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精索静脉曲张与介入放射学:关于诊断、治疗干预及对生殖健康影响的综合案例研究

Varicocele and Interventional Radiology: A Comprehensive Case Study on Diagnosis, Therapeutic Intervention, and Implications for Reproductive Health.

作者信息

Mehakar Saurabh, Anjankar Namrata, Bachate Praful, Jadhao Ritesh, Gajabe Gauri, More Akash, Khemani Shivani

机构信息

Clinical Embryology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.

Interventional Radiology, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.

出版信息

J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2995-S2998. doi: 10.4103/jpbs.jpbs_156_24. Epub 2024 May 29.

DOI:10.4103/jpbs.jpbs_156_24
PMID:39346406
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11426632/
Abstract

Male infertility is known to be influenced by varicocele, a common vascular aberration marked by aberrant dilatation of the pampiniform plexus veins within the scrotum. In this instance, a 38-year-old man showed up with scrotal discomfort and swelling, which are clinical signs of varicocele. Scrotal ultrasonography provided diagnostic confirmation, confirming the existence of varicocele and identifying a concomitant minor hemorrhage in the left scrotal sac. Despite the initiation of conservative measures, such as bed rest, cryotherapy, and analgesics, the patient's clinical course was marked by persistent scrotal swelling and hematoma formation. Subsequently, interventional radiological techniques were employed, specifically coil deployment and varicocele embolization. These interventions demonstrated significant efficacy, leading to a notable reduction in the presenting symptoms. Follow-up assessments, conducted post intervention, indicated a complete resolution of both pain and hematoma. This clinical trajectory underscores the pivotal role of interventional radiology in managing varicocele-related complications. The multi-faceted nature of this case highlights the necessity of a comprehensive, inter-disciplinary approach integrating radiological interventions for the effective management of varicocele-associated symptoms, potentially optimizing reproductive health outcomes.

摘要

已知精索静脉曲张会影响男性不育,精索静脉曲张是一种常见的血管异常,其特征是阴囊内蔓状静脉丛异常扩张。在这个病例中,一名38岁男性因阴囊不适和肿胀前来就诊,这些都是精索静脉曲张的临床症状。阴囊超声检查提供了诊断依据,证实了精索静脉曲张的存在,并发现左侧阴囊伴有少量出血。尽管采取了保守措施,如卧床休息、冷冻疗法和使用镇痛药,但患者的临床病程仍以阴囊持续肿胀和血肿形成为特征。随后,采用了介入放射技术,特别是线圈置入和精索静脉曲张栓塞术。这些干预措施显示出显著疗效,使当前症状明显减轻。干预后进行的随访评估表明,疼痛和血肿均已完全消除。这一临床过程强调了介入放射学在处理精索静脉曲张相关并发症中的关键作用。该病例的多方面性质凸显了采用综合、跨学科方法的必要性,这种方法整合放射学干预措施以有效管理精索静脉曲张相关症状,可能会优化生殖健康结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9601/11426632/c242e1c161e6/JPBS-16-2995-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9601/11426632/3f6f7e773bb6/JPBS-16-2995-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9601/11426632/fb2b46ba9b6c/JPBS-16-2995-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9601/11426632/c242e1c161e6/JPBS-16-2995-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9601/11426632/3f6f7e773bb6/JPBS-16-2995-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9601/11426632/fb2b46ba9b6c/JPBS-16-2995-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9601/11426632/c242e1c161e6/JPBS-16-2995-g003.jpg

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本文引用的文献

1
Varicocele: To Treat or Not to Treat?精索静脉曲张:治还是不治?
J Clin Med. 2023 Jun 15;12(12):4062. doi: 10.3390/jcm12124062.
2
Surgical or radiological treatment for varicoceles in subfertile men.对不育男性精索静脉曲张的手术或放射治疗。
Cochrane Database Syst Rev. 2021 Apr 23;4(4):CD000479. doi: 10.1002/14651858.CD000479.pub6.
3
Basic embolization techniques: tips and tricks.基本栓塞技术:技巧与窍门。
Acta Biomed. 2020 Jul 13;91(8-S):71-80. doi: 10.23750/abm.v91i8-S.9974.
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Dilating Vascular Diseases: Pathophysiology and Clinical Aspects.扩张性血管疾病:病理生理学与临床方面
Int J Vasc Med. 2018 Aug 26;2018:9024278. doi: 10.1155/2018/9024278. eCollection 2018.
5
Varicocele management for infertility and pain: A systematic review.精索静脉曲张不育症及疼痛的治疗:一项系统评价
Arab J Urol. 2017 Dec 14;16(1):157-170. doi: 10.1016/j.aju.2017.11.003. eCollection 2018 Mar.
6
The Varicocele: Clinical Presentation, Evaluation, and Surgical Management.精索静脉曲张:临床表现、评估及手术治疗
Semin Intervent Radiol. 2016 Sep;33(3):163-9. doi: 10.1055/s-0036-1586143.
7
Percutaneous embolization of varicocele: technique, indications, relative contraindications, and complications.精索静脉曲张的经皮栓塞术:技术、适应证、相对禁忌证及并发症
Asian J Androl. 2016 Mar-Apr;18(2):234-8. doi: 10.4103/1008-682X.169985.
8
Varicocelectomy to treat pain, and predictors of success: a prospective study.精索静脉曲张切除术治疗疼痛及成功的预测因素:一项前瞻性研究。
Curr Urol. 2012 May;6(1):33-6. doi: 10.1159/000338867. Epub 2012 Mar 18.
9
The evolution of interventional radiology.介入放射学的发展
Semin Intervent Radiol. 2005 Mar;22(1):6-9. doi: 10.1055/s-2005-869570.
10
The association between varicocele, premature ejaculation and prostatitis symptoms: possible mechanisms.精索静脉曲张、早泄与前列腺炎症状之间的关联:可能的机制。
J Sex Med. 2009 Oct;6(10):2878-87. doi: 10.1111/j.1743-6109.2009.01417.x. Epub 2009 Aug 11.