Varicocele Different Operative Methods For Treatment Effect Analysis

Purpose 1.Observed in patients with varicocele divided according to different treatment by retroperitoneal high ligation, Spermatic vein bypass - abdominal vein bypass, microsurgical, percutaneous embolization of internal spermatic vein complications after its Postoperative recurrence, compared preoperative and postoperative semen analysis, etc. were reviewed to compare treatment effects;2. Spermatic venography observe whether the valve structure. In order to understand the pathogenesis of varicocele provide the basis;3.observe the conventional light microscope vessel wall structural changes and differences, and the wall atrophy and varicocele degree of relevance;Method 2008.9-2010.9. collected in Urology, Third Affiliated Hospital of Anhui Medical University, Binhu Hospital, the Third Affiliated Hospital of Anhui Medical University, Urology Shushan Branch 103 surgical patients hospitalized patients. The main reason for treatment in patients with sterile marriage (married 2 years of normal sexual life is not birth) or with perineal discomfort, pain, a few no symptoms, and physical examination found that varicocele, mean age 27.9 years (18 ~ 47 years). 57 cases in which infertility treatment, perineal discomfort, pain and symptoms of treatment of 30 cases, physical examination found that treatment of 16 cases. All patients before routine examination and semen analysis of B-ultrasound. 103 patients were divided into four groups, 2 cases were bilateral, were left over, A group: internal spermatic vein - inferior epigastric vein bypass 24 patients; B group: retroperitoneal high ligation of the spermatic vein of 50 cases; C group: 22 cases of micro-surgery group; D Group: into the vein by percutaneous intervention Embolization group of 7 cases. 103 cases by using different surgical methods of varicocele patients were followed up, compare the recent surgical complication rate and improve the quality of semen after recurrence, to evaluate the different surgical methods of treatment. In the surgical specimens while specimens from the spermatic vein (2cm), a total of 32 cases (7 cases was varicose, varicose second 12 cases, 13 cases of varicose three). Same period, the collection of Urology, Third Affiliated Hospital of Anhui Medical University Hospital 2 cases of surgical patients selected the left spermatic cord hydrocele patients with normal spermatic vein as a control study, these patients underwent preoperative Doppler ultrasound spermatic vessels, combined with Valsalva action to determine whether the varicose spermatic veins and varicose indexing. Four group vein samples were all performed conventional pathological microtomy and Hematoxylin and eosine(HE) stain. Through light microscope pathologic appearance were analysised. Percutaneous spermatic vein embolization in patients with intraoperative angiography, and 5 cases of testicular castration were taken during surgery, intraoperative imaging, as a control group without understanding the entire spermatic vein valve situation.Results Spermatic vein through the cross section of conventional biopsy under the microscope, we found that the normal spermatic vein varicose spermatic vein blood compared to expansion of the lumen significantly, full-thickness wall atrophy, atrophy and varicose-level analysis by the rank correlation , were correlated (p<0.05), that is more severe varicose atrophy more severe; Week of each group, around half of March and the recent symptoms (Department of bulge scrotum, pain, with or without belly, waist radioactive pain) and complications (hydrocele) improvement of internal spermatic vein bypass Group the highest rate of symptom improvement was significantly better than after ligation surgery, microsurgery, percutaneous spermatic vein embolization (p <0.05). Over time, each group there were no statistical differences between; Spermatic vein bypass group (B group) and recurrence rate (4.5%) than by ligation surgery (24.4%) (p <0.05), but micro-surgery (10.0%) Percutaneous spermatic vein embolization (0.0%) was similar (p> 0.05). Comparison of different surgical patients receiving perioperative, sperm count, sperm density, sperm motility and sperm deformity rate to determine whether semen quality improved, the results show that the different surgical semen quality after each group were significantly increased compared with the preoperative (p <0.05 ), Spermatic vein bypass group the degree of improvement in the semen treated better than the ligation group, no difference with the other two groups.. Percutaneous spermatic vein embolization, and intraoperative angiography castration testicular spermatic vein surgery in contrast we found no spermatic vein valves appear.Conclusion Symptoms after bypass surgery (Department of bulge scrotum, pain, with or without belly, lower back pain and radiation) to improve the time, the recent complications (hydrocele) to improve and place minimum; bypass the recurrence rate than ligation Low incidence; whether to accept what Surgical; postoperative semen quality were significantly improved compared with the preoperative; Atrophy trend of vessel wall was obviously in all layers with the degree progress of varicocele compared with normal spermatic vein,spermatic vein valve is not found.