| Objective:In this study,the hemodynamic parameters of left testicular capsular artery in patients with left varicocele were measured by energy Doppler ultrasonography spectrum,and the relationship between the hemodynamic parameters and semen quality was explored to provide a theoretical basis for predicting semen quality in patients with left varicocele through the blood flow of testicular capsular artery.Materials and Methods:From June 2017 to January 2019 in the Third Affiliated Hospital of Henan University of Chinese Medicine,patients with left varicocele subclinical t ype,clinical type I,clinical type II and clinical type III were selected as experimental group,20 patients were randomly selected in each group.From June 2017 to January 2019,40 healthy males aged 20 to 40 were randomly selected from the Third Affiliated Hospital of Henan University of Chinese Medicine as control group.All the subjects were required to sign the informed consent.The Danish BK Ultra View 800 ultrasonic diagnostic instrument equipped with a linear array probe was needed,and the probe frequency was set to be 12 MHz-18 MHz.All participants were in supine position and scrotum was exposed.The capsular arteries of left testis were displayed by color Doppler energy(CDE)imaging.The peak systolic velocity(PSV),end diastolic velocity(EDV),resistance index(RI)and pulsatility index(PI)of left testicular capsular arteries were measured by spectral Doppler.In three or more complete waveform spectrograms,the above indicators were measured three times and the average value was obtained.Within 24 hours,the testees were asked to collect semen,and the semen was examined by routine microscopy.Microscopic spermatic vein ligation was performed for those who met the surgical indications and agreed the surgery.3 months after operation,the testicular capsular artery hemodynamic parameters and semen quality were measured again,and their correlation was analysed again.Comparing the difference of hemodynamic parameters of testicular artery before and after operation.Comparing the difference of semen quality before and after operation.Results:1.With the increase of varicocele grade,PSV increased first and then decreased,RI and PI increased.Sperm concentration and forward motile sperm percentage decreased(P < 0.05).The EDV of patients with clinical type III was lower than that of other groups(P < 0.05).2.EDV was positively correlated with sperm concentration and forward motile sperm percentage in the experimental group,while RI and PI were negatively correlated with sperm concentration and forward motile sperm percentage respectively(P < 0.05).In the control group,there was a negative correlation between PSV of capsular artery and sperm concentration(P < 0.05).3.Sperm concentration and percentage of forward motile sperm increased after spermatic vein ligation(P < 0.05).4.The PSV and EDV of testicular capsular artery in postoperative patients were higher than in preoperative patients(P < 0.05),while RI and PI were lower(P < 0.05).5.In postoperative patients,RI and PI of left testicular capsular artery were negatively correlated with sperm concentration and forward motile sperm percentage respectively(P < 0.05),while EDV was positively correlated with sperm concentration(P < 0.05).Conclusions:1.EDV,RI and PI of left testicular capsular artery in patients with left varicocele are correlated with semen quality,and can be used as a reference index to predict semen quality in patients with left varicocele.2.Microscopic spermatic vein ligation can effectively improve semen quality in patients with varicocele.3.Scrotal power Doppler ultrasonography spectrum is a useful tool for detecting the changes of testicular microhemodynamics and evaluatin g the effect of microsurgical varicocelectomy.It can be used for follow-up of patients after microsurgical varicocelectomy. |
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