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目的:对多单位男性生殖功能流行病学研究中的睾丸体积测量进行质量控制研究。方法:我们构建了一个平衡分配数据矩阵,由10位来自5个不同研究所的调查者(从事男科学工作4到21年)在连续的两天内用 Prader 睾丸测量器测量12个男性志愿者(20—26岁)的睾丸体积。睾丸体积超声估计由一个经验丰富的技术人员完成。结果:10个调查者测量双侧睾丸体积的结果存在显著的组间统计差异(P<0.05)。睾丸体积测量结果显示调查者和志愿者之间存在显著的统计意义上的相互作用(P<0.01)。但是连续两天通过2种测量方法测得的双侧睾丸体积结果之间无显著差异。用超声波检查法测得的左右睾丸体积小于用睾丸测量器测得的值,但无显著差异(P>0.05)。调查者的工作经验没有显著影响睾丸体积测量结果的精确度。结论:研究表明10个调查者对睾丸体积的估计结果之间有显著差异,但组内差异不明显。因此,有必要在多单位男科学调研之前进行良好的培训和确定适当的测量标准。

Varicocele repair in adolescent remains controversial. Our aim is to identify and combine clinical trials results published thus far to ascertain the efficacy of varicocelectomy in improving testis volume and semen parameters compared with nontreatment control. A literature search was performed using Medline, Embase and Web of Science, which included results obtained from meta-analysis, randomized and nonrandomized controlled studies. The study population was adolescents with clinically palpable varicocele with or without the testicular asymmetry or abnormal semen parameters. Cases were allocated to treatment and observation groups, and testis volume or semen parameters were adopted as outcome measures. As a result, seven randomized controlled trials （RCTs） and nonrandomized controlled trials studying bilateral testis volume or semen parameters in both treatment and observation groups were identified. Using a random effect model, mean difference of testis volume between the treatment group and the observation group was 2.9 ml （95% confidence interval [CI]： 0.6, 5.2; P 〈 0.05） for the varicocele side and 1.5 ml （95% CI- 0.3, 2.7; P 〈 0.05） for the healthy side. The random effect model analysis demonstrated that the mean difference of semen concentration, total semen motility, and normal morphology between the two groups was 13.7 x 106 ml-1 （95% CI： -1.4, 28.8; P= 0.075）, 2.5% （95% CI：-3.6, 8.6; P= 0.424）, and 2.9% （95% CI： -3.0, 8.7; P= 0.336） respectively. In conclusion, although varicocelectomy significantly improved bilateral testis volume in adolescents with varicocele compared with observation cases, semen parameters did not have any statistically significant difference between two groups. Well-planned, properly conducted RCTs are needed in order to confirm the above-mentioned conclusion further and to explore whether varicocele repair in adolescents could improve subsequently spontaneous pregnancy rates.

Although idiopathic hypogonadotropic hypogonadism （IHH） has traditionally been viewed as a life-long disease caused by a deficiency of gonadotropin-releasing hormone neurons, a portion of patients may gradually regain normal reproductive axis function during hormonal replacement therapy. The predictive factors for potential IHH reversal are largely unknown. The aim of our study was to investigate the incidence and clinical features of IHH male patients who had reversed reproductive axis function. In this retrospective cohort study, male IHH patients were classified into a reversal group （n = 18） and a nonreversal group （n = 336）. Concentration of gonadotropins and testosterone, as well as testicle sizes and sperm counts, were determined. Of 354 IHH patients, 18 （5.1%） acquired normal reproductive function during treatment. The median age for reversal was 24 years old （range 21-34 years）. Compared with the nonreversal group, the reversible group had higher basal luteinizing hormone （LH） （1,0±0.7 IU 1-1 vs 0.4±0.4 IU 1-1, P 〈 0.05） and stimulated LH （28.3 ± 22.6 IU 1-1 vs 1.9 ±1.1 IU 1-1, P 〈 0.01） levels, as well as larger testicle size （5.1 ±2.6 ml vs 1.5± 0.3 ml, P〈 0.01）, at the initial visit. In summary, larger testicle size and higher stimulated LH concentrations are favorite parameters for reversal. Our finding suggests that reversible patients may retain partially active reproductive axis function at initial diagnosis.

The purpose of this study was to determine average penile length and to investigate the relationship between penile length and somatometric parameters in a group of young, healthy Turkish men. A total of 1132 men were included in the study. The age, height and weight of the subjects were recorded. Penile length was measured in both flaccid and stretched states. The correlation between penile length and somatometric parameters was analysed. The mean age of the subjects was 20.3±.0.9 years. The mean penile length in flaccid and stretched states was 9.3± 1.3 and 13.7± 1.6 cm, respectively （P〈0.001）. There was a positive correlation between flaccid and stretched penile length （r=0.800, P〈0.001）. The mean testicular volume was 22.0±2.8 cm3. A weak positive correlation was detected between penile length and mean testicular volume （r=0.143 for flaccid penile length and r=-0. 140 for stretched penile length, P〈0.001 for both）. Similarly, weak positive correlations were found between penile length （both flaccid and stretched） and height, weight and body mass index, respectively （P〈0.001, for all）. These results demonstrate that somatometric parameters are correlated with penile length. We believe that further studies would provide more information about the causal relationship.

The purpose of this study was to determine the relationships between monitors of spermatogenesis and predictors of the intracytoplasmic sperm injection （ICSI） outcome in patients with non-obstructive azoospermia （NOA） undergoing testicular sperm extraction （TESE）. Seventy-nine patients with NOA （mean age： 43.6±5.2 years）, each of whom yielded （97 000±3040） spermatozoa with conventional TESE, were considered in our analysis. Their partners （mean age： 35.8±5.1 years） underwent a total of 184 ICSI cycles; 632 oocytes were collected, 221 oocytes were injected, 141 oocytes were fertilized, 121 embryos were obtained, 110 embryos were transferred, 14 clinical pregnancies were achieved and only one miscarriage occurred. Multivariate regression analysis indicated relationships between the percentage of fertilized oocytes, transferred embryos and clinical pregnancies with the following variable values： female partner＇s age, number of spermatozoa collected, testicular volume, male partner＇s levels of follicle stimulating hormone （FSH）, number of oocytes collected, number of oocytes injected and number of ICSI cycles. A significant inverse relationship was found between female partner＇s age or male partner＇s FSH levels and biochemical pregnancies. A significant direct relationship emerged between the number of ICS! cycles and the percentage of oocytes fertilized, embryos transferred and biochemical pregnancies, and between the number of spermatozoa collected per testicular biopsy and biochemical pregnancies. The number of spermatozoa was positively linked to the number of clinical pregnancies, independent of the number of ICSI cycles and the number of oocytes collected/injected. The number of spermatozoa collected, FSH level and testicular volume are monitors of spermatogenesis linked to ICSI success.