转流术与断流术治疗精索静脉曲张症的疗效评价

Evaluation of the effect of shunt-type or ligation-type of internal spermatic vein surgery on infertility with varicocele

目的 为评价精索静脉转流术与结扎术二种手术方法对治疗精索静脉曲张引起男性不育的疗效。方法 于术后一年中分别随访 82例病人 ,接受转流者 47例 ,结扎者 35例。结果 (1)术后病人症状、精子质量均得到显著改善 ,但是 ,两组间无明显差异 (P >0 .0 5 )。 (2 ) 15例有症状者术后缓解 ,47例转流受术者无一复发 ,35例结扎受术者 2例复发 ,占 5 .7%。两者精子质量改善者共 47例 ,占 5 8.5 3% ,妊娠及分娩 2 5例 ,占 30 .5 %。 (3)术后 3月 ,精子活力提高明显好于精子质量的其它参数 ,而在术后半月中 ,精子活力的提高转流者 2 7例 ,结扎者仅 7例。

Objective To evaluate the therapeutic effect of internal spermatic vein shunt or ligation on infertile men with varicocele.Methods Over 82 patients were randomized into two groups over 12 years period.47 patients underwent shunt and 35 underwent ligation.The mean follow-up was 12 months.Results (1) The data showed significant improvement in the symptom and spermatic quality after treatment( P <0.01).There was no difference between the two methods ( P >0.05).(2) The symptoms of 15 patients were relieved after operation.No patient was recurred in shunt group,while 2 patients were recurred in ligation group.Improvement rate of spermatic quality was 58.53 % (47 cases) and rate of pregnancy was 30.5% (25 cases) in both groups.(3) The seminal velocity of both groups was better than other parameters of spermatic quality at 3 monthes after operation,especially in shunt group,and improvement of velocity was remarkable at a half month after surgery.Conclusions Using shunt surgery of internal spermatic veins is the better therapy on varicocele.