Differences Contrasting Of Identifying Anatomic Structures And Study On Its Clinical Significance During Macroscopic And Microscopic Assisted Varicocelectomy

Objective To contrast the differences of anatomic structures when identifying the same spermatic cord and its clinical significance during macroscopic and microscopic assisted varicocelectomy.Methods According to inclusive criteria and exclusive criteria,50 patients with primary varicocele and seminal abnormality were selected from October 2013 to November 2014) in ninth, Guangxi medical university affiliated hospital-Beihai people’s hospital. To investigate difference contrasting and clinical significance when identifying internal spermatic veins, testicular arteries and lymphatics during macroscopic and microscopic assisted procedure. Resuits During macroscopic varicocelectomy, lymphatics can’t be directly identified. An average of 0.74±0.45 internal spermatic veins each side were missed. Among them, the majority are adherent to the preserved testicular artery. An average of 0.54±0.55 testicular arteries were mistaken for veins and six were not identified during macroscopic procedure. Lymphatics were showed clearly using microscopy. More internal spermatic veins were identified and legated and testicular arteries were also found more readily when involving microscopy. Comparison of two groups is statistically significant. Semen parameters of all patients improved significantly (P<0.05) 3-6 months after operation compared with preoperation and only appear scrotal edema in 1 case and no postoperative recurrence. Review found no testicular atrophy with CDFI 3-6 months after operation comparedConclusion Compared to macroscopic procedure, not only lymphatics but also more internal spermatic veins can be identified, with more testicular arteries preserved,by microscopic varicocelectomy. The performance of the latter one can as well avoid the mistake of missing internal spermatic veins and ligating testicular arteries. Atrophy and ischemia of testicles after operation, epididymitis and hydrocele can be prevented effectively. It’s the the good way of treating VC due to its low postoperative recurrence rate at present, remarkably improved sperm status, few complications and less trauma, worth popularizing clinically.