СОВРЕМЕННЫЙ ОБЗОР АНАТОМО-МОРФОЛОГИЧЕСКИХ ОСОБЕННОСТЕЙ И ВОЗМОЖНОСТЕЙ ХИРУРГИЧЕСКОЙ КОРРЕКЦИИ ВАРИКОЦЕЛЕ У ДЕТЕЙ


Цитировать

Полный текст

Аннотация

Варикоцеле является частой патологией яичек, выявляемой во время профилактических осмотров и в последующем нередко связываемой с бесплодием. Чаще всего встречается левостороннее варикоцеле. Данный обзор представляет анатомические особенности и основные патофизиологические механизмы, развивающиеся при варикоцеле в детском возрасте. Для правильного лечения данной патологии необходим тщательный подход к обследованию и определению показаний и тактики планируемого оперативного вмешательства. Существует много разногласий по поводу необходимости, времени и техники проводимого вмешательства. Практикующий врач должен взвешенно соотносить все «за» и «против» для выбора времени наблюдения и варианта лечения.

Об авторах

Р. С. Задыкян

МБУЗ г. Сочи «Городская больница № 9»

Автор, ответственный за переписку.
Email: noemail@neicon.ru
Россия

С. Н. Зоркин

ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России

Email: zorkin@nczd.ru
Россия

С. С. Задыкян

МБУЗ г. Сочи «Городская больница № 9»

Email: noemail@neicon.ru
Россия

Список литературы

  1. Paduch DA, Skoog SJ. Diagnosis, evaluation and treatment of adolescent varicocele. The Scientific World Journal. 2004; 4: 263-78. [PubMed]
  2. McManus MC, Barqawi A, Meacham RB, Furness PD, III, Koyle MA. Laparoscopic varicocele ligation: are there advantages compared with the microscopic subinguinal approach? Urology. 2004; 64(2):357-61. [PubMed]
  3. Wishahi MM. Anatomy of the spermatic venous plexus (pampiniform plexus) in men with and without varicocele: Intraoperative venographic study. The Journal of Urology. 1992; 147(5):1285-9. [PubMed]
  4. Shafik A, Moftah A, Olfat S, Mohi-el-Din M, El-Sayed A. Testicular veins: anatomy and role in varicocelogenesis and other pathologic conditions. Urology. 1990; 35(2):175-82. [PubMed]
  5. Stassen CM, Weil EHJ, Janevski BK. Left renal vein compression syndrome (“nutcracker phenomenon”). RoFo Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin. 1989; 150(6):708-10. [PubMed]
  6. Gall H, Rudofsky G, Bahren W, Roth J, Altwein JE. Intravascular pressure measurements and phlebography of the renal vein: a contribution to the aetiology of varicocele. Urologe. 1987; 26(6):325-30. [PubMed]
  7. Green KF, Turner TT, Howards SS. Varicocele: reversal of the testicular blood flow and temperature effects by varicocele repair. The Journal of Urology. 1984; 131(6):1208-11. [PubMed]
  8. Nagler HM, Lizza EF, House SD, Tomashefsky P, Lipowsky HH. Testicular hemodynamic changes after the surgical creation of a varicocele in the rat. Intravital microscopic observations. Journal of Andrology. 1987; 8(5):292-8. [PubMed]
  9. Romanes GJ, editor. Cunningham’s Textbook of Anatomy. 10th edition. London, UK: Oxford University Press; 1964. The male genital organs; 495-507.
  10. Harrison RG, Barclay AE. The distribution of the testicular artery (internal spermatic artery). British Journal of Urology. 1948; 20(2):57-66. [PubMed]
  11. Harrison RG. The distribution of the vasal and cremasteric arteries to the testis. Journal of Anatomy. 1949; 83(3):267-82. [PubMed]
  12. Lechter A, Lopez G, Martinez C, Camacho J. Anatomy of the gonadal veins: a reappraisal. Surgery. 1991; 109(6):735-9. [PubMed]
  13. Beck EM, Schlegel PN, Goldstein M. Intraoperative varicocele anatomy: a macroscopic and microscopic study. The Journal of Urology. 1992; 148(4):1190-4. [PubMed]
  14. Wishahi MM. Anatomy of the venous drainage of the human testis: testicular vein cast, microdissection and radiographic demonstration. A new anatomical concept. European Urology. 1991; 20(2):154-60. [PubMed]
  15. Wishahi MM. Detailed anatomy of the internal spermatic vein and the ovarian vein. Human cadaver study and operative spermatic venography: clinical aspects. The Journal of Urology. 1991; 145(4):780-4. [PubMed]
  16. Mohammed A, Chinegwundoh F. Testicular varicocele: an overview. Urologia Internationalis. 2009; 82(4):373-9. [PubMed]
  17. Unlu M, Orguc S, Serter S, Pekindil G, Pabuscu Y. Anatomic and hemodynamic evaluation of renal venous flow in varicocele formation using color Doppler sonography with emphasis on renal vein entrapment syndrome. Scandinavian Journal of Urology and Nephrology. 2007; 41(1):42-6. [PubMed]
  18. Ahmed K, Sampath R, Khan MS. Current trends in the diagnosis and management of renal nutcracker syndrome: a review. European Journal of Vascular and Endovascular Surgery. 2006; 31(4):410-6. [PubMed]
  19. Coolsaet BLRA. The varicocele syndrome: venography determining the optimal level for sugical management. The Journal of Urology. 1980; 124(6):833-9. [PubMed]
  20. Ting AC, Cheng SW. Nutcracker phenomenon presenting as left varicocele. Hong Kong Medical Journal. 2002; 8(5):380-3. [PubMed]
  21. Chakraborty J, Hikim AP, Jhunjhunwala JS. Stagnation of blood in the microcirculatory vessels in the testes of men with varicocele. Journal of Andrology. 1985; 6(2):117-24. [PubMed]
  22. Hudson RW. The endocrinology of varicoceles. Fertility and Sterility. 1988; 49(2):199-208. [PubMed]
  23. Goldstein M, Eid J-F. Elevation of intratesticular and scrotal skin surface temperature in men with varicocele. The Journal of Urology. 1989; 142(3):743-5. [PubMed]
  24. Swerdloff RS, Walsh PC. Pituitary and gonadal hormones in patients with varicocele. Fertility and Sterility. 1975; 26(10):1006-12. [PubMed]
  25. Santoro G, Romeo C. Normal and varicocele testis in adolescents. Asian Journal of Andrology. 2001; 3(4):259-62. [PubMed]
  26. Santoro G, Romeo C, Impellizzeri P, Arco A, Rizzo G, Gentile C. A morphometric and ultrastructural study of the changes in the lamina propria in adolescents with varicocele. BJU International. 1999; 83(7):828-32. [PubMed]
  27. Alberts B. Molecular Biology of the Cells. New York, NY, USA: Garland Publishing; 1989.
  28. Santoro G, Romeo C, Impellizzeri P, Gentile C, Anastasi G, Santoro A. Ultrastructural and immunohistochemical study of basal lamina of the testis in adolescent varicocele. Fertility and Sterility. 2000; 73(4):699-705. [PubMed]
  29. Santoro G, Romeo C, Impellizzeri P, et al. Immunofluorescence distribution of actin-associated proteins in human seminiferous tubules of adolescent testes, normal and pathologic. Journal of Endocrinological Investigation. 2000; 23(6):369-75. [PubMed]
  30. Davidoff MS, Breucker H, Holstein AF, Seidl K. Cellular architecture of the lamina propria of human seminiferous tubules. Cell and Tissue Research. 1990; 262(2):253-61. [PubMed]
  31. Pelletier R-M, Byers SW. The blood-testis barrier and Sertoli cell junctions: structural considerations. Microscopy Research and Technique. 1992; 20(1):3-33. [PubMed]
  32. Romeo C, Santoro G, Impellizzeri P, et al. Myofibroblasts in adolescent varicocele: an ultrastructural and immunohistochemical study. Urological Research. 2000; 28(1):24-8. [PubMed]
  33. Dym M, Fawcett DW. The blood-testis barrier in the rat and the physiological compartmentation of the seminiferous epithelium. Biology of Reproduction. 1970; 3(3):308-26. [PubMed]
  34. Maekawa M, Kamimura K, Nagano T. Peritubular myoid cells in the testis : their structure and function. Archives of Histology and Cytology. 1996; 59(1):1-13. [PubMed]
  35. Santamaria L, Martin R, Nistal M, Paniagua R. The peritubular myoid cells in the testes from men with varicocele: an ultrastructural, immunohistochemical and quantitative study. Histopathology. 1992; 21(5):423-33. [PubMed]
  36. Мещеряков Ю.В., Николаева А.С.. Патофизиологические пути развития варикоцеле-ассоциированного бесплодия. Новое слово в науке и практике: гипотезы и апробация результатов исследований. 2016;22: 37-46. [elibrary]
  37. Nicòtina PA, Romeo C, Arena S, Arena F, Maisano D, Zuccarello B. Immunoexpression of aquaporin-1 in adolescent varicocele testes: possible significance for fluid reabsorption. Urology. 2005; 65(1):149-52. [PubMed]
  38. Arena S, Arena F, Maisano D, Di Benedetto V, Romeo C, Nicòtina PA. Aquaporin-9 immunohistochemistry in varicocele testes as a consequence of hypoxia in the sperm production site. Andrologia. 2011; 43(1):34-7. [PubMed]
  39. Romeo C, Ientile R, Santoro G, et al. Nitric oxide production is increased in the spermatic veins of adolescents with left idiophatic varicocele. Journal of Pediatric Surgery. 2001; 36(2):389-93. [PubMed]
  40. Santoro G, Romeo C, Impellizzeri P, et al. Nitric oxide synthase patterns in normal and varicocele testis in adolescents. BJU International. 2001; 88(9):967-73. [PubMed].
  41. Romeo C, Santoro G. Varicocele and infertility: why a prevention? Journal of Endocrinological Investigation. 2009; 32(6):559-61. [PubMed]
  42. Salzhauer EW, Sokol A, Glassberg KI. Paternity after adolescent varicocele repair. Pediatrics. 2004; 114(6):1631-3. [PubMed]
  43. Çayan S, Woodhouse CRJ. The treatment of adolescents presenting with a varicocele. BJU International. 2007; 100(4):744-77. [PubMed]
  44. Costabile RA, Skoog S, Radowich M. Testicular volume assessment in the adolescent with a varicocele. The Journal of Urology. 1992;147(5):1348-50. [PubMed]
  45. Dubin L, Amelar RD. Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertility and Sterility. 1970; 21(8):606-9. [PubMed]
  46. Hirsh AV, Cameron KM, Tyler JP. The Doppler assessment of varicoceles and internal spermatic vein reflux in infertile men. British Journal of Urology. 1980; 52(1):50-6. [PubMed]
  47. Lyon RP, Marshall S, Scott MP. Varicocele in childhood and adolescence: implication in adulthood infertility? Urology. 1982; 19(6):641-64. [PubMed]
  48. Lipshultz LI, Corriere JN., Jr. Progressive testicular atrophy in the varicocele patient. The Journal of Urology. 1977; 117(2):175-6. [PubMed]
  49. Witt MA, Lipshultz LI. Varicocele: a progressive or static lesion? Urology. 1993; 42(5):541-3. [PubMed]
  50. Beddy P, Geoghegan T, Browne RF, Torreggiani WC. Testicular varicoceles. Clinical Radiology. 2005; 60(12):1248-55. [PubMed]
  51. Kass EJ, Reitelman C. Adolescent varicocele. Urologic Clinics of North America. 1995; 22(1):151-9. [PubMed]
  52. Rigano E, Santoro G, Impellizzeri P, et al. Varicocele and sport in the adolescent age. Preliminary report on the effects of physical training. Journal of Endocrinological Investigation. 2004; 27(2):130-2. [PubMed]
  53. Glassberg KI, Korets R. Update on the management of adolescent varicocele. F1000 Medicine Reports. 2010; 2(1, article 25) [PMC free article] [PubMed]
  54. Diamond DA, Zurakowski D, Bauer SB, et al. Relationship of varicocele grade and testicular hypotrophy to semen parameters in adolescents. The Journal of Urology. 2007; 178(4):1584-8. [PubMed]
  55. Kolon TF, Clement MR, Cartwright L, et al. Transient asynchronous testicular growth in adolescent males with a varicocele. The Journal of Urology. 2008; 180(3):1111-5. [PubMed]
  56. Preston MA, Carnat T, Flood T, Gaboury I, Leonard MP. Conservative management of adolescent varicoceles: a retrospective review. Urology. 2008; 72(1):77-80. [PubMed]
  57. Осипов И.Б., Лебедев Д.А., Комиссаров М.И., Алешин И.Ю., Рихсибоев Ж.Р. Рентгенангиохирургическое лечение варикоцеле. Урологические ведомости. 2015; (1): 70-1. [elibrary].
  58. Деревянко Т.И., Панченко И.А., Ефименко А.П., Шипилов А.И., Гармаш О.Н., Марабян Э.С., Панченко Р.И. Варикоцеле: Оптимальный лечебно-диагностический подход и медицинская реабилитация репродуктивной функции. Курортная медицина. 2014; 4: 47-53 [elibrary]
  59. Насыров А.Р. Видеоретроперитонеоскопический метод лечения при рецидивах варикоцеле у детей. Медицинский вестник Башкортостана. 2014;9, (1):69-72 [elibrary].
  60. Çayan S, Shavakhabov S, Kadioğlu A. Treatment of palpable varicocele review in infertile men: a meta-analysis to define the best technique. Journal of Andrology. 2009; 1:33-40. [PubMed]
  61. Borruto FA, Impellizzeri P, Antonuccio P, et al. Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis. Journal of Pediatric Surgery. 2010; 45(12):2464-9. [PubMed].

Дополнительные файлы

Доп. файлы
Действие
1. JATS XML
Скачать

© , 2018

Данный сайт использует cookie-файлы

Продолжая использовать наш сайт, вы даете согласие на обработку файлов cookie, которые обеспечивают правильную работу сайта.

О куки-файлах