Efficacy Of Microscopic Internal Spermatic Vein Anastomosis In The Treatment Of Left Varicocele

Objective: To explore the clinical efficacy of "microscopic internal spermatic veininferior epigastric vein anastomosis" in the treatment of left varicocele and compare the clinical efficacy with "microscopic spermatic vein ligation" for the treatment of left varicocele.Methods: The clinical data of 48 patients with left varicocele who were hospitalized in the Department of Urology and Andrology of Sichuan Provincial People’s Hospital from July 2020 to July 2022 were analyzed.All patients were divided into two groups according to different surgical methods.Group A included 37 patients who had undergone "microscopic spermatic vein ligation(hereinafter referred to as " ligation ")",and Group B included 11 patients who had undergone "microscopic internal spermatic vein-inferior epigastric vein anastomosis(hereinafter referred to as " anastomosis ")".All research variables were statistically analyzed using IBM SPSS Statistics 27 software.When P value is less than 0.05,it will be considered as having statistical difference.Results: There was no significant difference in body mass index,age,sex hormone level,semen quality and left testicular volume between the two groups before operation.The maximum diameter of the left internal spermatic vein in the patients in the lower anastomosis group was larger than that in the ligation group when they breathed quietly,and the reflux time under the Valsalva action was longer than that in the ligation group.The quality of semen and the level of serum reproductive hormone were significantly improved in both groups.Compared with the ligation group,the sperm viability in the anastomosis group was improved significantly,but the operation time and hospital stay were longer.No recurrence was observed in the two groups during the follow-up period,and there was no significant statistical difference between the other postoperative observation indicators.Conclusion: The two surgical methods have good therapeutic effects on left varicocele.Anastomosis surgery can improve sperm viability more,but the operation time and hospital stay are longer.