Clinical application of microsurgical shunt in treatment or varicocele with oligospermia / 中华显微外科杂志

ABSTRACT

Objective To study the therapeutic efficacy and the application value of microsurgical shunt in varicocele (VC) with oligospermia. Methods Funicular vein elevatus ligation and microsurgical shunt were applied in 66 patients. Improvements of the symptom, sign,semen quality and the couple's pregnant rate in prognosis visiting were observed. Results in 71 sides by microsurgical shunt,symptom disappeared in 51 cases and obviously improved in 20 cases after 7 days. Half and one year later,symptom and sign were disappeared in 69 cases (97% );semen quality was improved in 52 cases (78% ). In 37 cases (56. 3% ),sperm density was ≥20 ? 109/L, progress sperm was ≥50% and morphologically normal sperm was ≥30 %. In 11 cases (16. 7% ),sperm density was increased from 5 ? 10,/L- 15 ? 109/L before operation to 10 ? 109/L- 19 ? 109/L after operation,and both of the sperm motility and viability were increased. In 4 cases (5% ),sperm density was increased from less than 5 ? 10s/L before operation to more than 5 ? 10,/L after operation. In 26 cases,the couple was pregnant;the pregnant rate was 39. 4%' Conclusion Vein elevatus ligation and microsurgical shunt blocked the vein blood reflux,established the new vein circuit and improved the blood supply of testis in the mean time. It was approved that the method was effective in diminishing the local symptom and sign, improving semen quality and preventing recurrence' It was especially suitable for classⅢ exudative VC patients