| Research Background:Varicocele(VC)is abnormal in the spermatic cord of the varicocele,resulting in tortuous,elongated and dilated veins,occupying an important position in many factors leading to male infertility.For men,the incidence rate is about 10% to 15% of the male population.The study found that VC in the male infertility cause in the first place,mainly for poor sperm motility,high rate of deformity in the testicular biopsy in most of the VC patients with sperm production damage.However,the reason why VC caused male infertility,on this aspect of the study is not very clear,with the continuous improvement of people,found that VC caused by changes in the patient's scrotum temperature of the sperm quality is closely related.VC can lead to elevated scrotal temperature,which affect the testicular spermatogenic function,leading to abnormal semen,resulting in male infertility.VC patients with elevated temperature of the scrotum affect fertility has been reported for many domestic scholars.And with the development of surgical technology,VC surgery constantly updated,not only to alleviate the pain of patients,but also to improve the quality of sperm great benefit.Therefore,this study selected bilateral varicocele caused by infertility patients,the use of microsurgical techniques to observe the patient before and after the operation of the scrotum temperature changes in sperm quality,to make a study and analysis.Objective:To explore the effect of microscopic spermatic vein ligation on scrotal temperature and sperm quality,and to explore the relationship between the changes of scrotum temperature and sperm quality,and to provide reliable basis for the male infertility patients with clinical diagnosis and treatment.Research objects and methods:Collected from the First Affiliated Hospital of Zhengzhou University,November 2014 to April 2015 during the treatment of bilateral varicocele clinical II ° patients in 190 cases,lost and incomplete data in 92 patients,follow-up during pregnancy,48 cases of conception,Fifty patients without complete information on the remaining pregnant patients.Patients aged 20 to 40 years old,the average age of 28 years old,are outpatient and inpatient hospital,the history of March to 5 years,an average of 1.2 years.Postoperative follow-up for six months.All patients before and after surgery are scrotum color Doppler ultrasound examination,semen analysis,scrotum parts of the temperature measurement and other relevant information records.And scrotal color Doppler ultrasonography and physical examination were confirmed as bilateral varicocele,to meet the inclusion and exclusion criteria,the use of temperature measuring instrument 50 cases of varicocele patients before and after surgery scrotum root,central,bottom temperature measurement.The temperature of the scrotum and its semen density and vigor were analyzed statistically by using the paired t test.Result:Under the microscope for low ligation of spermatic vein,each part of the scrotal(bottom,middle and root)temperature decreased significantly,compared with before surgery,the difference was significant(P<0.05);before and after surgery,were negatively related to changes in the location of the temperature of the scrotum and sperm motility,density(P<0.05);after the operation of sperm density and activity(A+B)increased,compared with before surgery,the difference was significant(P<0.05).Conclusion: 1.The scrotal temperature of the lower spermatic vein ligation was significantly lower than that before the operation;2.The sperm quality of the lower spermatic vein ligation was significantly improved before the operation,mainly in the sperm density and motility(A+B),and had a greater impact on the epididymis;3.The correlation between the scrotal temperature and the sperm quality is negative,which is manifested by the decrease of the scrotal temperature and the increase of sperm motility and density after the ligation of the spermatic vein. |
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