Therapeutic Effect Of Clustered High Ligation Of Spermatic Cord By Laparoscopic In The Treatment Of Bilateral Varicocele

Objective:To compare the preoperative and laparoscopic high-end ligation of cluster spermatic cord in patients with bilateral varicocele for the treatment of postoperative clinical symptom relief and testicular function improvement,and to evaluate the treatment of high-end ligation of cluster spermatic cord The effect and feasibility of bilateral varicocele.Method:Retrospective analysis of 68 patients with bilateral varicocele admitted from June 2016 to March 2018,including 65 patients undergoing laparoscopic clustering spermatic cord ligation,and 3 patients underwent abdominal cavity Microscopic selective spermatic vein internal ligation was performed.All patients underwent Doppler color Doppler ultrasound to measure testicular volume,testicular blood flow,and testicular parenchymal echo before and after surgery.The changes of testicular blood supply,testicular volume and semen quality were analyzed before and after operation.The patients were followed up for 10 months,and the recurrence and complications were observed.Results:The operation time of 65 patients who underwent high ligation of cluster varicocele was 24.80±5.50 min,and the length of hospitalization was 4.46±0.82 d.Six months after surgery,the testicular color Doppler flow imaging showed that all patients had good testicular blood supply and uniform testicular parenchymal echo;measured testicular diameters were calculated: left(6.76±0.61)cm3,right(6.87±0.72)cm3,compared with the left side of the testicular volume(4.72±0.64)cm3,the right side(4.75±0.65)cm3,the volume increased,the difference was statistically significant(p<0.05).Sperm routine was reviewed 6 months after surgery.Sperm density:(22.38±4.04)×106/ml,sperm motility:(36.28±6.27)%;and preoperative sperm density:(11.74±3.27)×106/ml,sperm motility :(18.57 ± 5.11)% comparison,semen quality improved significantly,the difference was statistically significant,p <0.05.During follow-up to 10 months after surgery,the incidence of complications was 13.9%,including 3 cases of scrotal edema(4.6%),4 cases of epididymitis(6.2%),2 cases of hydrocele(3.1%),and improved by conventional treatment.All patients had no testicular atrophy.Conclusion:Laparoscopic high-level ligation of clustered spermatic cord has the advantages of rapid operation,less bleeding,safe and reliable,obvious curative effect,less complications,and low recurrence rate.It can be routinely used in the treatment of bilateral varicocele.