1, varicocele
According to clinical experience, the symptoms of varicocele will only get worse gradually. Symptoms have not improved since marriage. Many patients who see a doctor after marriage have an obvious aggravating trend compared with those before marriage.
The causes of varicocele mainly include congenital anatomical factors and acquired factors.
Anatomically, the left internal spermatic vein is injected into the left renal vein at a right angle and compressed by the sigmoid colon in front, and the left renal vein passes between the aorta and the superior mesenteric artery. When standing or connective tissue is relaxed, the superior mesenteric artery squeezes the left renal vein, forming a proximal clamping phenomenon (also known as nutcracker syndrome or left renal vein compression syndrome). Nutcracker syndrome occurs in 13 ~ 16 years old, which is mainly caused by the rapid development of adolescence, rapid growth of height, excessive extension of spine, sharp change of body shape or nephroptosis, etc., and the angle between superior mesenteric artery and aorta becomes smaller, and the renal vein is compressed. The right common iliac artery sometimes compresses the left common iliac vein, resulting in distal clamping.
All the above factors affect the left internal spermatic vein reflux. Under normal circumstances, blood enters the left renal vein from the spermatic vein in the left kidney, and there is a valve at the entrance of the left renal vein to prevent backflow. For example, if the venous valve is underdeveloped or the smooth muscle or elastic fiber of the venous wall is weak, it will lead to varicocele. Varicose veins caused by this anatomical factor are called primary varicocele.
Acquired diseases are mainly due to retroperitoneal tumors, renal tumors, hydronephrosis or vagus nerve vessels compressing the internal spermatic vein. When the renal vein or inferior vena cava is blocked by tumor thrombus or other reasons, the internal spermatic vein is blocked, resulting in secondary varicocele.
Patients with infertility or abnormal semen should receive surgical treatment regardless of symptoms. For asymptomatic people, especially those with varicocele in adolescence, whether treatment is needed is still controversial. In recent years, more and more studies have shown that the damage of varicocele to testis can occur in the early stage of onset, and this damage is gradual. Timely and effective treatment may reverse the damage of varicocele to testis and reduce the chance of infertility in adulthood.
At present, the indications for varicocele surgery in adolescents recognized by many scholars are as follows: (1) The testicular volume is obviously reduced (the difference between B-ultrasound measurements is more than 2ml); (2) Patients with bilateral varicocele; (3) Adolescent patients with obvious symptoms; (4) Patients with third-degree varicocele; (5) Abnormal semen analysis.
Therefore, on the issue of premarital surgery or marital surgery, premarital surgery is better than marital surgery for patients who need surgery. The earlier the operation, the less damage caused by varicocele to the testis and the greater the chance of testicular function recovery. If the operation is too late and the testicular injury is too serious, even after the operation, the therapeutic effect may not be achieved.
2. Male infertility
In addition to congenital testicular malformation and dysplasia, the external potential harm of male infertility is male underwear, which is often overlooked.
The contraction of scrotum is to adjust the temperature of testis to about 2 degrees lower than the body temperature. Only when the testis is about 2 degrees lower than the body temperature, it is beneficial to achieve the best state of testosterone secretion. Testosterone is an important substance to promote sperm production. Nowadays, tight men's underwear is very popular. Generally, the front design is double-layered and wraps the scrotum and penis together. For a long time, the crotch has been exposed to high temperature and humidity for a long time, which has become a hotbed of viruses and bacteria. Long-term high temperature and high humidity under the crotch is a potential danger to cause prostatitis, varicocele, seminal vesiculitis, scrotal eczema and other common male diseases. Prostatitis, varicocele and seminal vesiculitis are common diseases of male infertility. Therefore, experts suggest that the scrotum bag underwear with good ventilation and heat dissipation should be penetrated to keep the crotch dry, breathable and heat dissipation for a long time.
Analysis of several causes of male infertility
Male infertility is closely related to living habits besides heredity and some organic diseases. If we can understand or overcome these bad habits in daily life, we can reduce or avoid the occurrence of many male infertility. So, what factors will lead to male infertility?
(1) unclean sex life: unclean sex life can easily cause male reproductive tract infection. The pathogens causing reproductive tract infection are Neisseria gonorrhoeae, Mycobacterium tuberculosis, virus, mycoplasma, chlamydia, trichomonas and so on. Among them, mycoplasma and chlamydia infection are the most common. Reproductive tract infection first affects the production and transportation of sperm, resulting in oligozoospermia and the decline of male reproductive ability. Secondly, it can cause the change of semen liquefaction time. The liquefaction of semen is mainly accomplished by semen liquefaction factors such as proteolytic enzyme and fibrinolytic enzyme produced by prostate, which destroys coagulation factors produced by seminal vesicle. Genital tract infection leads to prostate secretion dysfunction, which makes semen lack of liquefaction factors and forms nocturnal syndrome, which becomes the direct cause of infertility. Reproductive tract infection can also affect accessory gonads, and can also cause insufficient semen secretion, resulting in insufficient semen feedback, changes in pH value, changes in mucus composition, and serious decline in sperm motility, leading to infertility.
(2) Smoking and alcoholism: Some men are quite sensitive to the poison of tobacco and alcohol, especially germ cells. According to research, nicotine in tobacco leaves will reduce the secretion of sex hormones and kill sperm. Who smokes 30 cigarettes a day, the sperm survival rate is only 49%; The androgen secretion of smokers is less than that of non-smokers 16%-47%. Long-term alcoholism will damage testicular spermatogenic cells and affect sperm production.
(3) The environment is overheated: the testis is the organ that produces sperm. During spermatogenesis, the temperature of testis must be at 35℃. 5-36。 5℃, lower than normal body temperature 1- 1.5℃. Often take a bath with very hot water, especially the tub bath and sauna bath, so that the scrotum is often in a high temperature state, which will affect the spermatogenic function of the testis. Wearing tight pants for a long time will make scrotum and testis stick together, which will increase the local temperature of testis and hinder sperm production. Once testicular blood stasis is formed, it will also lead to infertility.
Male infertility should adjust their psychology and steam less saunas.
mental regulation
Male infertility patients have great psychological pressure, not only to face their wives, but also to face their family and friends. It is very important to adjust one's psychology. We should not give up on ourselves. With the improvement of medical level and the progress of medical technology, many infertile patients have been well treated, and patients should cooperate with doctors with a positive attitude. To face their diseases correctly, many patients feel that infertility is a very shameful thing, and they are afraid to see a doctor for fear of contempt from others. According to the survey of the International Society of Traditional Chinese Medicine and Andrology, at least 50 million men of childbearing age in China suffer from infertility, and there are about 654.38+500 million men with prostate diseases.
Shaozheng sauna
Sperm production in testis requires an environment that is 37℃ lower than normal body temperature 1℃- 1.5℃. Some data show that if people are immersed in warm water at 43℃-44℃ for 20 minutes for three consecutive days, the sperm density of people with normal sperm density can be reduced to below100000 /ml, which can last for three weeks. The "warm contraception" studied in recent years is based on this truth. Therefore, frequent and long-term hot water bath is not suitable for infertile patients with low sperm count and low motility. Of course, it is ok to take a hot bath 1-2 times a week for a short time.