慢性前列腺炎對精索靜脈曲張患者精液質量的影響

蔡大偉　潘春雨　劉學鋒　卜仁戈　王　俠　吳　斌

【摘 要】 目的:探討慢性前列腺炎對精索靜脈曲張患者精液質量的影響。方法:收集160例精液常規異常的精索靜脈曲張患者。術前檢查患者精索靜脈曲張程度,其中II度曲張89例, III度曲張71例;術前均行精液常規及前列腺液常規檢查,其中符合慢性前列腺炎診斷者47例。結果:不伴有慢性前列腺炎的精索靜脈曲張III度患者與II度患者的精子活率及活力存在差異(P<0.05),精子密度及精液液化時間無顯著差異(P>0.05);伴有慢性前列腺炎的精索靜脈曲張患者與不伴有慢性前列腺炎的精索靜脈曲張患者的精子密度、精子活率和精子活力無顯著差異(P>0.05),而精液液化時間均存在差異(P<0.05)。結論:隨著精索靜脈曲張程度的加重,精液質量會隨之下降;伴有慢性前列腺炎可能會加重精索靜脈曲張對精液質量的影響,尤其會延長精液液化時間,從而影響精子活率、活力及穿透宮頸粘液的能力,影響男性生育。所以術后精液質量無明顯好轉的精索靜脈曲張患者應注意排除慢性前列腺炎的可能。

【關鍵詞】 精索靜脈曲張; 男性不育; 精液分析

The study of semen parameters of varicocele patients with or without chronic prostatitis

CAI Dawei, PAN Chunyu, LIU Xuefeng, BU Renge, WANG Xia, WU Bin

Department of Urology, Sheng Jing Hospital,China Medical University,Liaoning, Shenyang, 110004 China

【Abstract】 Objectives: To explore the effect of chronic prostatitis on Semen Parameters of patients with varicocele. Methods: 160 patients with varicocele were selected with abnormal semen analysis. The degree of varicosity were examined before operation. There were 89 patients with degree II and 71 patients with degree III. They received semen analysis and prostatic fluid analysis before operation. And 47 patients are with chronic prostatitis. Results: The sperm motility and sperm vitality of varicocele III patients without chronic prostatitis were different from those of varicocele II patients without chronic prostatitis(P<0.05), but not difference in sperm density and liquefaction time(P>0.05); The sperm density, sperm motility and sperm vitality of varicocele patients without chronic prostatitis were not different from those of varicocele patients with chronic prostatitis (P>0.05), but difference in liquefaction time (P<0.05). Conclusion: With aggravate of varicosity degree in varicocele, it will lead to a decline in semen parameters; with chronic prostatitis may lead to the deterioration in semen parameters, especially liquefaction time will be delayed, thus affecting the sperm motility, sperm vitality and the ability to penetrate the cervical mucus, which could further affect male fertility. So if the semen parameters of varicocele patients were not improved after operation, the possibility of chronic prostatitis should be considered.

【Key words】 Varicocele; Male infertility; Semen analysis

精索靜脈曲張(varicocele, VC)多發生在青壯年男性,患者常因患側陰囊墜脹痛或/和不育就診查體時被發現。精索靜脈曲張在一般男性人群中發生率約為9%～23%,但是在原發性和繼發性不育癥患者中的發病率分別高達35%～40%和75%～80%[1]。在臨床工作中發現很多精索靜脈曲張的患者同時伴有慢性前列腺炎(chronic prostatitis, CP),關于慢性前列腺炎對精索靜脈曲張患者精液質量影響的研究還很少。本文收集精液常規檢查存在異常的精索靜脈曲張患者160例,同時行前列腺液常規檢查,分析慢性前列腺炎對精索靜脈曲張患者精液參數的影響。

1 資料與方法

1.1 臨床資料

1999年9月～2008年9月我院收治的精索靜脈曲張患者160例,年齡18～36歲,平均25.6歲;其中II度曲張89例, III度曲張71例。所有患者術前均行精液常規檢查和前列腺液常規檢查,其中符合慢性前列腺炎診斷者47例。所有……