Sigman M, Jarow J P
Department of Urology, Brown University School of Medicine, Providence, Rhode Island, USA.
J Urol. 1997 Aug;158(2):605-7.
The presence of ipsilateral testicular growth retardation (hypotrophy) is the most common indication for prophylactic varicocele repair in adolescents in an effort to prevent future infertility. We examined the relationship between semen parameters and ipsilateral versus contralateral testicular size in men with unilateral varicoceles to determine whether testicular size is an appropriate parameter for predicting future fertility.
We studied the records of consecutive patients with palpable unilateral left varicoceles for whom a history, physical examination and semen analysis were available. Total motile sperm counts of men with and without ipsilateral testicular hypotrophy were compared.
We identified 611 patients with unilateral clinical left varicoceles, including 305 (50%) with ipsilateral testicular hypotrophy. Mean total motile sperm counts plus or minus standard error of mean were significantly less in the patients with than without testicular hypotrophy (80 +/- 5.2 versus 126 +/- 7.8 x 10(6) sperm, p = 0.0018). Hypotrophy was more common in patients with large varicoceles (73%) than in those with medium (53%) or small (43%) varicoceles.
Infertile patients with testicular hypotrophy associated with unilateral varicoceles have worse semen parameters than those without hypotrophy. These data support the practice of varicocele repair in adolescents with varicocele associated testicular growth retardation.
同侧睾丸生长发育迟缓（萎缩）的存在是青少年预防性精索静脉曲张修复术最常见的指征，旨在预防未来的不育症。我们研究了单侧精索静脉曲张男性的精液参数与同侧和对侧睾丸大小之间的关系，以确定睾丸大小是否是预测未来生育能力的合适参数。
我们研究了连续的可触及单侧左侧精索静脉曲张患者的记录，这些患者有病史、体格检查和精液分析资料。比较了有和没有同侧睾丸萎缩的男性的总活动精子数。
我们确定了611例单侧临床左侧精索静脉曲张患者，其中305例（50%）有同侧睾丸萎缩。有睾丸萎缩的患者的平均总活动精子数加减平均标准误显著低于没有睾丸萎缩的患者（80±5.2对126±7.8×10⁶精子，p = 0.0018）。睾丸萎缩在大精索静脉曲张患者中（73%）比在中（53%）或小（43%）精索静脉曲张患者中更常见。
与单侧精索静脉曲张相关的睾丸萎缩的不育患者的精液参数比没有萎缩的患者更差。这些数据支持对患有精索静脉曲张相关睾丸生长发育迟缓的青少年进行精索静脉曲张修复术的做法。
