显微外科治疗青年男性精索静脉曲张的疗效分析

摘要

Objective:To investigate the clinical effect of microsurgical varicocelectomy in the treatment of young men varicocele.Methods:We retrospectively analyzed the clinical data and postoperative follow-up of 32 varicocele patients treated by microsurgical varicocelectomy from 2012 to the end of 2015 in our hospital.Postoperative semen quality,improvement of symptoms and complications were observed.Results:Thirty-two cases of varicocele were operated successfully.Twenty-nine cases (90.62%) were followed up for 3 months to 12 months and 3 cases (9.38%) were lost to follow-up (including 1 case of infertile and 2 cases of testicular pain or discomfort).Testicular pain or discomfort disappeared in 8 (72.72%) of the 11 followed-up patients who had complained of such symptoms,as relieved in 2 (18.18%),and remained unimproved in the other 1 (9.09%).The 18 followed-up patients with infertility or oligo asthenospermia all showed significantly improved sperm concentration and motility at 6th month after operation.There was no occurrence of hydrocele of testis,testicular atrophy,acute epididymitis and postoperative recurrence.Postoperative complication of scrotum edema occurred in 1 case (3.44%),and symptoms were relieved by conservative treatment.Conclusions:Microsurgical varicocelectomy can effectively improve symptoms and semen parameters and gradually becomes an ideal means for the treatment of young men varicocele.%目的:探讨显微外科技术治疗青年男性精索静脉曲张的临床疗效.方法:收集并分析2012~2015年底32例运用显微外科技术治疗青年男性精索静脉曲张的临床资料以及术后随访情况,观察术后精液质量、症状改善情况以及并发症.结果:32例患者手术成功,获得随访3~12个月的患者29例(90.62%),失访3例(9.38%),其中不育患者失访1例,睾丸坠胀不适、疼痛等症状就诊者失访2例.术前主要以睾丸坠胀不适、疼痛等症状获得随访的11例患者,术后症状消失者8例(72.72%),减轻2例(18.18%),无改善1例(9.09%).获得随访的18例不育或少弱精子症者术后6个月精子浓度及活力较术前显著改善.29例获访患者中术后发生阴囊水肿1例(3.44%),经保守治疗症状改善,无睾丸鞘膜积液、睾丸萎缩、急性附睾炎及术后复发等情况发生.结论:显微外科技术在治疗青年精索静脉曲张,可有效改善阴囊坠胀、疼痛等局部不适症状,并在一定程度上提高精液参数,逐渐成为治疗精索静脉曲张的理想手段.