精索静脉高位结扎术中同时结扎精索内动脉的临床初步评估

Clinical preliminary evaluation on both spermatic vein and artery ligation in varicocelectomy

目的初步评估精索内动静脉同时结扎对睾丸生精功能及血浆睾酮水平的影响,对精索内静脉结扎术是否保留精索内动脉问题进行探讨。方法将精索静脉结扎术中同时行精索内动静脉结扎的病例与保留精索内动脉的病例进行临床对照研究。结果两组病例术前术后自身对照:精子密度、活率、畸形率三项指标均有明显改善(P<0.01),两病例组间对照:术前和术后三项指标均无显著性差异(P>0.05);两病例组间及术前和术后对照,血浆睾酮测定结果均无显著性差异(P>0.05)。精索内动脉保留组手术时间则明显较结扎组延长(P<0.01)。结论精索静脉高位结扎术中同时结扎精索内动脉对睾丸的生精功能及血浆睾酮水平无明显影响,因此在精索内动脉分离困难时应考虑同时结扎精索内动静脉。

Objective To evaluate the influence of spermatic vein and artery ligation on spermatogenesis and the plasma testosterone levels. Methods To make a clinical comparison between the group of both spermatic vein and artery ligation and the group of spermatic artery reservation. Results There was a significant difference between pre-operation and post-operation in each groups (P<0.01) in spermatic density, mobility, and deformity, but there was no significant difference between the groups (P>0.05). There was no significant difference between pre-operation and post-operation in plasma testosterone level in each groups, and no difference between the groups (P>0.05). The operative time of the group with spermatic artery reserved was longer than that of the group with both spermatic vein and artery ligation (P<0.01). Conclusions There is no significant influence on spermatogenesis and the plasma testosterone level after both spermatic vein and artery ligation in varicocelectomy. Spermatic vein and artery should be both ligated if it is necessary.