精索静脉曲张患者双侧睾丸体积差异与精液质量关系的探讨

Correlation of bilateral testicular volume discrepancy with semen parameters in men with varicocele

目的:探讨精索静脉曲张(varicocele,VC)对患者两侧睾丸体积差异的影响及其与精液质量的相关性。方法:回顾性分析181例VC患者和102例非VC正常生育男性的临床资料,包括VC的程度(Ⅰ～Ⅲ度)和位置(左侧、右侧或双侧),睾丸体积、精液质量分析结果。结果:181例VC患者中存在睾丸体积差异132例(72.9%),其中左侧睾丸小于右侧的患者共117例(88.6%),102例非VC中存在睾丸体积差异35例(34.3%),不存在睾丸体积差异67例(65.7%)。Ⅲ度、Ⅱ度、Ⅰ度和非VC组出现睾丸体积差异的几率分别为61.3%、33.5%、20.9%和14.3%(P<0.05);不同年龄组患者睾丸体积差异百分比具有显著性差异(P<0.05);差异不同程度组之间正常形态精子百分率和精子活力均显著不同(P均<0.05)。结论:睾丸体积差异更常见于左侧VC患者,且睾丸体积差异发生率和程度同VC等级相关;睾丸体积差异程度越大,精液质量越差。

Objective ： To investigate the influence of varicocele on the volume discrepancy of bilateral testes, and the relationship between testicular volume discrepancy and semen parameters. Methods： This study included 181 varicocele patients and 102 normal fertile men without varicocele. We retrospectively analyzed their clinical data, including the grades and locations of varicocele, testis volume and semen parameters. Results： Bilateral testicular volume discrepancy was found in 132 （72.9%） of the varicocele patients （including 117 cases of left testicular hypotrophy [88.6% ] ）, and 35 （34.3%） of the non-varicocele fertile men. The rates of bilateral testicular volume discrepancy were 61.3%, 3.5%, 20.9% and 14.3% in the grade-Ⅲ, grade- Ⅱ, grade- Ⅰ and non-varicocle groups, respectively （P 〈 0.05）, with statistically significant differences among different age groups （P 〈 0.05 ）. The percentage of morphologically normal sperm and sperm motility were reduced differently with different degrees of testicular volume discrepancy （ P 〈 0. 05）. Conclusion ： Testicular volume discrepancy is more common in men with left varicocele, and its prevalence and degree are correlated with the grade of varicocele. Semen quality decreases with the increase of testicular volume discrepancy.