不同术式一侧睾丸取精对对侧睾丸生精功能影响的比较

Effects of Different Procedures for Unilateral Testicular Sperm Aspiration on Contralateral Testicular Spermatogenic Function

目的比较不同术式一侧睾丸取精对对侧睾丸生精功能的影响。方法将30例梗阻性无精症患者随机分为经皮附睾精子抽吸术组(PESA组)、睾丸穿刺精子抽吸术组(TESA组)和开放手术组(对照组),每组10例。均行右侧睾丸或附睾取精,同时获取右侧睾丸组织,术后45 d穿刺获取左侧睾丸组织;将所取睾丸组织进行苏木精-伊红(HE)染色,切片后于光镜下观察,测量睾丸曲细精管直径、内径及上皮高度;同时检测各组手术前后抗精子抗体(AsAb)阳性率。结果3组左右两侧睾丸曲细精管直径、内径、上皮高度比较,差异均无统计学意义(P>0.05),3组术后左侧睾丸曲细精管直径、内径、上皮高度比较,差异均无统计学意义(P>0.05)。30例患者手术前后抗精子抗体阳性率比较,差异无统计学意义(P>0.05)。结论本研究中3种手术取精方式对对侧睾丸生精功能均无明显影响。

Objective To compare the effects of different procedures for unilateral testicular sperm aspiration on contralateral testicular spermatogenic function.Methods Thirty patients with obstructive azoospermia were divided into three groups:percutaneous epididymal sperm aspiration(PESA)group,testicular sperm aspiration(TESA)group and open surgery group,with 10 patients in each group.The sperm were extracted from the right testis or epididymis,and the right testicular tissues were obtained.The left testicular tissues were obtained by puncture 45 days after operation.The tissues were sectioned,stained with hematoxylin and eosin,and observed under a light microscope.The diameter,internal diameter and epithelial height of the seminiferous tubules were measured.Furthermore,the positive rates of anti-sperm antibody(AsAb)were detected before and after operation.Results There were no significant differences in the diameter,inner diameter and epithelial height of seminiferous tubules between the left and right testis in the three groups(P>0.05).There were no significant differences in the diameter,inner diameter and epithelial height of the left seminiferous tubules among the three groups(P>0.05).In addition,the positive rates of AsAb did not changed after operation in all the patients(P>0.05).Conclusion In our research,three procedures for unilateral testicular sperm aspiration have no significant effects on contralateral testicular spermatogenic function.