显微镜下精索静脉结扎术对患者血清睾酮及性功能的影响(1)
摘 要：目的 评价显微镜下精索静脉结扎术对患者血清睾酮及性功能的影响。方法 选择2013年8月～2017年3月于核工业四一六医院泌尿外科接受显微镜下精索静脉结扎术且有规律性生活的患者为研究对象，在征得患者同意后，分别于术前和术后6个月完成国际勃起功能指数(IIEF-5)量表和中国早泄患者性功能评价表(CIPE-5)的评分，同时检测患者血清性激素水平。结果 72例患者符合研究标准并得到有效随访，患者手术前后总IIEF-5评分、CIPE评分、血清睾酮水平均显著改善，各组手术前后比较差异具有统计学意义(P<0.05)，且患者术后血清游离睾酮的改变与IIEF的改善呈显著正相关。结论 显微镜下精索静脉结扎术不仅可以改善患者血清睾酮水平，对患者勃起功能的改善同样显著。
关键词：精索静脉曲张；显微镜下精索静脉结扎术；睾酮；国际勃起功能指数；中国早泄患者性功能评价表-5
中图分类号：R699.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.030
, 百拇医药
文章编号：1006-1959(2018)07-0095-03
Effect of Spermatic Vein Ligation under Microscope on Serum Testosterone and Sexual Function in Patients
WANG Xing，SHAO Ji-chun，ZENG Zhi-jun，LI Feng，YANG Jian-bo，HE Ting-ting
(Department of Urology，416 Hospital of Nuclear Industry，Chengdu 10000，Sichuan，China)
Abstract：Objective To evaluate the effect of spermatic vein ligation under microscope on serum testosterone and sexual function in patients.Methods From August 2013～March 2017 in the Department of Urology 416 Hospital of nuclear industry to accept the microscopic varicocelectomy and regular life patients as the research object，the consent of the patient，respectively，to complete the international index of erectile function 6 months before and after surgery(IIEF-5)scale and Chinese patients with premature ejaculation sexual function assessment form(CIPE-5)score，serum sex hormone levels in patients.Results 72 patients met the study criteria and effective follow-up，patients with total IIEF-5 score，CIPE score，serum testosterone levels were significantly improved， statistically significant difference between groups before and after surgery(P<0.05)，and postoperative changes of serum free testosterone and IIEF of the improvement was positively correlated.Conclusion Spermatic vein ligation under microscope can not only improve the level of serum testosterone，but also improve the erectile function of the patients.
, 百拇医药
Key words：Varicocele；Microscopical varicocele ligation；Testosterone；International erectile function Index；Sexual function Evaluation Table -5 of Chinese premature ejaculation patients
精索静脉曲张(varicocele，VC)是睾丸蔓状静脉丛的病理扩张，占青春后期男性的15%～20%，在原发性男性不育中占30%～40%，在继发性男性不育中占69%～81%[1，2]，是导致男性不育和精液质量异常的主要原因之一。精索靜脉结扎术可以改善患者精液质量，从而提高怀孕率。研究显示[3，4]，男性在患精索精索静脉曲张时，其性腺功能低下和勃起功能障碍更明显。虽然目前对精索静脉结扎术在改善男性生殖功能方面的研究较多，但在对睾丸内分泌功能的影响上则研究较少。多组研究均报道在精索静脉曲张行手术治疗后，其血清睾酮会提高。然而，并未对血清睾酮提高的临床意义进行评估。我们对2013年8月～2017年3月就诊于我院的精索静脉曲张患者采用显微镜下精索内静脉结扎术，术后随访发现该手术方式不仅可以提高患者的血清睾酮水平，对患者勃起功能及早泄的改善同样显著，现报告如下。, http://www.100md.com(王兴 邵继春 曾治军 李峰 杨剑波 何婷婷)
关键词：精索静脉曲张；显微镜下精索静脉结扎术；睾酮；国际勃起功能指数；中国早泄患者性功能评价表-5
中图分类号：R699.8 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.07.030
, 百拇医药
文章编号：1006-1959(2018)07-0095-03
Effect of Spermatic Vein Ligation under Microscope on Serum Testosterone and Sexual Function in Patients
WANG Xing，SHAO Ji-chun，ZENG Zhi-jun，LI Feng，YANG Jian-bo，HE Ting-ting
(Department of Urology，416 Hospital of Nuclear Industry，Chengdu 10000，Sichuan，China)
Abstract：Objective To evaluate the effect of spermatic vein ligation under microscope on serum testosterone and sexual function in patients.Methods From August 2013～March 2017 in the Department of Urology 416 Hospital of nuclear industry to accept the microscopic varicocelectomy and regular life patients as the research object，the consent of the patient，respectively，to complete the international index of erectile function 6 months before and after surgery(IIEF-5)scale and Chinese patients with premature ejaculation sexual function assessment form(CIPE-5)score，serum sex hormone levels in patients.Results 72 patients met the study criteria and effective follow-up，patients with total IIEF-5 score，CIPE score，serum testosterone levels were significantly improved， statistically significant difference between groups before and after surgery(P<0.05)，and postoperative changes of serum free testosterone and IIEF of the improvement was positively correlated.Conclusion Spermatic vein ligation under microscope can not only improve the level of serum testosterone，but also improve the erectile function of the patients.
, 百拇医药
Key words：Varicocele；Microscopical varicocele ligation；Testosterone；International erectile function Index；Sexual function Evaluation Table -5 of Chinese premature ejaculation patients
精索静脉曲张(varicocele，VC)是睾丸蔓状静脉丛的病理扩张，占青春后期男性的15%～20%，在原发性男性不育中占30%～40%，在继发性男性不育中占69%～81%[1，2]，是导致男性不育和精液质量异常的主要原因之一。精索靜脉结扎术可以改善患者精液质量，从而提高怀孕率。研究显示[3，4]，男性在患精索精索静脉曲张时，其性腺功能低下和勃起功能障碍更明显。虽然目前对精索静脉结扎术在改善男性生殖功能方面的研究较多，但在对睾丸内分泌功能的影响上则研究较少。多组研究均报道在精索静脉曲张行手术治疗后，其血清睾酮会提高。然而，并未对血清睾酮提高的临床意义进行评估。我们对2013年8月～2017年3月就诊于我院的精索静脉曲张患者采用显微镜下精索内静脉结扎术，术后随访发现该手术方式不仅可以提高患者的血清睾酮水平，对患者勃起功能及早泄的改善同样显著，现报告如下。, http://www.100md.com(王兴 邵继春 曾治军 李峰 杨剑波 何婷婷)