Spermatic venous sampling in assisting the diagnosis of reninoma: One case report and literature review / 中华内分泌代谢杂志

To investigate the renal venous and spermatic venous sampling in assisting the diagnosis of reninoma. The case of reninoma was retrospectively reviewed together with the literature review of reninoma diagnosed with renal venous and spermatic venous sampling. A young patient with hypertension and headache was admitted to our hospital. Laboratory test showed high plasma renin concentration (>500 mIU/L), and enhanced computed tomography(CT) in the upper abdomen showed a mass in left inferior renal pole. The concentration of renin in the left spermatic vein was significantly higher than that in renal veins and branches, and peripheral vein, which was considered the left reninoma possibility. The left renal mass was resected surgically and pathologic exam revealed reninoma. The renin level and the blood pressure recoveried normal after operation.The literature reported that the positive rate of renal vein segmental blood collection for locating renin tumor was only 8.3%-64%. The possible reason was that reninoma usually located in the renal cortex, and the tumor blood might be collected by renal capsule vein instead of renal vein. In fact, the renal capsule vein intersects with the lateral division of the spermatic vein, but there have been no reports about the localization of reninoma by spermatic vein sampling. Since renin secreted by reninoma may go into the spermatic vein through renal capsule vein, it should be noted that spermatic venous blood should be collected simultaneously in renal vein sampling when locating reninoma.

Observation on the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in the treatment of infertility caused by varicocele / 国际外科学杂志

Objective@#To observe the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in treating infertility caused by varicocele.@*Methods@#Retrospective analysis of 49 cases of infertility caused by varicocele admitted to the Affiliated Hospital Xuzhou Medical University from February 2015 to November 2016, average age was 27.5 years, aged 20-50 years; according to simple random method divided into experimental group (n=20) and control group (n=29). Patients in the experimental group were treated with laparoscopic high ligation of spermatic vein and compound xuanju capsule. Patients in the control group were treated with high ligation of spermatic vein. Semen quality (sperm concentration, forward motor sperm rate, sperm survival rate), peripheral blood sex hormone (follicle stimulating hormone, luteinizing hormone testosterone) were compared between the two groups before and 3 months after surgery. Pregnancy rate of the spouse 1 year after surgery were compared between the two groups. Measurement data were expressed as mean± standard deviation (Mean±SD), and t-test was used for comparison between groups; count data were compared by Chi-square test.@*Results@#Preoperative sperm concentration [(14.95±2.35) million/ml vs (15.69±3.35) million/ml, P=0.118], forward motor sperm rate [(24.35±3.72)% vs (25.10±3.89)%, P=0.221], sperm survival rate [(27.90±2.59)% vs (26.93±3.20)%, P=0.122]was not statistically significant between experimental group and control group. 3 months after operation, sperm concentration [(23.45±4.39) million/ml vs (20.07±2.91) million/ml, P=0.001], forward motor sperm rate [(34.80±3.56)% vs (31.62±3.75)%, P=0.001], sperm survival rate [(44.55±4.29)% vs (39.52±4.49)%, P=0.001] was statistically significant between experimental group and control group. Preoperative follicle stimulating hormone [(8.97±0.64) IU/L vs (9.17±0.96) IU/L, P=0.238] and luteinizing hormone [(6.75±0.49) IU/L vs (6.64±0.37) IU/L, P=0.744], testosterone [(10.87±1.66) nmol/L vs (9.98±1.17) nmol/L, P=0.064] was not statistical significance between experimental group and control group. 3 months after operation, Follicle stimulation. [(6.96±0.66) IU/L vs (7.34±0.77) IU/L, P=0.043], luteinizing hormone [(6.04±0.39) IU/L vs (6.15±0.38) IU/L, P=0.038], testosterone [(14.46±1.30) nmol/L vs (12.23±2.23) nmol/L, P=0.001] was statistically significant between experimental group and control group. Pregnancy rate of the spouse 1 year of the experimental group was higher than the control group [65.0% (13/20) vs 48.3% (14/29)], but it was not statistically significant between two groups (χ2=1.34, P=0.247).@*Conclusions@#Laparoscopic high ligation of spermatic vein combined with compound Xuanju capsule in the treatment of infertility caused by varicocele can significantly improve semen quality and sex hormone levels. From visual data, the natural pregnancy rate is also improved compared with the simple operation group. It is worthy of clinical recommendation.

Observation on the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in the treatment of infertility caused by varicocele / 国际外科学杂志

Objective To observe the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in treating infertility caused by varicocele.Methods Retrospective analysis of 49 cases of infertility caused by varicocele admitted to the Affiliated Hospital Xuzhou Medical University from February 2015 to November 2016,average age was 27.5 years,aged 20-50 years;according to simple random method divided into experimental group (n =20) and control group (n =29).Patients in the experimental group were treated with laparoscopic high ligation of spermatic vein and compound xuanju capsule.Patients in the control group were treated with high ligation of spermatic vein.Semen quality (sperm concentration,forward motor sperm rate,sperm survival rate),peripheral blood sex hormone (follicle stimulating hormone,luteinizing hormone testosterone) were compared between the two groups before and 3 months after surgery.Pregnancy rate of the spouse 1 year after surgery were compared between the two groups.Measurement data were expressed as mean ± standard deviation (Mean ± SD),and t-test was used for comparison between groups;count data were compared by Chisquare test.Results Preoperative sperm concentration [(14.95 ± 2.35) million/ml vs (15.69 ± 3.35) million/ml,P=0.118],forward motor sperm rate [(24.35 ± 3.72)％ vs (25.10 ± 3.89)％,P =0.221],sperm survival rate [(27.90 ± 2.59) ％ vs (26.93 ± 3.20) ％,P =0.122] was not statistically significant between experimental group and control group.3 months after operation,sperm concentration [(23.45 ± 4.39) million/ml vs (20.07 ± 2.91) million/ml,P =0.001],forward motor sperm rate [(34.80 ± 3.56) ％ vs (31.62 ± 3.75) ％,P=0.001],sperm survival rate [(44.55 ± 4.29)％ vs (39.52 ± 4.49)％,P =0.001] was statistically significant between experimental group and control group.Preoperative follicle stimulating hormone [(8.97 ±0.64) IU/L vs (9.17 ± 0.96) IU/L,P =0.238] and luteinizing hormone [(6.75 ± 0.49) IU/L vs (6.64 ±0.37) IU/L,P =0.744],testosterone [(10.87 ± 1.66) nmol/L vs (9.98 ± 1.17) nmol/L,P =0.064] was not statistical significance between experimental group and control group.3 months after operation,Follicle stimulation.[(6.96 ± 0.66) IU/L vs (7.34 ± 0.77) IU/L,P =0.043],luteinizing hormone [(6.04 ± 0.39) IU/L vs (6.15 ± 0.38) IU/L,P =0.038],testosterone [(14.46 ± 1.30) nmol/L vs (12.23 ± 2.23) nmol/L,P =0.001] was statistically significant between experimental group and control group.Pregnancy rate of the spouse 1 year of the experimental group was higher than the control group [65.0％ (13/20) vs 48.3％ (14/29)],but it was not statistically significant between two groups (x2 =1.34,P =0.247).Conclusions Laparoscopic high ligation of spermatic vein combined with compound Xuanju capsule in the treatment of infertility caused by varicocele can significantly improve semen quality and sex hormone levels.From visual data,the natural pregnancy rate is also improved compared with the simple operation group.It is worthy of clinical recommendation.

Microscopic spermatic vein ligation for nutcracker phenomenon complicated with left varicocele / 中华男科学杂志

Objective@#To investigate the clinical effect of microscopic spermatic vein ligation in the treatment of nutcracker phenomenon (NCP) complicated with left varicocele (VC).@*METHODS@#This retrospective study included 31 cases of NCP complicated with left VC treated in our hospital by subinguinal microscopic ligation of the left spermatic vein (group A, n = 11), open retroperitoneal high ligation of the left spermatic vein (group B, n = 11), or conservative therapy (group C, n = 9). The patients were followed up for 6－24 (15.3 ± 5.4) months. We compared the semen parameters, spermatic vein diameter, left testis volume, and recurrence rate among the three groups of patients before and after treatment.@*RESULTS@#Compared with the baseline, the semen quality parameters were significantly improved in both groups A and B at 6 months after treatment (P0.05), B (［9.77 ± 2.03］ vs ［9.96 ± 1.72］ ml, P>0.05), or C (［9.83 ± 1.59］ vs ［10.48 ± 2.05］ ml, P>0.05), nor in the recurrence rate between groups A and B (P>0.05).@*CONCLUSIONS@#Hematuria, proteinuria and other mild symptoms of nutcracker phenomenon complicated with left VC can be treated palliatively by microscopic ligation of the spermatic vein, which can relieve the clinical symptoms, improve the semen quality, and protect the testicular function of the patient.

Microsurgical bypass for varicocele with nutcracker syndrome / 中华男科学杂志

Objective@#To investigate the clinical effect and feasibility of internal spermatic vein-inferior epigastric vein (ISV-IEV) bypass surgery in the treatment of varicocele complicated by left renal vein nutcracker syndrome (NCS).@*METHODS@#We retrospectively analyzed the clinical data about 30 cases of varicocele with left renal vein NCS treated by ISV-IEV bypass surgery in our hospital from June 2014 to February 2017. We reviewed the follow-up data and results of ultrasonography, routine urianlysis and semen routine examination.@*RESULTS@#All the operations were successfully accomplished and postoperative color Doppler ultrasonography showed that varicocele was cured in all the cases. At 6 months after surgery, sperm concentration and the percentage of grade a+b sperm were significantly improved (［34.47 ± 8.60］ ×10⁶/ml and ［63.54% ± 9.58］ %) as compared with the baseline (［19.90 ± 8.97］ ×10⁶/ml and ［37.93 ± 8.73］ %) (P <0.05). Hematuria was cured in 23 and alleviated in 1 of the 24 cases. Proteinuria disappeared in all the 14 cases, with neither scrotal pain symptoms nor obvious complications.@*CONCLUSIONS@#ISV-IEV bypass surgery, with its advantages of safety, effectiveness, minimal invasiveness, and simple operation, deserves wide clinical application in the treatment of varicocele with left renal vein NCS.

Microscopic spermatic vein ligation for the treatment of varicocele / 中华男科学杂志

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.

Clinical research of adenosine triphosphate and spermatic vein ligation combined treatment of children with primary varicocele disease / 中国生化药物杂志

Objective To study the clinical effect of adenosine triphosphate and spermatic vein ligation combined treatment of children with primary varicocele disease.Methods80 cases of children with primary varicocele disease who were treated in pediatric surgery department of Hangzhou City Yuhang District MCH from May 2014 to May 2016 were selected, these children were divided into adenosine triphosphate and spermatic vein ligation combined treatment group (combined treatment group, n= 40) and spermatic vein ligation treatment group (monotherapy group, n=40) two groups according to the random number table, the postoperative pain score, gastrointestinal recovery time, hospital stay, cost of hospitalization, incidence of complications and recurrence of the two groups were statistically analyzed.ResultsThe postoperative pain score and hospitalization cost of the combined treatment group were significantly lower (P<0.05), the gastrointestinal function recovery time and hospital stay were significantly shorter (P<0.05), the incidence of complications 2.5% (1/40) was significantly lower than the monotherapy group 17.5% (7/40) (P<0.05), the recurrence rate 2.5% (1/40) was significantly lower than the monotherapy group 10.0% (4/40) (P< 0.05).ConclusionThe clinical effect of adenosine triphosphate and spermatic vein ligation combined treatment of children with primary varicocele disease is better than spermatic vein ligation treatment alone, so is worthy of promotion in the clinical.

Analysis of the sperm DNA fragmentation in different degrees of varicocele infertility patients after high ligation of the spermatic vein / 中国内镜杂志

Objective To analyze the sperm DNA fragmentation in different degrees of varicocele (VC) infertility patients after high ligation of the spermatic vein. Methods There were 57 patients with different degrees of VC infertility patients. 27 patients had been diagnosed with level two VC, and 30 patients had been diagnosed with level three VC. All patients' sperm DNA fragmentation index (DFI) were detected and calculated at preoperative one month and postoperative three months. Results 57 VC infertility patients were all suffered from laparoscopic high ligation of the spermatic vein on both sides. There was no statistically difference on preoperative sperm DFI between level two and level three patients (P > 0.05). All patients' sperm DFI were decreased after laparoscopic (P < 0.05), and level two VC infertility patients had significant greater progress than level three patients (P < 0.05). Conclusion Laparoscopic high ligation of the spermatic vein can effectively improve VC infertility patients sperm DFI. It would be better for level two VC infertility patients.

The effect of the degree of left renal vein constriction on the development of adolescent varicocele in Sprague-Dawley rats / 亚洲男科学杂志(英文版)

Experimental models have allowed inquiry into the pathophysiology of varicocele (VC) beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degree of left renal vein constriction on the development of adolescent VC. Fifty adolescent male Sprague-Dawley rats (Rattus norvegicus) were randomly assigned to five groups of 10: the experimental groups (I-IV) underwent partial ligation of left renal veins with 0.5-, 0.6-, 0.7-, and 0.8-mm diameter needles, respectively. The control group (V) underwent a sham operation. The diameter of the left spermatic vein (LSV) was measured at baseline and 30 days postoperatively. In addition, the lesion of the left kidney was examined with the naked eye and assessed by Masson's trichrome staining. VC was successfully induced in 2 (20%), 4 (40%), 7 (70%), and 10 (100%) rats in groups I-IV, respectively. The other rats failed to develop VCs primarily due to left renal atrophy. No VC was observed in group V. The postsurgical LSV diameters in VC rats in groups III and IV were 1.54 ± 0.16 and 1.49 ± 0.13 mm, respectively (P > 0.05), and their increments were 1.36 ± 0.10 and 1.31 ± 0.10 mm, respectively (P > 0.05). These results suggest that suitable constriction of the left renal vein is critical for adolescent VC development. In addition, the 0.8-mm diameter needle may be more suitable for inducing left renal vein constriction in adolescent rat models.

Correlation of the inner diameter parameters of the spermatic vein in different positions and states of the varicocele patient with the results of seminal examination / 中华男科学杂志

<p><b>Objective</b>To study the correlation of the inner diameter parameters of the spermatic vein in different positions and states of the varicocele (VC) patient with the results of seminal examination.</p><p><b>METHODS</b>A total of 149 VC patients underwent ultrasonography, routine semen examination, and sperm morphological analysis. The parameters obtained from ultrasonography included the bilateral testis volume in a supine position, the largest spermatic vein diameter in a supine position at rest (DSR), the largest spermatic vein diameter in a supine position following Valsalva manoeuvre (DSV), the largest spermatic vein diameter in an upright position at rest (DUR), and the largest spermatic vein diameter in an upright position following Valsalva manoeuvre (DUV). Then we calculated the parameters △DS=DSV－DSR, △DU=DUV－DUR, △DR=DUR－DSR, and △DV=DUV－DSV and analyzed the correlation of the above parameters with the results of semen examination using the ROC curve.</p><p><b>RESULTS</b>Based on the results of semen examination, 119 (79.87%) of the patients were allocated to the abnormal group and the other 30 (20.13%) to the normal group. Statistically significant differences were observed between the two groups in △DU (P=0.007), △DR (P=0.0001), and △DV (P=0.04), but not in DSR (P=0.35), DSV (P=0.34), DUR (P=0.06), DUV (P=0.12), and △DS (P=0.64), nor in the volume of the testis affected (P=0.323). The area under the ROC curve was 0.55 for DSR, 0.57 for DSV, 0.64 for DUR, 0.62 for DUV, 0.49 for △DS, 0.28 for △DU, 0.86 for △DR, and 0.69 for △DV. The corresponding cutoff values were 2.25, 2.51, 2.48, 2.63, 0.30, 0.23, 0.25, and 0.20, the corresponding sensitivities of semen detection were 50.42%, 65.55%, 60.50%, 60.50%, 49.90%, 29.41%, 79.83%, and 65.55%, and the corresponding specificities were 56.67%, 63.33%, 63.33%, 63.33%, 56.67%, 33.33%, 80%, and 63.33%, respectively.</p><p><b>CONCLUSIONS</b>The difference between the largest spermatic vein diameters in supine and upright positions at rest provides a high diagnostic accuracy for semen detection and helps to predict abnormality in seminal examination for VC patients.</p>

The application of transumbilica single-port laparoscopic surgery in the treatment of bilateral varicocele / 中国综合临床

Objective To explore the clinical value of transumbilica single-port laparoscopic surgery in the treatment of bilateral varicocele.Methods From Jan. 2010 to Sep. 2010,42 patients with bilateral varicocele underwent laparoscopic high ligation of bilateral spermatic vein.Of these patients,20 were treated with transumbilica single-port laparoscopic surgery,22 with traditional laparoscopic surgery.The two groups of patients were compared for the parameters such as intraoperative blood loss,testicular artery preservation,operating time,time of activities after surgery,time of intestinal function recovery and hospitalization duration.The semen quality 1 year after the surgery was compared with that before treatment.At the out-patient re-examination at 1,3,6months and 1 year after the surgery,the incision,scrotum,spermatic cord,testis were checked for possible complications.The relief of discomfortness in the scrotum was also followed up.Results Both operation procedures were successful,without severe complications.In the single-port laparoscopic surgery produced blood lose ( [ 5 ± 1 ] ml vs.[ 5 ± 1 ] ml,t =- 0.452,P ＞ 0.05 ),the operating time ( [ 41 ± 7 ] min vs.[ 39 ± 3 ] min,t =0.686,P ＞ 0.05 ),postoperative intestinal function recovery time ( [ 11 + 1 ] h vs.[ 11 + 2 ] h,t =- 1.631,P ＞0.05 ) and postoperative hospital stay ( [ 3.1 + 0.7 ] d vs.[ 3.4 + 0.7 ] d,t =- 1.447,P ＞ 0.05 ) which were all comparable to that from conventional laparoscopic surgery.There was significant difference in the population using analgesics,single-port laparoscopic surgery vs.conventional laparoscopic surgery ( 1 case [ 5.0％ ] vs 7case [ 31.8％ ].The difference was statistically significant (x2 =4.886,P ＜ 0.05 ).The single-port laparoscopic surgery produced neglectable scar at the incision.All of the patients were questionaired for their satisfaction with the incision 1 year after the surgery.The difference was statistically significant (x2 =7.636,P ＜ 0.01 )Conclusion Single-port laparoscopic high ligation of bilateral spermatic vein produces comparable outcomes to that of conventional laparoscopic surgery,but it is a more microinvasive procedure producing good aesthetic appearance,representing the trend of laparoscopic technique.

Hydrodynamic Relationship between Color Doppler Ultrasonography Findings and the Number of Internal Spermatic Veins in Varicoceles

PURPOSE: The improvement of testicular volume, testosterone levels and sperm concentration was suggested to be significantly associated with the number of internal spermatic veins (ISVs) ligated during varicocelectomy. Herein, we investigated preoperative color Doppler ultrasonography (CDU) findings as potential preoperative predictors of the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy. MATERIALS AND METHODS: In a prospective evaluation of 40 patients, maximal vein size and maximal reflux velocity were measured, while the total cross-sectional area of the affected testicular veins during a Valsalva maneuver was calculated using CDU by a single uroradiologist. Microsurgical subinguinal varicocelectomies were performed by one urologist. RESULTS: Among the semen parameters, semen morphology showed significant improvement (p=0.033), which was much clearer in the patients with a higher number of ISVs ligated than a lower number of ISVs ligated. Among the various preoperative variables, maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated (r=-0.442, p=0.004; r=0.594, p=0.000, respectively). Furthermore, univariate and multivariate linear regression analyses showed that maximal reflux velocity and total cross-sectional area on CDU were independent predictive factors of the number of ISVs ligated. CONCLUSION: Maximal reflux velocity and total cross-sectional area on CDU were related to the number of ISVs ligated. This means that the maximal reflux velocity and total cross-sectional area measured by preoperative CDU can predict the number of ISVs requiring ligation during microsurgical subinguinal varicocelectomy, which might be related to significant improvement of semen parameters after varicocelectomy.

Laparoscopic high selective ligation of spermatic veins for treatment of varicocele / 中华泌尿外科杂志

Objective To discuss the treatment choices of varicocele by laparoscopic. Methods Retrospective analysis clinical datas of 337 patients with primary varicocele above grade Ⅱ.All of them were treated by operation and followed-up,238 cases had scrotum pain.265 cases were infertility after married.History of diseases was between 1-13 years.249(197 patients with infertility)were treated with laparoscopic high selective ligation of spermatic veins,as Group A.88(68 patiets with infertility)were treated with laparoscopic cluster ligation,as Group B.The clinical data were compared. Results Three hundreds and thirty-seven cases were followed-up 2 years after operation.The operative times of two groups were(38.04±10.9)min、(19.04±7.5)min,the incidences of hydrocelewere 0.4%(1/249),11.3%(10/88);theincidences oftesticular atrophywere 0%(0/249),3.4%(3/88);the improving rates of semen quality in 3 months were 77.1%(192/249),62.5%(55/88);the spontaneous pregnant rates of his spouses in 2 years were 56.8%(112/197),39.7%(27/68).There were significant differences among the 2 groups(P<0.05).The recurrence rates were 5.6%(14/249),4.5%(4/88),there was no significant difference among the 2 groups(P>0.05). Conclusion Laparoscopic high selective ligation of spermatic veins in this study had less complications,higher improving rates of semen quality and pregnant rates.

Laparoscopic treatment for varicocele: A report of 235 cases / 中国微创外科杂志

Objective To study the effectiveness of laparoscopic treatment for varicocele. Methods Clinical records of 235 cases of laparoscopic high ligation of the spermatic vein between September 1993 and July 2003 were retrospectively analyzed. Results All the operations were completed successfully. The operation time was 5~20 min (mean, 12 min). The postoperative hospital stay was 2~5 days (mean, 3 days). Follow-up observations for 6~18 months in 210 cases found 9 cases of recurrence, with a recurrence rate of 4 3% (9/210). Eleven patients with sterility had their wives pregnant 6~12 months after the surgery. Conclusions Laparoscopic high ligation for varicocele offers minimal invasion, good cosmetic results, and satisfactory effects, especially suitable for patients with bilateral varicocele, recurrent varicocele after open surgery, and surgical history in the groin.

Blood Gas Analysis of the Spermatic Vein and Antecubital Vein in the Patients with Bilateral Varicocele / 대한비뇨기과학회지

Varicocele remains an important correctable cause of infertility. There are many theories of the mechanism about the cause of infertility, yet pathophysiology remains poorly understood. Several investigators have found no alterations in oxygen or carbon dioxide pressures in spermatic venous blood in varicocele patients. We checked blood gas of the left, right internal spermatic vein, and antecubital vein of 21 patients with clinical varicocele. The mean of carbon dioxide pressure in the left (43.5mmHg) and the right (44.3mmHg) internal spermatic vein was not higher than antecubital vein (47.8mmHg) (p<0.05). The mean oxygen pressure in the left internal spermatic vein (60.5 mmHg) was not lower than antecubital vein (42.5mmHg)and the mean oxygen pressure in the left internal spermatic vein was higher than right internal spermatic vein (50.9 mmHg). Both Leydig cell and germinal cell dysfunction caused by testicular hypoxia secondary to venous stasis and small-vessel occlusion must be reestablished.

A Study of Internal Spermatic Vein Cortisol in Patients with Varicocele / 대한비뇨기과학회지

Although it is generally accepted that varicocele is a major cause of male infertility, the mechanism by which varicocele exerts its deleterious effect on spermatogenesis still remains obscure. So, to elucidate the cause of infertility that is the result of varicocele, cortisol levels in the internal spermatic vein blood samples were compared with those of the peripheral vein blood samples from 20 patients with varicocele. In 14 of the 20 patients, cortisol levels were found to be lower in the internal spermatic vein blood than in the peripheral vein blood. In the other 6 patients, cortisol levels were higher in the internal spermatic vein blood. However, no significant differences were observed between the concentrations in the internal spermatic vein (13.12+/-12.12 microgram/dl) and those in the peripheral vein (13.89+/-9.94 microgram/dl) of all cases. Therefore it seems unlikely that testicular dysfunction in patients with varicocele is caused by reflux of adrenal venous blood with toxic metabolites into the internal spermatic vein.

A Study of Internal Spermatic Vein Cortisol in Patients with Varicocele / 대한비뇨기과학회지

Although it is generally accepted that varicocele is a major cause of male infertility, the mechanism by which varicocele exerts its deleterious effect on spermatogenesis still remains obscure. So, to elucidate the cause of infertility that is the result of varicocele, cortisol levels in the internal spermatic vein blood samples were compared with those of the peripheral vein blood samples from 20 patients with varicocele. In 14 of the 20 patients, cortisol levels were found to be lower in the internal spermatic vein blood than in the peripheral vein blood. In the other 6 patients, cortisol levels were higher in the internal spermatic vein blood. However, no significant differences were observed between the concentrations in the internal spermatic vein (13.12+/-12.12 microgram/dl) and those in the peripheral vein (13.89+/-9.94 microgram/dl) of all cases. Therefore it seems unlikely that testicular dysfunction in patients with varicocele is caused by reflux of adrenal venous blood with toxic metabolites into the internal spermatic vein.

Percutaneous Embolization of the Internal Spermatic Vein for Treatment of Varicocele: 4 Cases / 대한비뇨기과학회지

Percutaneous embolization of the internal spermatic vein under the phlebography is a new alternative method in the treatment of idiopathic varicocele. Embolization with the stainless steel coil was attempted in 4 cases of varicocele which showed passive reflux from the left renal vein to the internal spermatic vein on the phlebography. 3 cases were corrected by the percutaneous embolization successfully and no dislocation of the coil was observed on the follow-up films. In failure case, the renal catheter could not be engaged into the internal spermatic vein.

Clinical Evaluation of Intraoperative Phlebography of Internal Spermatic Vein in Varicocele / 대한비뇨기과학회지

Intraoperative internal spermatic vein phlebography was performed in 12 primary and 3 recurrent cases of varicocele. The following results were obtained. 1. Marked dilation of the left internal spermatic vein was observed in 13 cases (87%), and retrograde flow was seen in 7 cases (47%). 2. Double or triple left internal spermatic vein was seen in 8 cases (53%). 3. Cross collateral venous circulation was noted in 6 cases (40%). 4. Intraoperative internal spermatic vein phlebography enabled to us understand the venous anatomy and the etiology of primary and recurrent varicoceles, and was an aid for the surgical removal of varicocele.