High Ligation Of Spermatic Vein Research Articles

The Application Effect of Jiawei Sanyu Shengjing Decoction Combined with High Ligation of the Spermatic Vein in Varicocele Male Infertility Patients.

Objective To analyze the application effect of Jiawei Sanyu Shengjing decoction combined with high ligation of the internal spermatic vein in male infertility patients with varicocele (VC). Methods 106 male infertility patients with VC treated in our hospital from December 2018 to March 2019 were selected as examples. According to the length of stay, they were divided into the control group and observation group, with 53 cases in each group. High ligation of the internal spermatic vein was performed in both groups. On this basis, the observation group was treated with modified Sanyu Shengjing decoction, and the therapeutic effects of the two groups were compared. Results The effective rate of 94.34% in the observation group was higher than 79.25% in the control group (P < 0.05). After treatment, the serum index level and sperm deformity rate in the observation group were lower than those in the control group, and the semen density and sperm activity were higher than those in the control group (P < 0.05). Conclusion The treatment of VC male infertility with modified Sanyu Shengjing decoction combined with high ligation of the internal spermatic vein can effectively improve the number of sperm and reduce the density of semen.

Observation on the efficacy of laparoscopic high ligation of spermatic vein combined with compound xuanju capsule in the treatment of infertility caused by varicocele

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. Key words: Varicocele; Laparoscopes; High ligation of spermatic vein; Compound xuanju capsule; Infertility

Treatment of varicocele combined with asthenospermia by microsurgical shunt: 3 cases report

To investigate the clinic value of microsurgical shunt for the treatment of varicocele combined with asthenspermia, the clinical data and therapeutic method for 3 patients, who conducted the microscope spermatic vein high ligation combined with superficial epigastric vein flow, were retrospectively analyzed. No postoperative complications were found, and the original symptoms and signs were disappeared. All patients were conducted scrotal ultrasound and semen routine after 3 months, and all indexes, including maximum internal diameter of the cord vein (erect position), sperm density, sperm survival rate, sperm deformity rate and sperm forward movement rate, were gradually improved. Consequently, high ligation of spermatic vein combined with vascular bypass surgery under the microscope can block the countercurrent venous blood and establish a new return channel to the testis. Meanwhile, it can also protect the testicular artery and lymph-vessel. It is worth to be spread for the treatment of varicocele combined with asthenospermia.

Expression and significance of miR-210 in the epididymis in rats with varicocele and following varicocelectomy

Objective: To investigate the expression of microRNA 210 (miR-210) in the epididymis of rats with varicocele and changes in miR-210 expression following high spermatic vein ligation, so as to explore the significance of the surgery in treating varicocele. Methods: A total of 21 male Sprague-Dawley (SD) rats aged 7 weeks were randomly divided into control group (n=7), experimental group (n=7), and surgical group (n=7). Varicocele model was established in both the experimental and surgical groups, while only vein isolation was performed in the control group. After 8 weeks, spermatic vein diameter were measured in the control and experimental rats, and collected the left epididymis (fixed in formaldehyde and frozen in refrigerator at -80 ℃). In the surgical group, left high spermatic vein ligation was performed, and the left epididymis was collected after 4 weeks as in the control and the experimental groups. The fixed epididymis tissues were treated with HE staining for observation of tissue injuries. The miR-210 expression in the epididymis was detected with reverse transcription-polymerase chain reaction (RT-PCR). At last every group had 5 rats. Results: The pathological examination showed that the number and distribution of mature sperms in epididymal duct in the experimental group were lower and less even compared to the control group, while the two indicators in the surgical group were better than those in the experimental group. The diameter of the left spermatic vein in the experimental group and pre-treatment surgical group were significantly enlarged than in the control group (P<0.01). The expression of miR-210 in the left epididymis in the experimental group was significantly higher compared with the control group(1.32±0.06 vs 0.98±0.14, P<0.01), while the expression of miR-210 in the left epididymis in the surgical group was significantly decreased compared with the experimental group (0.96±0.16 vs 1.32±0.06, P<0.01); the difference between the control group and the surgical group was not statistically significant (P>0.05). Conclusion: The expression of miR-210 in the epididymis may be increased by varicocele and reduced after high ligation of the affected spermatic vein.

Postoperative complications of microsurgery combined with dispersing stagnated liver, strengthening spleen and tonifying kidney in varicocele associated infertility

Objective Compare the postoperative complications of some kinds of surgical approaches and dispersing stagnated liver, strengthening spleen and tonifying kidney to varicocele associated infertility. Methods From 204 varicocele associated infertility hospitalized patients, which were randomly devided into 4 groups.51 cases of high ligation of spermatic vein with laparoscope(group A);50 cases of ligation of spermatic vein with microscope(group B); 52 cases of microscope with the traditional Chinese medicine(group C);51 cases of microscope with the traditional Chinese medicine(group D), compared postoperative complications(unwell in scrotum, scrotal edemas, hydrocele)after the operations of one week,one month, three months, six months and twelve months in four groups and recurrence of half a year. Results The rate of symptom improvement in D group was significantly better than the other three groups(P<0.05).Over time, there was no statistical difference between four groups. The recurrence rate of D group(0.00%)was obviously lower than A group(11.76%), the B group(2.00%)and the C group(3.85%)(P<0.05). Conclusion Microscope with the traditional Chinese medicine is a good choice in preventing postoperative the rate of symptom and recurrence. Key words: Varicocele; infertility; dispersing stagnated liver qi strengthening spleen tonifying kidney; microsurgery; laparoscopy; complications

腹腔镜与显微镜下治疗青年精索静脉曲张疗效分析

目的：探讨腹腔镜与显微镜下治疗青年原发性精索静脉曲张的疗效、安全性。方法：回顾性分析71名青年原发性精索静脉曲张患者治疗后随访资料，其中有5例慢性前列腺炎患者。39例接受腹腔镜精索静脉高位结扎术(腹腔镜组)，2例慢性前列腺炎患者；32例接受显微镜下精索静脉结扎组(显微镜组)，3例慢性前列腺炎患者。比较两组患者术前、术后3月精液质量、激素水平、睾丸体积变化情况及手术时间、住院天数、费用。结果：两组患者手术均顺利完成，腹腔镜组与显微镜组相比手术时间明显缩短(85.94 ± 20.44 vs 39.00 ± 9.69, P 0.05)。两组患者术后精液质量较术前无差异(P > 0.05)，精子密度、精子存活率、A + B级精子明显改善，差异有统计学意义(P 0.05)。腹腔镜组术后2例(5.1%)复发，1例(2.6%)附睾炎，2例(5.1%)症状持续存在，2例(5.1%)阴囊水肿；显微镜组术后无复发、附睾炎、阴囊水肿，但是有1例(3.1%)患者症状持续存在。结论：青年精索静脉曲张患者精液质量大多已受影响，早期手术可以恢复精液质量或减轻精液质量的下降。腹腔镜与显微镜下治疗精索静脉曲张均为微创手术，创伤小、疗效好，但是显微镜下治疗精索静脉曲张费用低、术后复发率低、并发症更少。 Objective: To compare curative effect between microscopic and laparoscopic approach for treatment of varicocele. Method: We retrospectively analyzed 71 adolescence varicocele patients after treatment follow-up data. 39 cases underwent laparoscopic high ligation of spermatic vein (laparoscopic group). 32 patients received ligation of varicocele group under the microscope (microscopy group). The semen quality, hormone levels and testicular volumes of these two groups of patients before and after the operation, operation time, hospitalization days and cost were compared. Results: All patients were successfully completed the operation. Laparoscopic group compared with microscope group operation time is obviously shortened (85.94 + 20.44VS39.00 + 9.69, P 0.05), but the cost was significantly increased (4866 + 541.45VS7820 + 906.21, P < 0.05). Compared with preoperative semen quality, postoperative semen quality of these two groups of patients showed no statistical significance. Sperm density, sperm survival rate, A + B grade sperm significantly improved (P < 0.05). In the laparoscopic group after operation, 2 cases (5.1%) of recurrence, 1 case (2.6%) of patients with epididymitis; 2 cases (5.1%) clinical symptoms persisted and 2 cases (5.1%) occurred scrotal edema. However, no recurrence, epididymitis, scrotal edema in the microscope group after operation, but 1 case (3.1%) of patients with persistent symptoms. Conclusion: Most of the youth semen quality of patients with varicocele has affected; early operation can restore the semen quality or decrease the damage level of semen quality. Laparoscopic and microscope to treat varicocele were minimally invasive operation. They have the characteristics of small trauma, good curative effect, but the microsurgical operation has the advantages of low cost, lower postoperative recurrence rate and fewer complications characteristics.

Laparoscopic high selective ligation of spermatic veins for treatment of varicocele

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). Conclusion Laparoscopic high selective ligation of spermatic veins in this study had less complications,higher improving rates of semen quality and pregnant rates. Key words: Laparoscopes; Varicocele; High selective; High ligation of spermatic vein

Report on varicocele and infertility

Controversies regarding diagnosis and treatment of varicoceles in male partners in infertile couples are considered in detail.

Laparoscopic high ligation of spermatic vein in the treatment of critical varicocele

目的 探讨腹腔镜下精索内静脉高位节段切除术治疗重度精索静脉曲张的临床疗效.方法 回顾性分折腹腔镜下精索内静脉高位节段切除术治疗重度精索静脉曲张26例临床资料.结果 手术过程顺利,手术时间25～50 min,平均(28±3)min,术后随访3～24个月,症状与体征全部消失,无术后复发和睾丸萎缩,术后患者妻子已怀孕8例.结论 腹腔镜下精索内静脉高位节段切除术治疗重度精索静脉曲张安全、创伤小,康复快,特别适合双侧重度精索静脉曲张。

Controlled trial of high spermatic vein ligation for varicocele in infertile men

International Journal of Gynecology & ObstetricsVolume 50, Issue 3 p. 317-317 Citations from the literature (including the russian literature) fertility and sterility Controlled trial of high spermatic vein ligation for varicocele in infertile men Madgar I.; Weissenberg R.; Lunenfeld B.; Karasik A.; Goldwasser B. ISR Fertil Steril 1995 63/1 (120–124) First published: September 1995 https://doi.org/10.1016/0020-7292(95)92791-XAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume50, Issue3September 1995Pages 317-317 RelatedInformation

Controlled trial of high spermatic vein ligation for varicocele in infertile men

To determine whether high ligation is an effective treatment for infertile men with clinical varicocele. A randomized, controlled trial of high spermatic vein ligation was carried out. The patients were treated and observed for 3 years. Infertility treatment clinic and andrology laboratory in a hospital. Infertile men with abnormal semen analysis because of varicocele only. High ligation 1 year postrecruitment (group A) and at the beginning of the study (group B). Among the 20 couples in group A, 2 pregnancies (10%) were achieved within the 1st year of observation period. During the year after high ligation, there were 8 pregnancies (44.4%), and during the 2nd year after high ligation, there were 4 more pregnancies (22.2%). In group B, 15 pregnancies (60%) occurred within the 1st year after operation. Three pregnancies (12%) and 1 pregnancy (4%) occurred during the 2nd and 3rd year, respectively. After operation in all patients of both groups, there was significant improvement in semen parameters, regardless of pregnancy occurrence. The difference in pregnancy rate (PR) between the operated group B and nonoperated group A during the 1st year of study was found to be highly significant. It is concluded that in a population of infertile men presenting varicocele as the only demonstrable factor of infertility, the varicocele is clearly associated with infertility and reduced testicular function, and its correction by ligation improves sperm parameters and fertility rate. Furthermore, the highest PR in both groups occurred during the 1st year postoperation.

Efficacy of varicocele embolization versus ligation of the left internal spermatic vein for improvement of sperm quality

Efficacy of surgical varicocelectomy versus embolization of the spermatic vein was studied in 137 men diagnosed as suffering from left varicocele. The men were divided randomly into three groups according to the methods of treatment: A--embolization of the internal spermatic vein (51 men); B--Ivanissevich technique of high ligation of the spermatic veins (43 men); and C--Bernardi technique of high ligation (43 men). The groups were similar in terms of age, duration of infertility and possessed semen characterized as oligoteratoasthenozoospermia. The fertility of the female partners was evaluated carefully and they were found to be potentially fertile. Varicocele was diagnosed by at least two of the following methods: physical palpation during valsalva manoeuvre, venography, or scrotal scanning using the technetium pertechnetate radioactive method. Semen quality was assessed before treatment and at 3, 6 and 9 months post-treatment. Fecundity was followed-up for 18 months. The major results were: (i) Shrinkage of the varicocele was found in all three groups studied. The same rate of recurrence was recorded in the three groups (24%, 37% and 35% in groups A, B and C, respectively). (ii) Improvement of sperm quality was significant in groups A and B, with better results in group B. (iii) The pregnancy rate was significantly higher in group B, compared with A (38.2% vs. 20.6%; P less than 0.05). Thus, high ligation of the internal spermatic vein yields better results than low ligation or embolization as far as semen quality and pregnancy is concerned.

Clinical experience with gossypol in non-chinese men: A follow-up

Gossypol monoacetic acid was administered to 12 Brazilian volunteers. The initial dose was 20 mg daily for 4 months. The dose was then reduced to 60 mg weekly (20 mg three times weekly). A significant reduction in sperm motility was detected in all subjects. An increase in the number of immature cells in the ejaculate was also detected in all subjects. Severe oligospermia or azoospermia developed in all subjects at the end of the loading phase. Two years following discontinuation, 3 men were still azoospermic. Only 1 man who was azoospermic 2 years after discontinuation had a late (3 years) recovery. Two of the 3 men who were subjected to high spermatic vein ligation because of varicocele remained azoospermic 2 years after the operation. The third patient, who did not have the operation, also remained azoospermic. Of the 9 patients who recovered, 3 have fathered children during the last 2 years.

Histochemical location of 17 beta-hydroxysteroid oxidoreductase in the adult and infantile human testis.

17 beta-Hydroxysteroid oxidoreductase in the human testis was investigated histochemically using tissues obtained from seven patients with undescended testis or varicocele at the time of orchiopexy or high ligation of spermatic vein. Formazan precipitates were formed from nitro-blue tetrazolium in the tissue utilizing hydrogen released by oxidation of testosterone, which is catalyzed by the reductase function of 17 beta-hydroxysteroid oxidoreductase. The precipitates were formed specifically in the presence of 17 beta-hydroxy-C19-steroids under the conditions employed in the present study. In infantile testes, the precipitates were formed in cytoplasm of immature Sertoli cells, while in pubertal or adult testes, marked formazan precipitates were found in cytoplasm of both Sertoli and Leydig cells. The results indicate the presence of two distinct 17 beta-hydroxysteroid oxidoreductases in the human testis; one in Sertoli cells and detectable independent of age and the other only in functional Leydig cells.

The Varicocele: Elevated Serotonin and Infertility

Serotonin is known to be toxic to testicular function. In a series of canine studies serotonin was found to be elevated in both spermatic veins after creation of a varicocele by partial ligation of the left renal vein. A total of 42 consecutive infertile male patients with a palpable varicocele and a seminal stress pattern had peripheral and spermatic vein serotonin levels determined at the time of high spermatic vein ligation. Of these patients 27 (64 per cent) had spermatic vein serotonin levels equal to or greater than peripheral levels. These patients demonstrated significantly lower sperm motility, percentage of live sperm and elevated percentages of immature and tapered sperm forms compared to those patients with lower spermatic vein serotonin levels. The interrelationships among the varicocele, premature sloughing of immature sperm and serotonin are discussed.

Operative management of variocele by high retroperitoneal ligation of the spermatic vein.

High retroperitoneal ligation of the internal spermatic vein has been performed in 30 cases of varicocele. Renospermatic reflux had been demonstrated by preoperative phlebography in every case. Retrograde pressure brought to bear on the spermatic vein from the renal vein has been ascertained by intraoperative measurements of the pressures in the internal spermatic vein. On the ground of the results, high ligation of the spermatic vein is regarded as suitable for the surgical management of varicocele in case of renospermatic reflux.