精索静脉曲张男性的生殖潜能修复

G. Roitberg, Zh. V. Dorosh, T. Tarasova, I. Saushev, E. Tyurina, Irina V. Shuligina
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摘要

的相关性。在大多数男性中,睾丸静脉曲张(精索静脉曲张)不会引起不适且无症状,只有10%的患者会出现阴囊疼痛。在2/3的病例中,精索静脉曲张是临床表现。在这种情况下,精索静脉曲张是男性不育的最常见原因。研究的目的。精索静脉曲张患者生殖潜能的恢复。材料与方法。我们对219例精索静脉曲张患者进行了精索静脉曲张手术治疗后3、6、12个月的射精研究(WHO, 2010)。在12个月的随访期间,我们考虑了射精中正常精子恢复生殖功能和配偶开始怀孕的情况。结果和讨论。219例精索静脉曲张患者中2/3男性有射精异常。诊断为病理精子症的患者年龄为31+11岁。66例(39.5%)精索静脉曲张患者精子活动能力降低。手术治疗后(根据Marmara的说法是精索静脉曲张切除术),几乎每2名男性中就有1名患有正常精子症。然而,已婚夫妇在精索静脉曲张切除术后6个月以上怀孕的人数为24(32.8%)。手术治疗精索静脉曲张可使男性生殖功能恢复30%。在我们的研究中,几乎每2例患者中就有一例精索静脉曲张切除术后的无精子症。精索静脉曲张睾丸超声改变对男性生育能力的恢复是不利的预后。结论。精索静脉曲张的手术治疗可以恢复几乎每两个育龄男性的生殖潜能。此外,在手术后6个月怀孕的女性中,配偶怀孕的比例更高。
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Reproductive potential repair in men with varicocele
Relevance. In majority of men, varicose veins of the testicle - varicocele - does not cause discomfort and is asymptomatic, and scrotal pain only bothers 10 % of patients. In 2/3 of cases, varicocele is a clinical finding. In this case, varicocele is the most common cause of male infertility. Aim of the study. Recovery of the reproductive potential of patients with varicocele. Materials and Methods. In 219 patients with varicocele, weve carried an ejaculate study out (WHO, 2010) 3, 6, 12 months after surgical treatment of varicocele. We considered the reproductive function restored by normozoospermia in the ejaculate and the onset of pregnancy in the spouse during the follow - up period of 12 months. Results and Discussion. The 2/3 men of the 219 patients with varicocele had ejaculate abnormalities. The age of patients who were diagnosed with pathospermia was 31+11 years. 66 (39.5 %) patients with varicocele had spermatozoa with reduced mobility. After surgical treatment (varicocelectomy according to Marmara), normozoospermia was present almost in every second man. Nevertheless, the number of pregnancies in a married couple was higher than 6 months after varicocelectomy - 24(32.8 %). The surgical method of treatment of varicocele allows to restore the reproductive function of a man in 30 %. In our study, normozoospermia after varicocelectomy was recorded in almost every second patient. Ultrasound changes in the testicle with varicocele are an unfavorable prognosis for the restoration of male fertility. Conclusion. Surgical treatment of varicocele can recover the reproductive potential of almost every second man of reproductive age. Moreover, a greater number of pregnancies six months right after the operation were registered in spouses.
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