[Microscopic spermatic vein ligation for the treatment of varicocele].

OBJECTIVE: To explore the effect of spermatic vein ligation under the microscope in the treatment of varicocele (VC). METHODS: A total of 120 VC patients received in our department from September 2011 to February 2015 were randomly divided into an experimental and a control group of equal number, the former treated by microscopic spermatic vein ligation and the latter by conventional open high ligation. Comparisons were made between the two groups of patients in the internal diameters of the spermatic vein during eupnea and Valsalva maneuver, the reflux time of the spermatic vein, blood flow parameters of the testicular artery, and semen quality before and at 3 months after surgery. RESULTS: At 3 months after surgery, the experimental group, as compared with the control, showed significantly decreased reflux time of the spermatic vein (［0.41 ± 0.10］ vs ［1.08 ± 0.10］ s, P <0.05) and peak systolic velocity (9.26 ± 1.35 vs 10.64 ± 1.28, P <0.05) and resistance index (0.52 ± 0.03 vs 0.61 ± 0.03, P <0.05) of the testicular artery but markedly increased internal diameters of the spermatic vein during eupnea (［1.63 ± 0.07］ vs ［1.59 ± 0.06］ mm, P <0.05) and Valsalva maneuver (［1.72 ± 0.05］ vs ［1.68 ± 0.07］ mm, P <0.05), sperm concentration (［46.84 ± 5.24］ vs ［35.35 ± 4.26］ ×10⁶/ml, P <0.05), sperm motility (［63.75 ± 7.73］ vs ［53.87 ± 6.46］ %, P <0.05), and total sperm count (［89.54 ± 7.95］ vs ［75.24 ± 8.43］ ×10⁶/ml, P <0.05). CONCLUSIONS: Microscopic spermatic vein ligation has a definite effect in the treatment of varicocele, which can significantly improve the testicular blood flow and semen quality of the patient.