Está en la página 1de 7

Anales de Radiologa Mxico 2011;4:296-302.

ARTCULO ORIGINAL

Dr. Daniel Mauricio lvarez Arrazola*


Dr. Antonio Guardiola Fernndez**
Dr. Carlos Cuello Garca***
Dr. Eduardo Barrera Jurez****
Dr. Jorge Fernndez de la Torre*****

Varicocele e infertilidad: ndices


de resistencia y pulsatilidad en
ramas capsulares de la arteria
testicular y su relacin con la
cuenta espermtica

RESUMEN

(O YDULFRFHOH HV OD FDXVD


FRUUHJLEOHTXLU~UJLFDPHQWHPiV
FRP~QGHLQIHUWLOLGDGPDVFXOLQD
/DKLSyWHVLVGHGLVPLQXFLyQHQ
HO DSRUWH VDQJXtQHR \ OD DOWHUDFLyQ HQ OD PLFURYDVFXODWXUD
GHOWHVWtFXORSRUDXPHQWRHQOD
SUHVLyQ YHQRVD VH UHHMDUtDQ
WHyULFDPHQWH HQ HO DXPHQWR

GH ORV tQGLFHV GH UHVLVWHQFLD \


SXOVDWLOLGDG HQ ODV UDPDV FDSVXODUHV GH OD DUWHULD WHVWLFXODU
6H HVWXGLDURQ  SDFLHQWHV
JUXSRGHHVWXGLRSDFLHQWHV
JUXSRFRQWUROSDFLHQWHV7RGRVVHHYDOXDURQFRQHFRJUDItD
WHVWLFXODU 'RSSOHU FRORU \ FRQ
HVSHUPRJUDPD FRPR PpWRGR
GLDJQyVWLFR GH UHIHUHQFLD 1R
VHGHPRVWUyGLIHUHQFLDHVWDGtV-

'HSDUWDPHQWRGH5DGLRORJtD,QWHUYHQFLRQLVWD 'HSDUWDPHQWRGH5DGLRORJtDH,PDJHQ
,QYHVWLJDFLyQFOtQLFD 'HSDUWDPHQWRGH8URORJtD -HIDWXUD&OtQLFDGHO'HSDUWDPHQWRGH5DGLRORJtDH,PDJHQGHO+RVSLWDO6DQ-RVp7HFGH0RQWHUUH\,JQDFLR0RURQHV
3ULHWRSWH&RO'RFWRUHV0RQWHUUH\1/
&RSLDV copies 'U'DQLHO0DXULFLR$OYDUH]$UUD]ROD(PDLODOYDUH]PDXULFLR#JPDLOFRP

Introduccin
(OYDULFRFHOHHVODFDXVDFRUUHJLEOHTXLU~UJLFDPHQWH
PiVFRP~QGHLQIHUWLOLGDGHQHOSDFLHQWHPDVFXOLQR1
/RV YDULFRFHOHV FOtQLFRV HVWiQ FODUDPHQWH DVRFLDGRV
FRQGLVPLQXFLyQGHODFXHQWDHVSHUPiWLFDSHURODHVSHUPRJUDPDHVXQSURFHGLPLHQWRGLDJQyVWLFRTXHQR
JR]DGHODVPHMRUHVRSLQLRQHV\UHVXOWDGRVWDQWRSRU
VXFRPSOHMLGDGHQODREWHQFLyQGHODPXHVWUDFRPRSRU
ODLQWHUSUHWDFLyQLQH[DFWDGHVXVUHVXOWDGRV/RVPHFDQLVPRVVLRSDWROyJLFRVGHODDOWHUDFLyQHQODFXHQWD
HVSHUPiWLFD \ GH ODV FDUDFWHUtVWLFDV PRUIROyJLFDV \
GLQiPLFDV GH ORV HVSHUPDWR]RLGHV D~Q QR KDQ VLGR
GHWHUPLQDGRVFRQH[DFWLWXG1XHVWURHVWXGLRSURSRQH
HOXVRGHGRVYDULDEOHVREWHQLGDVDWUDYpVGHOXOWUDVRQLGR'RSSOHUFRORU\HVSHFWUDOSDUDGHPRVWUDUVLH[LVWH
DOJ~QFRPSRUWDPLHQWRHVSHFtFRFLUFXODWRULRDUWHULDOHQ
SDFLHQWHV FRQ YDULFRFHOH \ GLVPLQXFLyQ HQ OD FXHQWD
HVSHUPiWLFD /D QDOLGDG HV RIUHFHU XQD DOWHUQDWLYD
GLDJQyVWLFDQRLQYDVLYDTXHJHQHUHXQDSUHGLFFLyQGHO

2 9 6 Octubre-Diciembre 2011

WLFDPHQWH VLJQLILFDWLYD HQ ORV


tQGLFHVGHUHVLVWHQFLD\SXOVDWLOLGDGHQODVUDPDVFDSVXODUHVGH
ODDUWHULDWHVWLFXODUHQSDFLHQWHV
FRQYDULFRFHOH
Palabras clave: 'RSSOHU
HVSHUPRJUDPDWHVWtFXORXOWUDVRQLGRYDULFRFHOH
Contina en la pg. 297

HVWDGRGHODFXHQWDHVSHUPiWLFDHQXQSDFLHQWHFRQ
YDULFRFHOHFOtQLFR
*HQHUDOLGDGHV\VLRSDWRORJtD
9DULFRFHOH HV OD GLODWDFLyQ SDWROyJLFD GHO SOH[R
SDPSLQLIRUPHGHOFRUGyQHVSHUPiWLFR1 LPDJHQ 6X
LQFLGHQFLD HQ OD SREODFLyQ JHQHUDO HV GH DSUR[LPDGDPHQWHSHURDXPHQWDDHQWUH\HQOD
SREODFLyQ HVWXGLDGD SRU LQIHUWLOLGDG1 /D HWLRORJtD GHO
YDULFRFHOHHVFRQWURYHUWLGDFRQWHRUtDVTXHYDQGHVGH
YDULDQWHV DQDWyPLFDV UHXMR YHQRVR VHFXQGDULR D
GLVIXQFLyQYDOYXODUFRQJpQLWDRDGTXLULGDKDVWDREVWUXFFLyQYHQRVD1
(ODXPHQWRHQODSUHVLyQYHQRVDSXHGHDIHFWDUHO
DSRUWH VDQJXtQHR \ OD PLFURYDVFXODWXUD GHO WHVWtFXOR
UHODFLRQiQGRVHFRQGLVPLQXFLyQGHOXMRDUWHULDOTXH
LQWHQWDPDQWHQHUODKRPHRVWDVLVGHODSUHVLyQLQWUDWHVWLFXODU2/DGLVWULEXFLyQHQODVUHVLVWHQFLDVYDVFXODUHV
LQGLFDTXHODSUHVLyQFDSLODUSXHGHVHUH[WUHPDGDPHQWH
VHQVLEOHDODXPHQWRHQODSUHVLyQYHQRVDFRQVLGHUDQGRHOPRGHORGHKiPVWHU2(QHOPRGHORH[SHULPHQWDO
DO OLJDU ODV YtDV FRODWHUDOHV GHO XMR YHQRVR \ RFOXLU
SDUFLDOPHQWH OD YtD SULQFLSDO GH VDOLGD GH XMR YHQRVRGLVWDODOSOH[RPiVGHGHODHOHYDFLyQHQOD

Viene de la pg. 296

ABSTRACT

9DULFRFHOH LV WKH OHDGLQJ


FDXVH RI VXUJLFDOO\ FRUUHFWLEOH
PDOH LQIHUWLOLW\ 7KH K\SRWKHVLV
RI GLPLQLVKLQJ EORRG RZ DQG
DOWHUDWLRQ LQ PLFURYDVFXODWXUH
RI WKH WHVWLFOH GXH WR LQFUHDVH

RI YHQRXV SUHVVXUH ZRXOG EH


UHIOHFWHG WKHRUHWLFDOO\ LQ DQ
LQFUHDVHRIUHVLVWDQFHDQGSXOVDWLOLW\ LQGLFHV LQ WKH FDSVXODU
EUDQFKHVRIWKHWHVWLFXODUDUWHU\
7KLUW\WKUHHSDWLHQWVZHUHVWXGLHGLQRXUVDPSOHVWXG\JURXS
 SDWLHQWV FRQWURO JURXS 
SDWLHQWV 7KH\ DOO ZHUH HYDOXDWHGZLWKWHVWLFXODU'RSSOHUFRORU
HFKRJUDSK\DQGZLWKVSHUPDWR-

SUHVLyQYHQRVDGHOSOH[RSDPSLQLIRUPHVHWUDVPLWHD
ODVYpQXODVSRVFDSLODUHV/DYDVRFRQVWULFFLyQFUyQLFD
SUHFDSLODUSXHGHWHQHUXQHIHFWRGHOHWpUHRDOGHMDUGH
VXSOLUQXWULHQWHVDOWHVWtFXOR\SXHGHDIHFWDUVHFXQGDULDPHQWHDODHVSHUPDWRJpQHVLV1
/DSUHVLyQYHQRVDHOHYDGDSXHGHDGHPiVLQGXFLU
FDPELRVHQODSUHVLyQRQFyWLFDHKLGURVWiWLFD\PRGLFDU
HOWUDQVSRUWH\DPELHQWHSDUDFULQRVGHKRUPRQDVFODYH
DJUHJDQGRDOWHUDFLRQHVHQHOLQWHUFDPELRPLFURYDVFXODU
GHXLGRV1/RVHVWXGLRVGH+VXHWDOVRQHYLGHQFLDGH
TXHHVWDVSURSXHVWDVSXHGHQVHUFRUUHFWDVDOGHPRVWUDUGLVPLQXFLyQGHODVFRQFHQWUDFLRQHVGHQXFOHyWLGRV
GH DGHQRVLQD \ UHGXFFLyQ GH QLFRWLQDPLGDDGHQLQD
GLQXFOHyWLGRFLWRFURPR & HQ UDWDV FRQ YDULFRFHOH
LQGXFLGR (VWRV HVWXGLRV VXJLHUHQ XQD IRVIRULODFLyQ
R[LGDWLYDPLWRFRQGULDOGHIHFWXRVDRELHQPHWDEROLVPR
HQHUJpWLFRGHIHFWXRVRHQORVWHVWtFXORVFRQYDULFRFHOH
LQGXFLGR

ELRVFRS\DVGLDJQRVWLFPHWKRG
1R VWDWLVWLFDOO\ VLJQLFDQW GLIIHUHQFH ZDV REVHUYHG LQ WKH
UHVLVWDQFHDQGSXOVDWLOLW\LQGLFHV
LQ FDSVXODU EUDQFKHV RI WKH
WHVWLFXODUDUWHU\LQSDWLHQWVZLWK
YDULFRFHOH
Key words: 'RSSOHU VSHUPRJUDP WHVWLFOH XOWUDVRXQG
YDULFRFHOH

'HVDIRUWXQDGDPHQWHQRKDVLGRSRVLEOHHVWDEOHFHU
XQPHFDQLVPR~QLFRFRPRUHVSRQVDEOHGHODVLRSDWRORJtDGHOYDULFRFHOH6LQGXGDORVPRGHORVDQLPDOHV
VRQ \ VHUiQ ~WLOHV SDUD LQWHQWDU HQWHQGHU HVWH FRPSOHMRSURFHVR(OPHFDQLVPRGHEHVHUPXOWLIDFWRULDO\
GHEHLQFOXLUXQDSUHGLVSRVLFLyQJHQpWLFDTXHSXGLHUD
UHVSRQGHUDODH[SUHVLyQFOtQLFDYDULDEOHGHORVYDULFRFHOHVUHVSHFWRDODHVSHUPDWRJpQHVLVHLQIHUWLOLGDG
HQKXPDQRV1
Ultrasonido Doppler color
3HUPLWH GHPRVWUDU OD PDFURYDVFXODWXUD \ SRU OR
WDQWRLQGLUHFWDPHQWHYDORUDUSHUIXVLyQDH[SHQVDVGHO
'RSSOHUFRORUSRZHU'RSSOHU\XOWUDVRQLGR'RSSOHUHVSHFWUDO(OWHMLGRWHVWLFXODUQRUPDOPXHVWUDQRUPDOPHQWH
XQSDWUyQYDVFXODUHVWHODU/RVIDFWRUHVWpFQLFRVGHO
XOWUDVRQLGR GHEHQ VHU DMXVWDGRV SDUD SRGHU UHFDEDU
XMRVGHEDMDYHORFLGDG 35)\OWURGHSDUHGEDMRV

Imgenes 1A y B.(VWUXFWXUDVWXEXODUHVDQHFRLFDVSURPLQHQWHVHQWRSRJUDItDGHOSOH[RSDPSLQLIRUPHL]TXLHUGRHQHVFDOD
GHJULVHV/DH[SORUDFLyQHVSHFWUDOFRQ'RSSOHUFRORUHVLPSUHVFLQGLEOHSDUDFRUURERUDUODQDWXUDOH]DYHQRVDGHODVLPiJHQHVWXEXODUHV
Octubre-Diciembre 2011

297

FRQJDQDQFLDGHFRORUJHQHUDOPHQWHDUULEDGH 
(O XOWUDVRQLGR 'RSSOHU FRORU UHSRUWD XQD VHQVLELOLGDG
GHHQWUH\SDUDGHWHFWDUYDULFRFHOHVXEFOtQLFR
(O tQGLFH GH UHVLVWHQFLD ,5  VH KD FRUUHODFLRQDGR
FRQODSHUIXVLyQWLVXODU'LIHUHQWHVDOWHUDFLRQHVWLVXODUHV
VHUHODFLRQDQFRQHODXPHQWRRODGLVPLQXFLyQGHO,5
hQVDOHWDOSXEOLFDURQTXHHO,5HVXQLQGLFDGRUGHOD
PLFURFLUFXODFLyQWHVWLFXODU\TXHHVWiLQFUHPHQWDGRHQ
ORVFDVRVGHYDULFRFHOHFOtQLFR(VQHFHVDULRFRQVLGHUDUHQXQIXWXURFHUFDQRXQDFRUUHODFLyQHQWUHORV,5HO
YROXPHQWHVWLFXODU\ODFXHQWDHVSHUPiWLFD
ndices de resistencia y pulsatilidad en las ramas
capsulares de la arteria testicular
'H DFXHUGR FRQ ORV UHVXOWDGRV GH hQVDO HW DO ORV
YDORUHVGHORVtQGLFHVGHUHVLVWHQFLD\SXOVDWLOLGDGHQ
ODV UDPDV FDSVXODUHV GH OD DUWHULD WHVWLFXODU HQ SDFLHQWHVFRQYDULFRFHOH IXHURQVLJQLFDWLYDPHQWHPiV
HOHYDGRVTXHHQORVFRQWUROHVVDQRV LPDJHQ /RV
tQGLFHV GH UHVLVWHQFLD \ SXOVDWLOLGDG VRQ SDUiPHWURV
FRQDEOHVSDUDHYDOXDUODUHVLVWHQFLDDOXMRHQHOVLVWHPDDUWHULDO\SDUDGHWHFWDUDOWHUDFLRQHVHQODFRQGLFLyQ
KHPRGLQiPLFDUHVSHFWRDODVPHGLGDVGHYHORFLGDG(O
DXPHQWRHQORVtQGLFHVGHUHVLVWHQFLD\SXOVDWLOLGDGHQ
SDFLHQWHVFRQYDULFRFHOHFOtQLFRSRGUtDVHUXQUHHMR
GHXQDPLFURFLUFXODFLyQDUWHULDODOWHUDGD
Material y mtodos
3URWRFROR GH HVWXGLR HYDOXDGR \ DSUREDGR SRU
HO&RPLWpGHeWLFDH,QYHVWLJDFLyQGHODLQVWLWXFLyQ

6HLQFOX\HURQSDFLHQWHVUHIHULGRVSRUODFRQVXOWD
XUROyJLFD S~EOLFD \ SULYDGD  SDUD UHDOL]DFLyQ GH
'RSSOHU WHVWLFXODU SRU LQIHUWLOLGDG GRORU HVFURWDO
HWFpWHUD$OJXQRVFRQWDEDQFRQXQDSUXHEDHVSHUPiWLFDUHFLHQWH ~OWLPRVPHVHV \DTXHOORVTXHQR
FRQWDEDQFRQHVWHH[DPHQGHODERUDWRULRUHFLELHURQ
IDFLOLGDGHVSDUDUHDOL]DUHOHVWXGLRHQXQODERUDWRULR
TXHSDUWLFLSyFRPRDSR\RGHHVWDLQYHVWLJDFLyQ6H
UHDOL]yHQWRGRVORVFDVRVXOWUDVRQLGR'RSSOHUWHVWLFXODU\FXHQWDHVSHUPiWLFDHQHOSHULRGRGHMXQLR
DRFWXEUHGH
6H REWXYR HO FRQVHQWLPLHQWR LQIRUPDGR GH WRGRV
ORVSDFLHQWHV UHTXLVLWRSDUDSRGHUVHULQFOXLGRHQHO
HVWXGLR \VHDSOLFyXQFXHVWLRQDULRPpGLFRRULHQWDGR
\GHWDOODGRSUHYLRHOHVWXGLR/RVFULWHULRVGHH[FOXVLyQ
IXHURQ
 &LUXJtDGHYDULFRFHOHSUHYLD
 (QIHUPHGDGVLVWpPLFD
 7UDWDPLHQWRSUHYLRFRQTXLPLRWHUDSpXWLFRV
 6RVSHFKDGHFiQFHUWHVWLFXODU
 (VWDWXVSRVYDVHFWRPtD
$WRGRVORVSDFLHQWHVVHOHVUHDOL]yH[SORUDFLyQHQ
HVFDODGHJULVHV\HYDOXDFLyQ'RSSOHUFRORUHVFURWDOFRQ
WUDQVGXFWRUOLQHDOGH0+]FRQHFWDGRDXQDPiTXLQD6RQROLQH$QWDUHV 6LHPHQV8OWUDVRXQG0RXQWDLQ
9LHZ&$ /RVSDFLHQWHVIXHURQGLYLGLGRVHQJUXSRV
FRQEDVHHQHOJUDGRGHYDULFRFHOHLGHQWLFDGRHQOD
H[SORUDFLyQHFRJUiFD

Imagen 2.'RSSOHUFRORU\HVSHFWUDOGHODUDPDFDSVXODU HFKD GHODDUWHULDWHVWLFXODU

2 9 8 Octubre-Diciembre 2011

1) Grupo controlSDFLHQWHVVLQYDULFRFHOH\RYDULFRFHOH
JUDGR
2) Grupos de estudioSDFLHQWHVFRQYDULFRFHOHJUDGRV
\
(VFDODGHJUDGXDFLyQGHOYDULFRFHOH LPDJHQ 
a) Grado 0VLQYHQDVGLODWDGDV
b) Grado 1YHQDVGLODWDGDVPPGHGLiPHWURVLQ
IXJDYHQRVDFRQPDQLREUDGH9DOVDOYD
c) Grado 2 YHQDV GLODWDGDV \ WRUWXRVDV GLiPHWUR
HQWUH\PP\IXJDYHQRVDFRQPDQLREUDGH
9DOVDOYD
d) Grado 3YHQDVGLODWDGDV\WRUWXRVDV!PPGH
GLiPHWUR\IXJDYHQRVDFRQPDQLREUDGH9DOVDOYD
3DUD HO DQiOLVLV 'RSSOHU FRORU \ HVSHFWUDO GH ODV
UDPDV FDSVXODUHV \ GH ODV UDPDV LQWUDWHVWLFXODUHV
LPDJHQ VHREWXYLHURQORVVLJXLHQWHVSDUiPHWURV
 9HORFLGDGGHSLFRVLVWyOLFR
 9HORFLGDGGLDVWyOLFDQDO

 QGLFHGHUHVLVWHQFLD
 QGLFHGHSXOVDWLOLGDG
7RGDV ODV HFRJUDItDV IXHURQ HIHFWXDGDV SRU HO
PLVPR RSHUDGRU HQ OD PLVPD PiTXLQD VLJXLHQGR \
JDUDQWL]DQGRDVtXQSURWRFRORGHHVWXGLRKRPRJpQHR
\ UHSURGXFLEOH 6H DGTXLULHURQ PHGLFLRQHV HQ WUHV R
FXDWURDUWHULDVLQWUDWHVWLFXODUHV\FDSVXODUHVGHFDGD
WHVWtFXOR (O DQiOLVLV HVSHFWUDO GHO 'RSSOHU FRORU IXH
UHDOL]DGR SRU RWUR UDGLyORJR FRQ DPSOLD H[SHULHQFLD
HQHFRJUDItDXURJHQLWDOTXHQRWHQtDFRQRFLPLHQWRGHO
KLVWRULDOFOtQLFR\ORVUHVXOWDGRVGHOHVSHUPRJUDPD6H
SURPHGLDURQ  PHGLGDV FRQVHFXWLYDV HQ WUD]RV TXH
LQFOXtDQSRUORPHQRVFXUYDVHVSHFWUDOHVLGpQWLFDV
LPDJHQ DGHPiVVHHYDOXyODDQDWRPtDHVFURWDO\
ODSUHVHQFLD\JUDGRGHYDULFRFHOH
/RV YRO~PHQHV WHVWLFXODUHV IXHURQ DXWRPiWLFDPHQWH
FDOFXODGRVSRUHOSURJUDPDLQFOXLGRHQHOHTXLSRXVDQGR
ODIyUPXODHOtSWLFDGHDFXHUGRFRQODVGLVWDQFLDVSHUSHQGLFXODUHVPiVODUJDVHQORVGLiPHWURVGHOWHVWtFXOR
PHGLGDVFRQcalipersHOHFWUyQLFRV(OHVSHUPRJUDPDIXH
UHDOL]DGRVLQFRQWDUFRQLQIRUPDFLyQGHORVKDOOD]JRVGHO
XOWUDVRQLGR\FRPSUHQGH
([DPHQVLFRTXtPLFRD OLFXHIDFFLyQ E DVSHFWR
F YROXPHQG YLVFRVLGDG\H S+
([DPHQPLFURVFySLFRTXHHYDO~DD PRYLOLGDGE 
DJOXWLQDFLyQ F  YLDELOLGDG G  FRQFHQWUDFLyQ H  PRUIRORJtD\I FpOXODVGLIHUHQWHVDORVHVSHUPDWR]RLGHV
(OSDUiPHWURXWLOL]DGRSDUDFRQVLGHUDUROLJRVSHUPLD
IXH OD FRQFHQWUDFLyQ HVSHUPiWLFD HQ PLOORQHVPO XWLOL]DQGR FRPR UDQJR GH UHIHUHQFLD HO RWRUJDGR SRU OD
20610 PLOORQHVPO

Imagen 3. &DUDFWHUL]DFLyQ GH OD IXJD YHQRVD HQ HO SOH[R
SDPSLQLIRUPH

Imagen 4. $QiOLVLV HVSHFWUDO GH OD DUWHULD LQWUDWHVWLFXODU


L]TXLHUGD

Anlisis estadstico
6HUHDOL]yHODQiOLVLVHVWDGtVWLFRGHORVUHVXOWDGRV
FRQ 3$:6 DQWHV 6366  YHUVLyQ  GH :LQGRZV
/DSUXHEDWGH6WXGHQWVHHPSOHySDUDFRPSDUDUORV
UHVXOWDGRV8QYDORUGHpPHQRUDIXHFRQVLGHUDGR
HVWDGtVWLFDPHQWHVLJQLFDWLYR
Resultados
(OJUXSRGHHVWXGLRVHFRQIRUPyFRQSDFLHQWHV
FRQHGDGSURPHGLRGHDxRV UDQJR )XHQHFHVDULDXQDH[FOXVLyQWDUGtDSRUUHIHULUGHVSXpVGH
KDEHUOHUHDOL]DGRHOHVWXGLRGHHFRJUDItDWUDWDPLHQWR
SDUDYDULFRFHOHFRQHVFOHURWHUDSLD)LQDOPHQWHVHLQFOX\HURQVyORSDFLHQWHV
(OJUXSRFRQWUROFRQWyFRQSDFLHQWHVFRQHGDG
SURPHGLR GH  DxRV UDQJR   /D GLVWULEXFLyQ
GH ORV YDULFRFHOHV VH PXHVWUD HQ HO FXDGUR , (O YROXPHQWHVWLFXODUSURPHGLRHQHOJUXSRFRQWUROIXHGH
FPHQHOJUXSRGHHVWXGLR YDULFRFHOH IXH
GHFP FXDGUR,, 
Octubre-Diciembre 2011

299

Cuadro I. 'LVWULEXFLyQGHORVYDULFRFHOHV
3DFLHQWHVFRQ
KHPLHVFURWR
GHUHFKR n 

500.00

3DFLHQWHVFRQ
KHPLHVFURWR
L]TXLHUGR n 

1RYDULFRFHOH

 

 

*UDGR

*UDGR

 

 

*UDGR

 

Concentracin espermtica (millones/mL)

*UDGR

1RYDULFRFHOH\JUDGRIXHURQDFHSWDGRVFRPRYDULFRFHOH
VXEFOtQLFRV JUXSRFRQWURO 
*UDGRV\IXHURQDFHSWDGRVFRPRYDULFRFHOHVFOtQLFRV
JUXSRGHHVWXGLR 
SDFLHQWHVSUHVHQWDURQYDULFRFHOHELODWHUDOJUDGR
Cuadro II. 9ROXPHQWHVWLFXODUSRUJUXSRVGHODSREODFLyQHQ
HVWXGLR

*UXSRFRQWURO
*UXSRYDULFRFHOH

9ROXPHQWHVWLFXODU

9DORUGHp







400.00

300.00

32

200.00

100.00

0.00
Control

Varicocele
Grupo de estudio

Figura 1. *UiFD GH GLVWULEXFLyQ LQWHUFXDUWLO GH OD FXHQWD


HVSHUPiWLFDHQDPERVJUXSRVGHODSREODFLyQHQHVWXGLR

(QHODQiOLVLVHVSHFWUDO'RSSOHUQRVHGHPRVWUyGLIHUHQFLDHVWDGtVWLFDPHQWHVLJQLFDWLYDHQODPHGLFLyQ
GHORVtQGLFHVGHUHVLVWHQFLD\SXOVDWLOLGDGGHODVUDPDV
FDSVXODUHVDVtFRPRWDPSRFRGHODVUDPDVLQWUDWHVWLFXODUHVGHUHFKDVRL]TXLHUGDV FXDGUR,,, 
/DUHYLVLyQGHORVYDORUHVGHFRQFHQWUDFLyQHVSHUPiWLFD HQ PLOORQHVPO HQ DPERV JUXSRV GH HVWXGLR

HV FRQJUXHQWH FRQ OR GHVFULWR HQ OD OLWHUDWXUD FRQ


UHODFLyQ D OD GLVPLQXFLyQ HQ OD FXHQWD HVSHUPiWLFD
HQORVSDFLHQWHVFRQYDULFRFHOH JXUD /DUHODFLyQ
HQWUHHODXPHQWRHQORVtQGLFHVGHUHVLVWHQFLD ,5 HQ
HODQiOLVLVHVSHFWUDOGHOXOWUDVRQLGR'RSSOHUFRORU\OD
ROLJRVSHUPLDHQSDFLHQWHVFRQYDULFRFHOHQRSXGRVHU
GHPRVWUDGD FXDGUR,9 

Cuadro III.5HVXOWDGRVGHODQiOLVLVHVSHFWUDOGHODVUDPDVWHUPLQDOHVGHODDUWHULDWHVWLFXODU
5DPDVFDSVXODUHV

5DPDVLQWUDWHVWLFXODUHV

*UXSRGH
HVWXGLR

*UXSRFRQWURO

9DORUGHp

*UXSRGH
HVWXGLR

*UXSRFRQWURO

9DORUGHp

'HUHFKR













,]TXLHUGR













'HUHFKR













,]TXLHUGR













'HUHFKR













,]TXLHUGR













'HUHFKR













,]TXLHUGR













936

9)'

,5

,3

936 YHORFLGDGGHSLFRVLVWyOLFR9') YHORFLGDGGLDVWyOLFDQDO,5 tQGLFHGHUHVLVWHQFLD,3 tQGLFHGHSXOVDWLOLGDG


0HGLDGHVYLDFLyQHVWiQGDU

3 0 0 Octubre-Diciembre 2011

Cuadro IV.'LVWULEXFLyQGHSDFLHQWHVFRQROLJRVSHUPLD

*UXSRGHHVWXGLR
n 

*UXSRFRQWURO
n 

9DORUGHp

 

 



Discusin
$SHVDUGHODVP~OWLSOHVWHRUtDVDOUHGHGRUGHOSURFHVR
PHGLDQWH HO FXDO ORV YDULFRFHOHV FDXVDQ GLVPLQXFLyQ
HQ OD FXHQWD HVSHUPiWLFD D~Q QR H[LVWH XQD YHUGDG
DEVROXWDDOUHVSHFWR\VHFRQVLGHUDSRVLEOHXQDFDXVD
PXOWLIDFWRULDO(QORVWUDEDMRVSUHVHQWDGRVSRU6ZHHQH\
HWDO2VHPHQFLRQDDODXPHQWRHQODSUHVLyQYHQRVD
FRPRFDXVDLQGLUHFWDGHDXPHQWRHQODSUHVLyQDUWHULDO
DQLYHOGHODVUDPDVFDSVXODUHVGHODDUWHULDWHVWLFXODUOR
FXDOHVFRPSHQVDGRSRUXQDYDVRFRQVWULFFLyQDUWHULDO
(OWUDEDMRGH+VXHWDOFRQFOX\HTXHXQDGLVPLQXFLyQ
GHO XMR VDQJXtQHR HQ ORV WHVWtFXORV GH UDWDV FRQ
YDULFRFHOHLQGXFLGRJHQHUDGLVPLQXFLyQGHORVQXWULHQWHVDHVWHQLYHO\SRUORWDQWRXQDHVSHUPDWRJpQHVLV
DOWHUDGD(VWDSUHPLVDHVFODYHSDUDDVXPLUTXHPX\
SUREDEOHPHQWHpVWHVHDXQRGHORVPHFDQLVPRVVLRSDWROyJLFRVSDUDH[SOLFDUODGLVPLQXFLyQGHODFXHQWD
HVSHUPiWLFDHQHVHWLSRGHSDFLHQWHV(QORV~OWLPRV
DxRVVHKDQUHSRUWDGRP~OWLSOHVLQWHQWRVGHFDUDFWHUL]DU
ODVDOWHUDFLRQHVHQODYDVFXODULGDGHQORVWHVWtFXORVFRQ
YDULFRFHOHDWUDYpVGHODVGLVWLQWDVKHUUDPLHQWDVGHO
XOWUDVRQLGR GLDJQyVWLFR VLQ UHVXOWDGRV FRQFOX\HQWHV
'HVWDFDXQDUWtFXORUHFLHQWHPHQWHSXEOLFDGRSRUhQVDO
HWDOGRQGHVHDSR\DODWHRUtDGHOHTXLSRGHWUDEDMR
GH6ZHHQH\LGHQWLFDHODXPHQWRHQORVtQGLFHVGH
UHVLVWHQFLD\SXOVDWLOLGDGHQODVUDPDVFDSVXODUHVGH
OD DUWHULD WHVWLFXODU GH SDFLHQWHV FRQ YDULFRFHOH 6LQ
HPEDUJR HO DQiOLVLV GH ORV tQGLFHV GH UHVLVWHQFLD \
SXOVDWLOLGDGGHODVUDPDVFDSVXODUHVHLQWUDWHVWLFXODUHV
GH OD DUWHULD WHVWLFXODU HQ SDFLHQWHV FRQ YDULFRFHOH \
FRQWUROHVHQQXHVWURHVWXGLRQRLGHQWLFyGLIHUHQFLD
HVWDGtVWLFDPHQWHVLJQLFDWLYDGHORVPLVPRVDVtFRPR
WDPSRFRIXHSRVLEOHREWHQHUXQDFRUUHODFLyQGHpVWRV
FRQUHVSHFWRDODFXHQWDHVSHUPiWLFD
1XHVWURHVWXGLRSRGUtDHVWDUOLPLWDGRSRUHOWDPDxRGH
ODPXHVWUD Q  VLQHPEDUJRHOHVWXGLRGHhQVDOHWDO
QRSUHVHQWDXQDPXHVWUDVLJQLFDWLYDPHQWHPD\RU Q  
\OD~QLFDGLIHUHQFLDGHVGHHOSXQWRGHYLVWDWpFQLFRHFRJUiFRHVHOXVRGH'RSSOHUFRORUHQQXHVWURHVWXGLR\QR
HOGH3RZHU'RSSOHU hQVDOHWDO /RDQWHULRUQRHVXQD
UD]yQGHSHVRSDUDLQFLGLUVREUHORVUHVXOWDGRVSUHVHQWDGRV\DTXHHOHPSOHRGH'RSSOHUFRORUR3RZHU'RSSOHU
QRDIHFWDHQORVFiOFXORVGHORVtQGLFHVGHUHVLVWHQFLDR
SXOVDWLOLGDG/DVUDPDVFDSVXODUHVGHODDUWHULDWHVWLFXODU
WLHQHQ XQ iQJXOR DQDWyPLFR IDYRUDEOH SDUD HO DQiOLVLV
HVSHFWUDOFRQ'RSSOHUFRORUVLWXDFLyQTXHVHGLFXOWDDO
LQWHQWDUDQDOL]DUODVUDPDVLQWUDWHVWLFXODUHVGHELGRDOD

WRUWXRVLGDGHQVXGLVSRVLFLyQDQDWyPLFDVLWXDFLyQTXH
IDYRUHFHOHFWXUDVPHQRVH[DFWDVRPHQRVFRQDEOHV
1XHVWURVUHVXOWDGRVFRLQFLGHQFRQDOJXQRVWUDEDMRVSXEOLFDGRVFRPRHOGH*UDVVR/HDQ]DHWDO11GRQGHQRVH
HQFRQWUyHOHYDFLyQHQODYHORFLGDGGHSLFRVLVWyOLFRGHOD
DUWHULDWHVWLFXODUHQSDFLHQWHVFRQYDULFRFHOHFRPSDUDGD
FRQXQJUXSRGHFRQWUROHV
1XHVWUDFDVXtVWLFDQRGLHUHHQHOQ~PHURFDUDFWHUtVWLFDVRJUDGRGHYDULFRFHOHFRQUHVSHFWRDOUHSRUWH
GHhQVDOHWDOTXHSURFODPDtQGLFHVGHUHVLVWHQFLD\
SXOVDWLOLGDG HOHYDGRV HQ ORV WHVWtFXORV FRQ YDULFRFHOH
VLWXDFLyQTXHQRSXGLPRVUHSURGXFLUHQQXHVWURXQLYHUVR
GHSDFLHQWHV&RPRREVHUYDFLRQHVSDUDOHODVLGHQWLFDPRVORVLJXLHQWH$WUDYpVGHODQiOLVLVHVWDGtVWLFRGH
ODVYDULDEOHVHVWXGLDGDVVHUDWLFDFRQXQYDORUHVWDGtVWLFDPHQWHVLJQLFDWLYRODGLVPLQXFLyQGHYROXPHQHQ
HOWHVWtFXORFRQYDULFRFHOH\XQDWHQGHQFLDDSUHVHQWDU
EDMDVFXHQWDVHVSHUPiWLFDVHQHVWHPLVPRJUXSR\
1XHVWURVUHVXOWDGRVVXJLHUHQTXHQRH[LVWHQDXPHQWRV
HQORVtQGLFHVGHUHVLVWHQFLD\SXOVDWLOLGDGHQODVUDPDV
FDSVXODUHVGHODDUWHULDWHVWLFXODUHQSDFLHQWHVFRQYDULFRFHOH\TXHSRUORWDQWRQRHVSRVLEOHVHxDODUXQD
UHODFLyQGLUHFWDFRQODFXHQWDHVSHUPiWLFD6LQHPEDUJR
VHUtDLQGLVSHQVDEOHXQHVWXGLRFRQXQDPXHVWUDGHPD\RUWDPDxRSDUDFRQUPDUHVWRVUHVXOWDGRV
Conclusin
$ SHVDU GH TXH VLRSDWROyJLFDPHQWH VH SUHVXPH
TXHHQHOYDULFRFHOHHODXPHQWRHQODSUHVLyQYHQRVD
SUHFDSLODUWLHQHFRPRUHSHUFXVLyQGLUHFWDODYDVRFRQVWULFFLyQ DUWHULDO HQ HVWD LQYHVWLJDFLyQ QR IXH SRVLEOH
UHSURGXFLU HVWH PHFDQLVPR HQ HO DQiOLVLV HVSHFWUDO
FRQ XOWUDVRQLGR 'RSSOHU HQ ODV UDPDV FDSVXODUHV GH
ODDUWHULDWHVWLFXODU/DFRPSOHMLGDGGHODWpFQLFDSDUD
UHFDEDU LQIRUPDFLyQ HVSHFWUDO FRQ 'RSSOHU GH HVWRV
YDVRV\HOFDUiFWHURSHUDGRUGHSHQGLHQWHGHOSURFHGLPLHQWRUHVXOWDLPSUiFWLFRHQHVWHPRPHQWRSDUDHO
HMHUFLFLRFOtQLFRFRWLGLDQR3RUORWDQWRFUHHPRVTXHQR
HVYLDEOHFDWDORJDUDWUDYpVGHODQiOLVLVHVSHFWUDOFRQ
'RSSOHUGHODVUDPDVWHUPLQDOHVGHODDUWHULDWHVWLFXODU
HQ SDFLHQWHV FRQ YDULFRFHOH D DTXHOORV TXH WHQGUiQ
DOWHUDFLRQHVHQODFXHQWDHVSHUPiWLFD
/DLQWHQFLyQGHHYLWDUHOHVSHUPRJUDPDEDViQGRVH
HQHODQiOLVLVHVSHFWUDOGHDUWHULDVLQWUDWHVWLFXODUHV\R
FDSVXODUHVGHOWHVWtFXORQRSXHGHVXVWHQWDUVHFRQEDVH
HQORVUHVXOWDGRVGHQXHVWUDLQYHVWLJDFLyQ\GHKHFKR
SRQH HQ HQWUHGLFKR ORV UHVXOWDGRV GHO ~QLFR UHSRUWH
GHhQVDOHWDOTXHSUHWHQGHQIDYRUHFHUDOXOWUDVRQLGR
'RSSOHUHVSHFWUDOFRPRXQSURFHGLPLHQWRSURQyVWLFR
SDUDVXVWLWXLUDOHVSHUPRJUDPDFRPRSUXHEDREOLJDGD
HQHOHVWXGLRGHODSDUHMDFRQKLVWRULDOGHLQIHUWLOLGDG
Agradecimiento
$JUDGHFHPRVD/DERUDWRULRV'U0RUHLUDSRUODVIDFLOLGDGHVRWRUJDGDVSDUDODUHDOL]DFLyQGHHVWHHVWXGLR
Octubre-Diciembre 2011

301

Referencias
 1DXJKWRQ &. 1DQJLD$.$JDUZDO$
9DULFRFHOH DQG PDOH LQIHUWLOLW\ 3DUW ,,
3DWKRSK\VLRORJ\RIYDULFRFHOHVLQPDOH
LQIHUWLOLW\+XPDQ5HSURGXFWLRQ8SGDWH

 6ZHHQH\ 7( 5R]XP -6 *RUH 5:
$OWHUDWLRQ RI WHVWLFXODU PLFURYDVFXODU
SUHVVXUHVGXULQJYHQRXVSUHVVXUHHOHYDWLRQ$P-3K\VLRO++
 +VX+6&KDQJ/6&KHQ07HWDO
'HFUHDVHGEORRGRZDQGGHIHFWLYHHQHUJ\PHWDEROLVPLQWKHYDULFRFHOHEHDULQJ
WHVWLFOHRIUDWV(XU8URO
 6FKXULFK0$LJQHU))UDXVFKHU)3DOOZHLQ
/7KHUROHRIXOWUDVRXQGLQDVVHVVPHQWRI
PDOH IHUWLOLW\ (XURSHDQ -RXUQDO RI 2EVWHWULFV  *\QHFRORJ\ DQG 5HSURGXFWLYH
%LRORJ\666

3 0 2 Octubre-Diciembre 2011

 +RHNVWUD7:LWW0$7KHFRUUHODWLRQRI
LQWHUQDO VSHUPDWLF YHLQ SDOSDELOLW\ ZLWK
XOWUDVRQRJUDSKLFGLDPHWHUDQGUHYHUVDO
RIYHQRXVRZ-8URO
 hQVDO $ 7XUJXW $77DVNLQ ).RVDU
8.DUDPDQ&=5HVLVWDQFHDQGSXOVDWLOLW\LQGH[LQFUHDVHLQFDSVXODUEUDQFKHV
RIWHVWLFXODUDUWHU\LQGLFDWRURILPSDLUHG
WHVWLFXODUPLFURFLUFXODWLRQLQYDULFRFHOH"
-&OLQ8OWUDVRXQG
 &KLRX 5. $QGHUVRQ -& :RELJ 5
5RVLQVN\'HWDO&RORU'RSSOHU8OWUDVRXQG&ULWHULDWRGLDJQRVHYDULFRFHOHV
&RUUHODWLRQ RI D QHZ VFRULQJ V\VWHP
ZLWK SK\VLFDO H[DPLQDWLRQ 8URORJ\

 %RRWH(-'RSSOHU86WHFKQLTXHV&RQFHSWV RI EORRG RZ GHWHFWLRQ DQG RZ
G\QDPLFV5DGLRJUDSKLFV

 +HUW]EHUJ%6&DUUROO%$%RZLH-'HW
DO'RSSOHU86DVVHVVPHQWRIPDWHUQDO
NLGQH\V DQDO\VLV RI LQWUDUHQDO UHVLVWLYLW\ LQGH[HV LQ QRUPDO SUHJQDQF\ DQG
SK\VLRORJLF SHOYLFDOLHFWDVLV 5DGLRORJ\

&RRSHU71RRQDQ(9RQ(FNDUGVWHLQ6
$XJHU-HWDO:RUOG+HDOWK2UJDQL]DWLRQUHIHUHQFHYDOXHVIRUKXPDQVHPHQ
FKDUDFWHULVWLFV +XPDQ 5HSURGXFWLRQ
8SGDWH
*UDVVR/HDQ]D)3HSH33DQHOOD3HW
DO9RORFLPHWULFHYDOXDWLRQRIVSHUPDWLF
YHVVHOV ZLWK HFKRFRORU 'RSSOHU LQ SDWLHQWVZLWKLGLRSDWKLFYDULFRFHOH0LQHUYD
8URO1HSKURO

También podría gustarte