Analysis Of The Effect Of Spermatic Vein Ligation Under Microscope And Originally Operation On Semen Quality Of Male Infertility Patients Caused By Varicocele

Object: compare the effect of spermatic vein ligation operation by microscope and original surgery repair technique on the improvement of semen quality in male infertility patients.Materials and Methods: This study collected the data of 379 male infertility patients due to varicocele who underwent surgical repair from November 1,2020 to July 31,2022 in the First Affiliated Hospital of Dali University.Before operation All patients were diagnosed as primary varicocele by physical examination and ultrasound.The operation methods were microscopic varicocele ligation and original varicocele ligation(ligation of retroperitoneal varicocele or ligation of inguinal varicocele)respectively.According to the different operation methods,379 patients were divided into two groups: microscope repair group and original surgery repair group.The general condition(age,distribution of affected side)before operation,relevant conditions of operation and pre-operative period(operation time,hospital stay,number of cases of scrotal edema,number of cases of incision infection)of the two groups were analyzed by chi square or t-test statistical method,and the routine condition of semen was reviewed 3 months after operation.The severity of illness and postoperative pain of the two groups were compared by rank sum test.Result:1.Preparation General Conditions: 379 patients,including 279 patients in the microscopic varicocelectomy group and 100 patients in the original surgery repair technique group.The average age of the microscope group(27.55 ± 2.58 years),the distribution of the affected side(left: right=227:52),the average age of the original surgery repair group(29.03± 3.38 years),and the distribution of the affected side(left: right=67:33).Cases in microscope group were grade II,cases in microscope group were grade III;the patients in the original surgery repair group were Grade II and Grade III respectively.There was no significant difference between the above conditions(p>0.05).2.Operative and preoperative conditions: operation time(74.52 ± 2.53), hospital stayed time(4.5 ± 0.52),scrotum swelling and edema in microsurgery group;in the original surgery repair technique group,the operation time was(31.27 ± 2.21),the hospital admitted time was(6.51 ± 0.51),and the number of patients with scrotal edema was.The above indexes were statistically different(p<0.05).The operation time of the microscopic operation group was higher than that of the original surgery repair group,and the hospital admitted time and the number of cases of scrotal edema were significantly lower than that of the originally operation group.The rank sum of severity was 1674.5 in the microscopic group and 2511.5 in the original surgery group.There was significant statistical difference between them(p<0.05).There was no significant difference in the incidence of incision infection between the two groups(p>0.05).3.Post operation 3 months : the results of recheck: the sperm concentration in the microsurgery group was(13.42 ± 4.04)106/ml before operation and(33.79 ± 6.0)106/ml 3 months after operation;the sperm concentration in the original surgery repair technique group was(13.19 ± 3.70)106/ml before operation and(31.73 ± 4.84)106/ml 3months after operation;The sperm activity rate before operation in the microscopic operation technique group was(47.57 ± 4.55)% and three months after operation was(71.21± 5.79)%.The sperm activity rate before operation in the original surgery repair technique group was(46.78 ± 3.89)% and three months after operation was(55.76 ± 3.02)%.There were statistical differences in the above items,and the microscopic varicocelectomy group was significantly better than the original surgical repair group.Conclusion:1.Both low ligation of spermatic vein under microscope and original surgery repair technique can effectively improve the semen treatment of male infertility patients caused by varicocele.2.The sperm concentration and sperm activity rate in the microsurgery group were significantly higher than those in the original surgery repair group.Or because the operation is more delicate,the levator muscle structure,internal spermatic artery and lymphatic vessels and other important structures are largely preserved.3.The microsurgery group had a longer operation time,but a shorter postoperative hospital stays,and the incidence of scrotal edema and pain was significantly lower than that of the original technique group,so that patients could benefit to the greatest extent.