生精冲剂对精索静脉曲张大鼠睾丸生精功能的作用

目的:探讨生精冲剂对精索静脉曲张睾丸损伤的作用.方法:观察生精冲剂对实验性精索静脉曲张大鼠睾丸组织结构、超微结构的影响.测定各组实验大鼠睾丸SOD、CAT、ACE活性和LPO、NO含量.结果:治疗组鼠睾丸组织结构与超微结构的损害程度明显低于模型组;SOD、CAT、ACE活性测定值明显高于模型组,LPO、NO含量明显低于模型组(P<0.05).结论:生精冲剂对精索静脉曲张造成的睾丸损害有保护作用,其提高精液质量和生育率的机制可能与抗脂质过氧化和增强抗氧化酶活性有关.     

五羟色胺对精索静脉曲张患者睾丸生精功能的影响

５０只雄性Ｓ－Ｄ大鼠被分成五羟色胺（５－ＨＴ）组，精索精脉曲张模型给和对照组，观察睾丸生殖病理变化，进行组织学定量评价，并与人精索静脉曲张相比较。同时测定不同静脉血中５－ＨＴ含量。结果表明：精索静脉曲张者精索内静脉血中５－ＨＴ浓度明显增高，并与精子计数，精子活之间呈负相关。５－ＨＴ对模型鼠睾生精功能有毒性作用，其组织学改变和人精索静脉曲张相似。提示：５－ＨＴ对睾丸的毒性作用是精索静脉曲张不育的得要     

中药生精冲剂对精索静脉曲张大鼠的治疗

目的：研究中药生精冲剂对大鼠精索静脉曲张的影响及疗效。方法：从80只SD雄性大鼠中随机抽出20只作为假手术组，余60只均建立精索静脉曲张病理模型后随机均分为模型组、生精冲剂组和克罗米芬组。造模后15d生精冲剂组和克罗米酚组分别给予生精冲剂4g/（kg·d）和克罗米芬20mg/（kg·d）灌胃，模型组和假手术组正常喂食。造模后45d放免法测定血清性激素（FSH、LH和T）及观察各组大鼠睾丸组织结构。结果：生精冲剂组大鼠光镜下睾丸组织结构优于模型组和克罗米芬组；血清FSH、LH生精冲剂组显著低于模型组和克罗米芬组（P〈0.05），而克罗米芬组显著高于其他3组。T在生精冲剂组、克罗米芬组和假手术组之间无显著差异，但均显著高于模型组（P〈0.05）。结论：中药生精冲剂对精索静脉曲张引起的睾丸损害有保护及修复作用，且可能优于克罗米芬。     

D-柠檬烯对精索静脉曲张大鼠生精功能的保护作用

目的:探讨D-柠檬烯对精索静脉曲张(VC)大鼠生精功能的保护作用。方法:雄性SD大鼠40只随机分为4组,假手术组(A组),假手术+D-柠檬烯组(B组),VC组(C组),VC+D柠檬烯组(D组)。C、D组行左肾静脉缩窄术建立VC大鼠模型,B、D组术后每日腹腔注射D-柠檬烯200 mg/kg,A、C组注射等量生理盐水,4周...     

实验性精索静脉曲张大鼠生精状态评价

目的 通过对大鼠实验性精索静脉曲张(varicocele,VC)模型睾丸生精小管生精上皮结构、性激素水平的分析,探讨精索静脉曲张致不育的机制.方法 40只雄性青春期Wistar大鼠随机分为VC8周组(n=12)、VC12周组(13=12)和相应对照组(分别n=8);左肾静脉部分结扎建立实验性大鼠VC模型.术后8周或12周,分别测量各组大鼠:(1)左侧精索静脉直径、睾丸温度及体质量、睾丸生精小管生精上皮;(2)外周血中促卵泡刺激素(FSH)、黄体生成素(LH)和睾酮(T)的水平.结果 VC8周和VC12周组大鼠左侧精索静脉明显扩张,与对照相比血管直径差异有统计学意义(P<0.01);VC8和VC12周组大鼠左侧睾丸体质量均低于自体右侧睾丸和对照组睾丸,差异有统计学意义(P<0.05);光镜下,VC组大鼠双侧睾丸生精小管生精上皮精子发生阻滞、细胞脱落和细胞层数减少等,VC12周组损伤程度较VC8周组明显加重,左侧较右侧显著;与对照组相比,VC组大鼠外周血FSH、LH升高,T降低,差异均有统计学意义(P<0.01).结论 本研究提示:VC对大鼠双侧睾丸生精小管生精上皮产生明显的损害作用,并导致大鼠血中T水平降低和FSH、LH水平升高.     

精索静脉曲张致睾丸生精功能障碍的机制研究进展

精索静脉曲张(Varicocele,VC)是男性生殖系统常见病之一,随着男性不育发病率越来越高,对VC与男性生殖关系的研究成为生殖医学的热点问题之一。近年来,对VC影响睾丸生精功能障碍机制的研究,主要着眼于睾丸温度升高、缺氧、氧化应激、返流、细胞凋亡等诸多环节,但对其确切的机制尚未阐明。探讨VC致睾丸生精功能障碍的机制对临床应用具有重要意义,本文对国内外VC致睾丸生精功能障碍的相关文献进行综述,以期为临床应用提供参考。     

精索静脉曲张大鼠睾丸低氧与生精细胞凋亡的研究

目的 观察实验精静索静咏曲张(varicocele,VC)大鼠睾丸低氧诱导因子1α(HIF-1α)的表达与睾丸生精细胞凋亡的关系,探讨VC导致不育的病理生理机制.方法 40只大鼠,随机分为3组.建立模型49d后,取其左侧睾丸组织,检测睾丸组织的HIF-1α的表达和生精细胞的凋亡率.结果 westernblot和免疫组化检测的实验组睾丸HIF-1α的表达(2.529±1847,78.57%)显著高于对照组(0.308±0.165,14.29%)和假手术组(0.309±0.164,0.00%)(P<0.05),差异均具统计学意义;实验组睾丸细胞凋亡指数(20.79±5.70)显著低于对照组(0.6±1.4)和假手术组(0.36±0.71)(P<0.001),差异均具统计学意义;实验组睾丸HIF-1α的表达与其细胞凋亡指数呈正相关(r=0.844,P=0.017).结论 VC可引起睾丸低氧,而低氧可以通过诱导生精细胞凋亡来引起睾丸功能的改变.同时,HIF-1α是一种预测生精细胞凋亡程度的有用指标.     

精索静脉曲张大鼠生精小管生精上皮的超微结构研究

目的 通过精索静脉曲张大鼠睾丸的透射电镜观察,了解生精上皮更多的细胞病理现象.方法 雄性Sprayue-Dawley大鼠30只,随机分为(1)精索静脉曲张组(VG)20只,(2)假手术对照组(SOG)10只,按Saypol方法建立左精索静脉曲张模型,处死观察大鼠,取其左、右侧睾丸组织,作透射电镜观察.结果 VG组双侧睾丸均出现生精小管生精上皮的结构损害,左侧相对较重.与SoG组比较,VG的生精上皮变化表现为:支持细胞胞质内出现大量空泡,大量溶酶体出现(72%vs 28%);紧密连接破坏(69%vs31%),线粒体数量减少(160 vs 362), 两者均有显著性差异(P＜0.01);精子顶体形成异常(62%vs38%),尾部线粒体鞘部分缺失,嵴肿胀(71%vs 29%),尾部横切面线粒体数目减少(186 vs 401), 两者均有显著性差异(P＜0.01).结论 生精小管生精上皮的结构损害是由精索静脉曲张导致男性不育的重要原因.     

生精冲剂对实验性精索静脉曲张大鼠生精细胞凋亡状况的影响

目的:探讨实验性精索静脉曲张大鼠睾丸生精细胞凋亡状况以及生精冲剂对其凋亡的影响。方法:将60只成年雄性W istar大鼠随机抽出20只为对照组,其余按石津和彦改良法制成左精索静脉曲张大鼠模型,再随机分为模型组20只,治疗组20只。用末端脱氧核苷酸转移酶介导的原位缺口末端标记法(TUNEL)检测睾丸生精细胞凋亡。结果:模型组大鼠睾丸生精细胞凋亡指数明显高于对照组(P<0.01)和治疗组(P<0.01),治疗组与对照组比较有明显差异(P<0.01)。结论:实验性精索静脉曲张大鼠睾丸生精细胞凋亡增加,这可能是影响生育力的机制之一;生精冲剂能够减少精索静脉曲张大鼠睾丸生精细胞凋亡,对睾丸生精功能具有保护作用,进而可提高睾丸的生殖能力。     

Electron microscopic evidence for deep invaginations of the lamina propria towards the seminiferous tubule lumen in a patient with varicocele

Ultrastructural studies on biopsy tissue from the right testis of a 39-year old patient with varicocele revealed 2.5-5 microns thick invaginations of the lamina propria towards the lumen of the seminiferous tubules. These invaginations were of various lengths. The presence of invaginations was confirmed through examination of serial semi-thin sections. In some seminiferous tubules two neighbouring deep invaginations were joined together thus completely encircling and thereby separating the basal compartment, and in some cases even the adluminal compartment, of the seminiferous tubule. The invaginations were surrounded continuously by the basement membrane and contained collagen fibres, cell processes of myoid cells and in some cases also their nuclei.     

Morphological findings in varicocele An ultrastructural study of 30 bilateral testicular biopsies

A systematic study of a series of thirty bilateral biopsies of testes was performed using electron microscopy. Observations showed how frequently there were bilateral changes within the Sertoli cells. These included a sometimes extensive vacuolization of the endoplasmic reticulum which may cause germ cells to exfoliate. Bilateral vascular lesions including modifications of the capillary endothelium which becomes thick and rich in pinocytotic vesicles and arteriolar spasms with an increase in number of microfilaments in the endothelial cells were constantly observed.     

The effect of varicocele repair on testicular volume in children and adolescents with varicocele

PURPOSE: We investigated the effect of varicocele repair on testicular volume according to age in children and adolescents and review the long-term results of varicocele surgery. MATERIALS AND METHODS: The study included 39 boys 11 to 19 years old with clinical palpable varicocele who underwent varicocele surgery with at least 1 year of postoperative followup. Preoperative and postoperative testicular volumes were monitored and measured with an ellipsoid Prader orchidometer. Physical examination findings (testicular volumes and testicular consistency) in all boys, and serum hormone values and semen parameters in 16 adolescents were recorded and compared before and after surgery. RESULTS: Left unilateral varicocelectomy was done in 29 boys (74%) and bilateral varicocelectomy in 10 (26%). While no postoperative hematoma, infection or testicular atrophy was observed, 1 boy (2.5%) had varicocele recurrence and 2 boys (5.1%) had minimal hydroceles that required no intervention. Significant increases were observed in postoperative sperm concentration (p = 0.01), total motile sperm count (p = 0.009), testis volume (p = 0.000) and serum testosterone level (p = 0.014). All 15 boys with preoperative soft testis had normal testicular consistency postoperatively. Of the 19 boys with preoperative testicular atrophy 10 (53%) did regain normal testicular growth, while 9 (47%) retained testicular volume loss after surgery. When comparing preoperative to postoperative increase in testicular volume according to age in all boys, the mean was statistically significantly higher in boys younger than 14 years (left testis p = 0.037, right testis p = 0.000). CONCLUSIONS: Testicular consistency achieved normal firmness after varicocelectomy in all boys with preoperative soft testis. While there was catch-up growth in comparison to the contralateral testis, testicular consistency improved but testicular volumes may not increase significantly after varicocele repair at ages older than 14 years. However, in these adolescents postoperative semen parameters and serum hormone values may significantly improve regardless of testicular volume. Therefore, boys with varicocele and their families should be fully informed in light of these findings.     

Ultrastructure of the seminiferous tubules in oligoasthenoteratozoospermic men associated with varicocele

Varicocele is associated with venous reflux that may cause increased heat and interstitial pressure within the testes, with variable pathological effects on spermatogenesis. This study aimed to study the ultrastructural testicular changes in the seminiferous tubules of 20 infertile severe oligoasthenoteratozoospermia (OAT) men associated with varicocele and five patients with obstructive azoospermia without varicocele as controls. They were subjected to testicular biopsy which was evaluated by transmission electron microscopy. Ultrastructurally, the seminiferous epithelium in the testicular biopsies of infertile severe OAT men associated with varicocele was variably affected in the form of thickening of the peritubular connective tissue, vacuolation of Sertoli cell and germ cell cytoplasm, presence of degenerated and apoptotic cells among the germinal epithelium, altered spermatids and abnormal spermatozoa. It is concluded that varicocele in severe OAT men is associated with ultrastructural changes in the seminiferous tubule.     

Obstruction of the tubuli recti and ductuli efferentes by dilated veins in the testes of men with varicocele and its possible role in causing atrophy of the seminiferous tubules

Hormone measurements, spermiograms and testicular biopsies studies were performed in young with varicocele. In addition, the testes and epididymides of 27 adults with varicocele were obtained from autopsies. Light and electron microscopic examination of biopsy and autopsy specimens revealed two types of lesions in testes with varicocele: 1) a diffuse lesion consisting of abnormal spermatozoa and spermatid morphology and sloughing of immature spermatozoa and spermatid; 2) focal lesion, distributed irregularly throughout the testicular parenchyma, affecting several small groups of seminiferous tubules. Each of these groups corresponded to a testicular lobule and showed different degrees of tubular atrophy, so that the focal lesions were distributed in a mosaic pattern. The testicular interstitium showed dilated veins and venules, and progressive collagenization. Some testes showed dilated veins in the rete testis, which compressed several tubuli recti and caused tubular atrophy in the seminiferous tubules opening into these tubuli recti. Other testes showed dilated young veins among the ductuli efferentes, and the rete testis channels appeared to be dilated. Among the different etiological mechanisms which have been suggested to for testicular lesions in varicocele, tubular obstruction at the level of either the tubuli recti or the ductuli efferentes might be responsible for lesions leading to testicular atrophy.     

Intratesticular varicocele: Report of two cases

Intratesticular varicocele is a rare entity and describes dilated intratesticular veins radiating from the mediastinum testis into the testicular parenchyma. Scrotal ultrasonography of two patients who presented to our urology clinic due to left scrotal pain revealed multiple tubular structures in the testes with diameters of more than 2 mm. Duplex spectral analysis showed a reversed flow response to Valsalva's maneuver. Apropos of two cases, intratesticular varicocele is reviewed.