臨床不顯著精索靜脈曲張病人合併男性不孕的預測因子
陳修聖
台北市立聯合醫院和平婦幼院區泌尿科
國立陽明大學 醫學院 泌尿學科
Significant predictive factors for subfertility in men with subclinical varicocele
Saint Shiou-Sheng Chen
Department of Urology, National Yang-Ming University School of Medicine
Division of Urology, Taipei City Hospital HepingFuyou Branch, Taipei, Taiwan
Purpose: To determine the useful parameters for predicting subfertility in patients with subclinical varicocele (SV) by a retrospective study.
Materials and methods: Between June 2001 and February 2011, 150 men with SV, and 17 age-matched men without SV were recruited. They were divided into three groups: Group 1 with subfertile patients (n=15), Group 2 with fertile patients (n=135), Group 3 with control patients (n=17), respectively. The parameters for evaluation and comparison were included age, body mass index, semen analysis and PH, testicular volume, scrotal temperature, resistive index (RI), pulsatility index (PI) and peak retrograde flow (PRF) by color Doppler ultrasound.
Results: Of 150 patients with SV, 120 (80%) were left; 22 (14.7%) bilateral and 8 (5.3%) right. Subfertile patients (Groups 1) with SV had significantly lower testicular volume, higher scrotal temperature, RI, PI and PRF than fertile men with subclinical varicocele (Groups 2) and control group (Groups 3). Elderly men (>50 years, n=30) with SV had a significantly higher incidence of bilateral SV (9/30; 30% vs. 11/120; 9.2%) than young men with SV. No significant difference was noticed for age, body mass index and semen PH among the patients in three groups.
Conclusion: Patients with SV may suffer from subfertility regardless of age. More attention should be given to SV patients with RI>0.55ml/sec, PI>0.99 ml/sec, total testicular volume <27 cc, scrotal temperature> 34.94℃ and PRF >29 cm per second.