精索静脉曲张分级能否预测显微外科腹股沟下修复术中的静脉数量和大小？

Does varicocele grade predict vein number and size at microsurgical subinguinal repair?

作者信息

Belani Jay S, Yan Yan, Naughton Cathy K

机构信息

Division of Urology, Washington University School of Medicine, St. Louis, Missouri 63108, USA.

出版信息

Urology. 2004 Jul;64(1):137-9. doi: 10.1016/j.urology.2004.02.006.

DOI:10.1016/j.urology.2004.02.006

PMID:15245951

Abstract

OBJECTIVES

To correlate the varicocele grade on physical examination with the number and size of the veins present and ligated during surgery. Varicoceles are correctable causes of male factor infertility. No prior anatomic studies have correlated the preoperative clinical grade of a varicocele with the number of veins discovered and ligated during microsurgical subinguinal repair.

METHODS

A total of 65 consecutive men (mean age 33.8 years) diagnosed during office evaluation with either unilateral left varicocele or bilateral varicoceles underwent microsurgical subinguinal varicocelectomy by one urologist. At surgery, the number and size (small, less than 1.0 mm; medium, 1.0 mm or greater to less than 4.0 mm; large, 4.0 mm or greater) of the spermatic cord veins present and ligated were recorded. These findings were correlated with the size of the preoperative varicocele grade.

RESULTS

Of the 71 varicocele units, 65 qualified for analysis. Of the patients with a grade 1 varicocele, a mean (+/-SD) of 2.4 (+/-2.5) small veins, 4.7 (+/-2.1) medium veins, 0.3 (+/-0.58) large veins, and 7.5 (+/-3.0) total veins were ligated. Of patients with a grade 2 varicocele, a mean of 2.6 (+/-2.3) small veins, 5.3 (+/-3.1) medium veins, 0.47 (+/-0.78) large veins, and 8.3 (+/-3.2) total veins were ligated. Of patients with grade 3 varicoceles, a mean of 1.8 (+/-1.8) small veins, 4.6 (+/-2.3) medium veins, 1.0 (+/-0.75) large veins, and 6.9 (+/-2.6) total veins were ligated. Using analysis of variance, the grade 3 varicoceles had significantly more large veins than did grade 1 varicoceles (P <0.05).

CONCLUSIONS

Grade 3 varicoceles have a greater number of large veins compared with grade 1 varicoceles.

摘要

目的

将体格检查时的精索静脉曲张分级与手术中发现并结扎的静脉数量及大小相关联。精索静脉曲张是男性不育因素中可纠正的病因。此前尚无解剖学研究将精索静脉曲张的术前临床分级与显微外科腹股沟下修复术中发现并结扎的静脉数量相关联。

方法

共有65例连续男性患者（平均年龄33.8岁），在门诊评估中被诊断为单侧左侧精索静脉曲张或双侧精索静脉曲张，由一名泌尿科医生为其实施显微外科腹股沟下精索静脉结扎术。手术中，记录存在并结扎的精索静脉数量及大小（小，小于1.0毫米；中，1.0毫米及以上至小于4.0毫米；大，4.0毫米及以上）。这些结果与术前精索静脉曲张分级的大小相关联。

结果

在71个精索静脉曲张单元中，65个符合分析条件。1级精索静脉曲张患者平均（±标准差）结扎2.4（±2.5）条小静脉、4.7（±2.1）条中静脉、0.3（±0.58）条大静脉以及7.5（±3.0）条总静脉。2级精索静脉曲张患者平均结扎2.6（±2.3）条小静脉、5.3（±3.1）条中静脉、0.47（±0.78）条大静脉以及8.3（±3.2）条总静脉。3级精索静脉曲张患者平均结扎1.8（±1.8）条小静脉、4.6（±2.3）条中静脉、1.0（±0.75）条大静脉以及6.9（±2.6）条总静脉。使用方差分析，3级精索静脉曲张的大静脉数量显著多于1级精索静脉曲张（P<0.05）。