Pan Lian-Jun, Xia Xin-Yi, Huang Yu-Feng, Gao Jian-Ping
Department of Andrology, Nanjing University School of Clinical Medicine, Nanjing General Hospital of Nanjing Military Region, Nanjing, Jiangsu 210002, China.
Zhonghua Nan Ke Xue. 2008 Jul;14(7):640-4.
Varicoceles is the most common identifiable cause of male infertility, and varicocele repair is a major means for the treatment of the disease. Conventional techniques of varicocele repair including Palomo operation, open inguinal varicocelectomy and laparoscopic varicocelectomy have a relatively high rate of postoperative hydrocele formation, varicocele recurrence and testicular artery injury. Recently, microsurgical varicocelectomy has gained a worldwide application in the treatment of varicocele, which can preserve the testicular artery and lymphatic vessels ligate all the spermatic but vasal veins and significantly lower the incidence of the complications. It can improve the semen parameters of male infertility patients and increase the pregnancy rate in their female partners. It can also improve the semen parameters of the patients with non-obstructive azoospermia or severe oligoasthenospermia. Nowadays microsurgical varicocelectomy has become the "golden standard" for the treatment of varicocele.
精索静脉曲张是男性不育最常见的可识别病因,精索静脉曲张修复术是治疗该疾病的主要手段。传统的精索静脉曲张修复技术包括Palomo手术、开放腹股沟精索静脉高位结扎术和腹腔镜精索静脉高位结扎术,术后鞘膜积液形成、精索静脉曲张复发和睾丸动脉损伤的发生率相对较高。近年来,显微外科精索静脉高位结扎术在精索静脉曲张的治疗中得到了广泛应用,该手术可保留睾丸动脉,结扎所有精索静脉但不结扎输精管静脉,显著降低并发症的发生率。它可以改善男性不育患者的精液参数,提高其女性伴侣的妊娠率。它还可以改善非梗阻性无精子症或严重少弱精子症患者的精液参数。如今,显微外科精索静脉高位结扎术已成为治疗精索静脉曲张的“金标准”。