身高与成年男性群体相当。小儿精索静脉曲张常与较小且发育不良的睾丸相关，睾丸也呈现组织学和进行性变化。成人精索静脉曲张的手术矫正通常效果不佳。为提高成年后的生育率，有人建议早期进行精索静脉结扎术。基于我们自己的研究并在回顾文献后，我们得出结论，所有III级精索静脉曲张以及伴有睾丸发育不良的II级精索静脉曲张都必须尽早手术。这种手术能提供更高的生育率，并可防止因精索静脉结扎术延迟而导致的生育力下降。
