Yaman O, Ozdiler E, Anafarta K, Göğüş O
Department of Urology, University of Ankara School of Medicine, Turkey.
Urology. 2000 Jan;55(1):107-8. doi: 10.1016/s0090-4295(99)00374-x.
The traditional treatment for a painful varicocele consists of conservative measures followed by varicocelectomy. We report our results with microsurgical subinguinal varicocele ligation to treat pain.
From 1996 to 1999, a total of 119 men underwent subinguinal microsurgical varicocele ligation for painful varicocele. The diagnosis of varicocele was based on the findings of both physical examination and color Doppler ultrasound. Patients described pain with testicular discomfort as scrotal heaviness or a dull ache. While waiting for the operation (range 3 to 5 weeks), all the patients underwent a preoperative trial of conservative management for pain.
Of 119 men, 82 (69 %) were available for follow-up 3 months postoperatively. Of those 82 patients, 72 (88%) reported complete resolution of pain, 4 patients (5%) partial resolution, 5 patients (6%) no change, and 1 patient (1%) epididymal discomfort that resolved with conservative measures. Of the 9 patients with partial or no change, 2 patients had reflux recurrence as seen on color Doppler ultrasound.
Subinguinal microsurgical varicocele ligation is an effective treatment for painful varicocele when performed in selected patients.
疼痛性精索静脉曲张的传统治疗方法包括保守治疗措施，随后进行精索静脉结扎术。我们报告采用显微外科腹股沟下精索静脉曲张结扎术治疗疼痛的结果。
1996年至1999年，共有119名男性因疼痛性精索静脉曲张接受了腹股沟下显微外科精索静脉曲张结扎术。精索静脉曲张的诊断基于体格检查和彩色多普勒超声检查结果。患者将疼痛伴睾丸不适描述为阴囊沉重感或隐痛。在等待手术期间（3至5周），所有患者都接受了疼痛的术前保守治疗试验。
119名男性中，82名（69%）在术后3个月接受了随访。在这82名患者中，72名（88%）报告疼痛完全缓解，4名患者（5%）部分缓解，5名患者（6%）无变化，1名患者（1%）出现附睾不适，经保守治疗后缓解。在9名部分缓解或无变化的患者中，2名患者经彩色多普勒超声检查发现有反流复发。
对于选定的患者，腹股沟下显微外科精索静脉曲张结扎术是治疗疼痛性精索静脉曲张的有效方法。
