男性不孕症中的睾丸微石症：患病率、诊断和治疗算法

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研究的目的。申请生殖医学中心的男性睾丸微石症（TM）的患病率和结构研究，并创建一个管理TM患者的算法。材料与方法。回顾性分析了143名男性（平均年龄为34.6±7.9岁）一直申请International Centre for Reproductive Medicine不孕不育的调查。检查包括对阴囊器官进行超声检查，评估其状况和体积，并记录TM的存在和流行。结果。根据超声资料，睾丸体积在0.5至33.3ml之间，平均为12.3±5.8 ml。睾丸发育不全、精索静脉曲张、鞘膜积液和睾丸垂体囊肿分别有88例（61.5%）、35例（24.5%）、9例（6.3%）和50例（35%）的患者。12例（8.4%）男性患者检测到TM超声征象，5例（42%）为典型，7例（58%）为局限型，5例（42%）为双侧型。1例（8%）双侧TM患者检测到左侧睾丸肿瘤的超声征象，触诊未见，进行了根治性手术治疗。有TM时，睾丸体积更小，无精子症和睾丸肿瘤的检出率高于无TM时（分别p为0.002、0.013和0.085）。TM患者被告知需要进行肿瘤方面的谨慎操作，并遵循自我检查的建议；同时存在睾丸癌危险因素的男性被要求进行睾丸活组织检查，但所有接受检查的患者都不同意这种干预。已开发出一种诊断和治疗TM患者的算法，考虑到他们是否同意接受睾丸活检，以在他们不同意的情况下尽量减少他们负面后果的风险。结论。TM在不育男性中很常见，为了检测它，他们被显示要对阴囊器官进行超声检查。提出的男性TM诊断与治疗算法，旨在提高睾丸恶性肿瘤的早期发现率和治疗成功率，并保留生殖功能的实现前景。

作者简介

Igor Korneyev

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation; International Centre for Reproductive Medicine

编辑信件的主要联系方式.
Email: iakorneyev@yandex.ru
ORCID iD: 0000-0001-7347-1901
SPIN 代码: 4780-2266
Scopus 作者 ID: 6506000592
https://www.ooorou.ru/ru/users/iakorneyev-yandex-ru.html

Doctor of Medical Science, Professor, Department of Urology; Medical Director

俄罗斯联邦, Saint Petersburg

Ruslan Zasseev

International Centre for Reproductive Medicine

Email: r.zasseev@gmail.com

Urologist

俄罗斯联邦, Saint Petersburg

Aram Aloyan

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation

Email: uroved@mail.ru

Student

俄罗斯联邦, Saint Petersburg

Anastasia Grinina

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation

Email: uroved@mail.ru

Student

俄罗斯联邦, Saint Petersburg

Pavel Kondrashkin

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation

Email: uroved@mail.ru

Student

俄罗斯联邦, Saint Petersburg

Vladimir Makeev

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation

Email: uroved@mail.ru

Student

俄罗斯联邦, Saint Petersburg

Valeriy Furin

Academician I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of the Russian Federation

Email: uroved@mail.ru

Student

俄罗斯联邦, Saint Petersburg

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