[腹和男性不孕症]
E Huyghe1, C Methorst2, A Faix3
1Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; UMR DEFE, Inserm 1203, université de Toulouse, université de Montpellier, Toulouse, France.
概括
微手术静脉动脉切除术是因静脉动脉引起的男性不孕症的首选治疗方法,可显著改善妊娠和精子参数. 不建议治疗亚临床静脉瘤.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 生殖医学 生殖医学
- 安德罗学与人类学
背景情况:
- 静脉是男性不孕症最常见的可纠正的原因.
- 法国泌尿病学协会 (AFU) 的最近推的雄性病学和性医学委员会 (CAMS) 为管理提供了一个框架.
- 这次审查更新了自CAMS建议以来的文献.
研究的目的:
- 综合重新评估目前治疗静脉的适用性.
- 根据最近的进展,重新审视瘤管理的当代问题.
- 为临床医生提供最新的基于证据的审查.
主要方法:
- 对2020年至2023年期间进行了最新的文献搜索.
- 搜索的重点是与CAMS建议相关的研究.
- 本综述综合了最新文献中的发现.
主要成果:
- 微手术下腹静脉切除术是临床静脉和异常精子参数的不孕男性的黄金标准手术治疗,复发率低于4%.
- 这种外科手术方法显著提高了自然和体外受精妊娠率,同时改善了精子数量,运动性,形态和DNA碎片化.
- 静脉等级和双边性预测了更好的结果,而亚临床静脉治疗不建议. 反向栓塞是一种可行的替代方案.
- 并发症很少见,包括水 (0.5%) 和单边丸缩 (1/1000).
结论:
- 泌尿科医生应与男性伴侣和辅助生殖 (MPA) 团队讨论水栓治疗选择.
- 个性化的方法至关重要,考虑到患者特定的因素和治疗目标.
- 共享决策确保了与瘤有关的不孕不育的最佳管理策略.
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