显微外科精索静脉曲张切除术治疗男性不育

Microsurgical Varicocelectomy for Male Infertility

精索静脉曲张(VAC)是导致男性不育的常见原因。手术是治疗VAC的主要方法。传统手术方法包括Palo-mo手术、经腹股沟精索内静脉高位结扎术及腹腔镜手术术后睾丸鞘膜积液、睾丸动脉损伤等并发症的发生率及VAC复发率较高。近年来国际上兴起的显微外科精索静脉曲张切除术(MV)可有效的保护精索淋巴管及睾丸动脉,彻底结扎除输精管静脉外的所有精索静脉,使并发症及复发率大为降低。MV可显著改善VAC不育患者的精液质量,提高妊娠率;对严重少弱精子症或非梗阻性无精子症的患者的精液质量也有改善作用,目前已成为治疗VAC的"金标准"。

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.