Giordanengo F, Vandone P L, De Monti M, Lazaridis J, Giuffrida G F
Institute of General and Cardiovascular Surgery, University of Milan.
Minerva Chir. 1993 Jul;48(13-14):767-71.
Varicocele must be regarded of the utmost importance in determinating male infertility. Surgical indications should be considered of primary interest in order to achieve a qualitative and quantitative improvement in spermiogram parameters in the majority of the cases. Recent reports showed that it is not the severity of the lesions to determine the alterations in seminal parameters but the length of time of the varicocele. In our report we consider the results achieved on the spermiogram parameters in two groups of 25 patients surgical treated with different techniques. The first group was treated, in others Centers, by means of the traditional technique of ligature of the spermatic vein (Ivanissevich, Palomo). We treated all the patients of the second group (53 patients) with microsurgical technique of anastomosis pampiniform plexus-saphenous vein, and we control the sepermiogram parameters in 25 patients. The first group showed an improvement of the spermiogram parameters after 6 months from the surgical treatment in the 64% of the cases, while in the second group the improvement was of the 92%. Moreover we registered the persistence of this improvement after 12/36 months from the operation time. On the basis of these observations we think that the microsurgical technique leads to the best and longest results on the most invalidating cause of this pathology.
精索静脉曲张在男性不育的判定中必须被视为极其重要的因素。为了在大多数病例中实现精液参数在质量和数量上的改善，手术指征应被视为首要关注点。最近的报告显示，决定精液参数改变的并非病变的严重程度，而是精索静脉曲张的持续时间。在我们的报告中，我们考量了两组各25例接受不同技术手术治疗的患者的精液参数结果。第一组在其他中心采用传统的精索静脉结扎技术（伊万尼塞维奇法、帕洛莫法）进行治疗。我们用精索静脉丛 - 大隐静脉吻合的显微外科技术治疗了第二组的所有患者（53例），并对其中25例患者的精液参数进行了对照。第一组在手术治疗6个月后，64%的病例精液参数有所改善，而第二组的改善率为92%。此外，我们记录到术后12/36个月这种改善依然持续。基于这些观察结果，我们认为显微外科技术针对这种疾病最具致残性的病因能带来最佳且最持久的效果。
