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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.
ABSTRACT
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.
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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.
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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.