精索静脉曲张睾丸温度升高机制探讨

THE MECHANISM OF TESTICULAR HYPERTHERMIA IN VARICOCELE PATIENTS

目的探讨精索静脉曲张（ＶＣ）患者睾丸温升高机制。方法对２２例生育者、４４例ＶＣ患者及１７例原发无精症（ＰＡ）患者行远红外阴囊测温。结果①ＶＣ患者双侧阴囊温度显著高于生育者（Ｐ＜０．０１）而低于ＰＡ患者（Ｐ＜０．０１）。②精液正常ＶＣ患者阴囊温度无升高，精液异常ＶＣ患者阴囊温度显著高于精液正常ＶＣ患者。③ＰＡ患者与ＶＣ合并无精症患者的阴囊温度无显著差异。④单侧ＶＣ患者的双侧阴囊温度升高无差异，且温度升高与静脉曲张程度无关。结论ＶＣ并非引起睾丸温度升高的原因。阴囊温度调节功能障碍可能是睾丸温度升高的直接原因。

Objective To study the mechanism of testicular hyperthermia in varicocele (VC) patients.Methods Bilateral scrotal temperatures (Ts) were measured in 22 fertile men, 44 VC patients and 17 primary azoospermia (PA) patients by infrared scrotal thermography.Results 1.The Ts of VC patients was significantly higher than that of fertile men ( P <0.01),but lower than that of PA patients ( P <0.01).2.The Ts of VC patients with normal semen was similar to that of fertile men, but lower than that of VC patients with poor semen ( P <0.01).3.The Ts of PA patients did not significantly differ from that of VC patients with azoospermia.4.In unilateral VC patients was found bilateral elevation of Ts,and the elevation of Ts was not related to the degree of VC.Conclusion Varicocele is not the direct cause of testicular hyperthermia.It is possible that athermoregulatory dysfunction of the scrotum accounts for the testicular hyperthermia.