MSV術式治療精索靜脈曲張26例分析

Analysis of 26 cases of varicocele treated with microscopic subinguinal varicocelectomy

鄭巍(ZHENG Wei)；陳泰業(CHAN Tai Yip)；胡峰(HU Feng)；(Satish Shrestha)；關永為(KWAN Weng Wai)；葉蔭霆(YIP Yam Ting)；曾紀寧(CHENG Kei Ning)

精索靜脈曲張 ； 陰囊不適 ； 男性不育症 ； 顯微鏡下外環水平精索靜脈結紮術 ； Varicocele ； scortal discomfort ； male infertility ； Microscopic Subinguinal Varicocelectomy

鏡湖醫學

21卷1期（2021 / 06 / 01）

35 - 37

繁體中文;英文

目的：回顧性分析本院顯微鏡下外環水平精索靜脈結紮術（microscopic subinguinal varicocelectomy, MSV）治療精索靜脈曲張患者病例，並進行相關文獻複習，進一步明確該術式的優勢。方法：收集2015年1月～2018年7月收治的精索靜脈曲張患者26例，術後時間6～42個月，並進行隨訪，瞭解患者陰囊不適症狀情況，不育症以及精液異常患者術後精液品質改變的情況，結合相關文獻複習。結果：所有陰囊不適患者的局部症狀均有明顯改善；不育症患者及精液異常患者術後精液品質明顯提高（其中自然受孕1例；人工輔助生殖成功1例；受孕後流產1例；2例失訪）；26例患者術後發生陰囊水腫1例，無鞘膜積液、睾丸萎縮併發症發生。結論：顯微鏡下外環水平精索靜脈結紮術治療精索靜脈曲張效果明顯，復發率低，併發症少，術後受孕率高，推薦為首選術式。

Objective: Retrospective study of Varicocele patient treated with Microscopic Subinguinal Varicocelectomy (MSV) in Kiang Wu Hospital. Methods: 26 cases of varicocele from January 2015 to July 2018 were selected which were followed up for 6 months to 42 months after surgery. Scrotal discomfort, male infertility and sperm abnormalities were studied and combined with related literature. Results: The local symptoms of all patients with scrotal discomfort were significantly improved. The quality of semen in patients with infertility and semen abnormalities was significantly improved (1 case of natural conception, 1 case of assisted reproductive techniques, 1 case of abortion after conception, 2 cases were lost during follow-up). Only one patient had postoperative scrotal edema without hydrocele and testicular atrophy. Others had no obvious complications. Conclusion: MSV is effective in treating varicocele, with low recurrence rate, few complications, and high postoperative pregnancy rate. Therefore this procedure should be recommended as initial surgical method in treatment of Varicocele.