[精索静脉曲张矫正治疗男性不育症:是时候改变模式了吗?]

Q4 Medicine Urologiia Pub Date : 2024-05-01
B Shomarufov A, A Akilov F, T Mukhtarov Sh, A Bozhedomov V
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引用次数: 0

摘要

我们分析了近期有关不育夫妇男性精索静脉曲张切除术的文献。一些患有精索静脉曲张的男性出现睾丸功能障碍的具体发病机制仍不清楚。最近的欧洲和美国泌尿外科指南建议对精子参数 "异常 "的不育男性进行精索静脉曲张治疗。尽管世界卫生组织《人类精液检查和处理实验室手册》第 6 版并未给出正常和异常精液参数之间的临界值。此外,目前还不清楚为什么约有三分之一的患者在接受精索静脉曲张切除术后生育能力没有得到改善。根据最近的一项分析,总进行性活动精子计数(TPMSC)和精子浓度可能是精索静脉曲张切除术后提高射精质量和怀孕的重要预测指标。不过,需要注意的是,已发表的研究报告的质量为中低水平。所有这些问题都表明,有必要进一步开展大规模、多中心、随机临床试验。
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[Varicocele correction in treatment of male subfertility: is it time to change paradigms?]

We have analyzed the recent literature regarding varicocelectomy in men from infertile couples. The specific pathogenesis of testicular dysfunction in some men with varicocele is still unclear. Recent European and American urological guidelines suggest treatment of varicocele in infertile men with "abnormal" sperm parameters. Although, according to the 6th edition of WHO laboratory manual for the examination and processing of human semen the threshold values between normal and abnormal semen parameters are not given. It is also still unclear why approximately a third of patients do not experience improvement in fertility after varicocelectomy. According to a recent analysis, the total progressive motile sperm count (TPMSC) and sperm concentration may be important predictors of improved ejaculate quality and pregnancy after varicocelectomy. However, it should be noted that the quality of the published studies was low to moderate. All of these issues point to the need for further large-scale, multicenter, randomized clinical trials.

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来源期刊
Urologiia
Urologiia Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
160
期刊最新文献
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