| Varicocele is one of the most common diseases in andrology.Because of its symptoms,such as scrotal pain and discomfort,testicular atrophy,it brings a great burden to patients' health and quality of life.Varicocele is also one of the important reasons leading to male infertility,which can induce sperm cell apoptosis,affect testicular spermatogenesis,sperm storage,transportation and capacitation in epididymis.Objective:To understand the basic conditions and clinical features of patients with varicocele through case collection and data analysis.Analyze the factors affecting the degree of varicocele,and provide evidence for the prevention and diagnosis of varicocele.Methods:157 varicocele patients who visited the urology department of a top three hospital in Changchun City from January 2016 to June 2017 were enrolled.According to the inclusion and exclusion criteria,we collected general information of patients through the design of the questionnaire.Clinical indicators of patients were collected through clinical observation and electronic medical records.Comparison among groups of continuous variables were calculated by One-Way ANOVA.Categorical data were compared using Fisher's exact test or Kruskal-Wallis test when appropriate.Risk factors for aggravating the degree of varicocele were analyzed by multivariate ordered logistic regression.Statistical analysis was performed using SPSS 18.0 software.All statistical tests were two-sided,and P<0.05 was considered significant.Results:1.A total of 157 patients were involved in the analysis.The average age was 29.79±9.58 years old,of which 11(7.0%)were younger than 18 years old,121(77.1%)were 18-35 years old,20(12.7%)were 36-60 years old,and 5(3.2%)were older than 60 years old.The mean BMI index was 21.47±2.68 kg/m2,and the systolic and diastolic blood pressure distributions were 130(120~145)mmHg and 85(80~96)mmHg,respectively.The blood glucose level was 5.44 ± 1.49 mmol/L.Among all patients,22(14%)were rural residents and 135(86.0%)were urban residents.There were 38 cases of unmarried,1 case of divorce and 118 cases of marriage.There were 15(9.6%)cases of hypertension,122(77.7%)of smokers,and 135(86.0%)of drinkers.The onset age of all patients was 27.72±9.22 years old.The incidence season was mainly spring and winter,accounting for 69.4%.The affected side of the patient was mainly left,accounting for 93.0%,and only 11 patients had bilateral lesions,accounting for 7.0%.Of the 157 patients,43(27.4%)were infertile.2.Univariate analysis showed that the age distribution of patients with four clinically graded was different(P<0.05).Except for subclinical patients,the older the VC patients,the more severe the varicose veins.The varicocele degree of the adolescent patients was relatively higher,while middle-aged and older patients were mainly II and III varices.Patients with lower BMI index have a higher degree of varicocele(P<0.05),while patients with higher systolic(P<0.05)and diastolic(P<0.05)blood pressure have a greater degree of varicocele.Patients with a history of hypertension had a higher proportion of grade III varices(P<0.05).Compared with patients who did not smoke and drink,VC patients who smoked(P<0.05)and consumed alcohol(P<0.05)have a greater degree of varicocele.The onset age of VC patients with four clinically grades was different(P<0.05).In addition to the subclinical patients,the older the onset age,the more severe the varicocele.The difference of blood glucose level,place of residence,disease season and affected side of patients with different clinical grades was not statistically significant(P>0.05).3.For each additional year of age,the risk of exacerbation of varicocele increased to 1.274 times(OR=1.274,95%CI:1.092-1.487);for each 1mmHg increase of diastolic blood pressure,the risk increased to 1.031 times(OR=1.031,95%CI:1.003-1.137);for every 1kg/m2 increase in BMI,the risk of varicocele aggravation was reduced to 0.885 times,and the high BMI index was a protective factor for varicocele(OR=0.885,95%CI:0.711-0.945).Patients with varicocele with a history of hypertension have a 2.89-fold higher risk of varicose curvature(OR=2.807,95%CI:2.614-2.997);patients with varicocele who have a smoking habit have a higher risk of varicose veins to 4.145 times(OR=4.145,95%CI:2.898-5.632).4.Compared with subclinical and grade I patients,the proportion of infertility in patients with grade II and III was significantly higher,and the difference was statistically significant(P<0.05).Conclusions:1.The age of admission to patients with varicocele is 18 to 35 years old,and the admission season is mainly in spring and winter,with more urban residents;most of the patients are married;most of the patients are smokers and drinkers;the affected side of the patient is mostly left.2.The proportion of infertility in patients with severe varicocele is relatively high.3.Patients with advanced age,high diastolic blood pressure,history of hypertension and smoking have a greater risk of severe varicocele. |
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