Aşci R, Sarikaya S, Büyükalpelli R, Yilmaz A F, Yildiz S
Department of Urology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Br J Urol. 1998 May;81(5):750-2. doi: 10.1046/j.1464-410x.1998.00631.x.
To determine the effects of varicocelectomy on semen quality, testicular volumes and serum hormone levels in subfertile men with an absent or atrophic right testis.
Seventeen patients whose wives were gynaecologically normal were evaluated with at least two semen analyses and measurements of serum hormone levels and antisperm antibodies. Scrotal ultrasonography was used to determine testicular volumes and spermatic vein diameters. Varicocelectomy was performed by high ligation via an inguinal approach. All patients were seen at a follow-up 3 months later, and after 6, 9 and 12 months the scrotal ultrasonography, hormone assessment and semen analyses were repeated. Any pregnancies in their wives were recorded over a median follow-up of 19 months.
After surgery, all patients had significant improvements in sperm motility, morphology and concentration (P<0.01) but the differences in pre- and post-operative testicular volumes and plasma hormone levels were not statistically significant (P>0.01). No patients had immunological infertility. Eleven of the wives became pregnant during the follow-up.
Higher pregnancy rates can be achieved by left varicocelectomy in subfertile men with an absent or atrophic right testis. Sperm concentration, motility and morphology are significantly improved by varicocelectomy.
确定精索静脉曲张切除术对右侧睾丸缺如或萎缩的不育男性精液质量、睾丸体积和血清激素水平的影响。
对17名妻子妇科检查正常的患者进行了至少两次精液分析、血清激素水平及抗精子抗体检测。采用阴囊超声检查确定睾丸体积和精索静脉直径。通过腹股沟入路高位结扎行精索静脉曲张切除术。所有患者在术后3个月进行随访，术后6、9和12个月重复阴囊超声检查、激素评估和精液分析。记录其妻子在中位随访期19个月内的妊娠情况。
术后，所有患者的精子活力、形态和浓度均有显著改善（P<0.01），但术前和术后睾丸体积及血浆激素水平的差异无统计学意义（P>0.01）。无患者存在免疫性不育。随访期间11名患者的妻子怀孕。
对右侧睾丸缺如或萎缩的不育男性行左侧精索静脉曲张切除术可获得更高的妊娠率。精索静脉曲张切除术可显著改善精子浓度、活力和形态。
