精索静脉曲张致男性不育的研究进展

Research progress of male infertility caused by varicocele

精索静脉曲张(VC)是引起男性不育的重要因素,其形成的因素常与解剖因素和精索静脉先天发育异常相关。曲张的精索静脉导致精索静脉抗返流作用减弱或消失,静脉血返流进入睾丸,对睾丸引起一系列的损害,最终导致不育。引起不育的机制尚未完全清楚,可能与睾丸局部温度升高、睾丸组织缺氧、氧化应激、肾上腺及肾脏代谢产物返流入睾丸、睾丸激素分泌的异常、免疫异常等相关。精索静脉曲张的诊断主要是通过临床表现、影像学检查、实验室检测等。对于精索静脉曲张的治疗,以手术治疗为主,不同的手术方式各有利弊。本文对VC致男性不育的研究进展作一综述。

Varicocele （VC） is an important cause of male infertility, also a common disease.VC not only causes male infertility, but also leads to the bulge feeling and the pain of ipsilateral scrotum.Moreover, the heavier patients may even cause mental illness.Congenital spermatic vein and anatomic abnormality may contribute to varicocele.Varicocele leads to the anti reflux effect of spermatic vein reduced or disappeared, and venous blood reflux into the testes, which causes series of damage to testiculara, eventually leads to infertility.The mechanism for varicocele causing sterility has not yet fully understood, may associated with local temperature rising in testis, testis hypoxia, oxidative stress, adrenal gland and kidney metabolites reflux to testis, testosterone abnormal secretion, immune abnormalities.The diagnosis of varicocele mainly by clinical manifestation, imaging examination, laboratory tests, etc.The treatment of varicocele is mainly about surgical, different ways of operation have different advantages and disadvantages.This article mainly on the mechanism of varicocele causing sterility mechanism, the diagnosis and treatment of the disease.