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Varicocele and reproductive function: pathozoospermia treatment (a prospective comparativeстатья
Информация о цитировании статьи получена из
Scopus
Дата последнего поиска статьи во внешних источниках: 29 сентября 2021 г.
- Авторы: Bozhedomov VA, AB Shomarufov, GE Bozhedomova, OA D., DM Kamalov, NI Sorokin, AA Kamalov
- Журнал: Urologii͡a (Moscow, Russia
- Номер: 2
- Год издания: 2021
- Первая страница: 62
- Последняя страница: 68
- DOI: 10.18565/urology.2021.2.62-68
- Аннотация: Varicocele does not always lead to infertility; varicocelectomy does not always improve sperm.Objective: to evaluate the standardized effect (Es) of nutrient therapy, microsurgical and laparoscopic varicocelectomy for pathozoospermia.Study design: a multicenter case-control study with stratified randomization.Materials and methods: data of a clinical and laboratory examination of patients with clinical varicocele over a 3-month period in the groups: A) the observation/control group (n=33), B) the group treated with nutrients (n=63), C) the group of patients after microsurgical varicocelectomy with a subinguinal mini access (n=86), D) the group of patients following laparoscopic surgery (n=36). The ejaculate was evaluated according to WHO-2010, DNA fragmentation by chromatin dispersion in an agarose gel.Results: After 3 months, varicocelectomy leads to an increase in sperm concentration and motility: the median of the total number of progressively motile spermatozoa in the ejaculate in A is +0.4 million; B - +1.9 million; C - +17.1 million (p<0.05); D - +21.2 million (p<0.05). A clinically significant increase in this indicator after varicocelectomy was found in 2/3 of cases: 65% (B; p<0.05) and 67% (G; p<0.05) with 38% (A) and 42% (B). Varicocelectomy leads to a decrease in sperm DNA fragmentation by an average of 5.5% (p<0.05) with an improvement in 59% of patients, but a 3-month therapy with nutrients reduces DNA fragmentation in a similar way: 5.5% (p<0.05), 66% of improvement cases. The differences in effect between B and D are insignificant (p>0.05). The laparoscopic surgery demonstrated higher Es than microsurgical operation (Es=0.70 and 0.44, with 0.29 in the patient receiving nutrients and 0.22 in the patients in the control group) Conclusion Varicocelectomy significantly improves sperm quality in 2/3 of cases, including 5.5% decrease in DNA fragmentation. Nutrient therapy produces similar DNA fragmentation improvement. Further research is necessary to identify who really requires varicocelectomy and who does not.
- Добавил в систему: Шомаруфов Азизбек Баходир угли