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Abstract

Volume 24, Issue 6 (November 2022) 24, 624–627; 10.4103/aja202232

An alternative surgical technique for varicoceles: a preliminary experience of the microsurgical spermatic (distal end)-inferior or superficial epigastric vein anastomosis in symptomatic varicoceles associated with perineal pain

Zi Wan1, Hai-Ming Cao2, Bi-Cheng Yang1, Yong Gao3, Li Ding4, Peng Luo3, Guang-Wen Yang5, Lin Ma6, Chun-Hua Deng1

1 The Andrology Department, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
2 The Andrology Department, The Reproductive Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China
3 The Reproductive Medicine Center, The Key Laboratory for Reproductive Medicine of Guangdong Province, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
4 The Pathology Department, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
5 The Urology Department, Tongren Municipal People's Hospital, Tongren 554399, China
6 The Reproductive Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China

Correspondence: Dr. L Ma (malin8@mail.sysu.edu.cn) or Dr. CH Deng (dch0313@163.com)

Date of Submission 10-Oct-2021 Date of Acceptance 15-Apr-2022 Date of Web Publication 03-Jun-2022

Abstract

Many therapies are effective in treating varicoceles, including dilation of the pampiniform plexus in males. The most common method of treatment is varicocelectomy. We aimed to assess an alternative technique (microsurgical spermatic [distal end]-superficial or inferior epigastric vein anastomosis) that preserves the normal blood flow pattern for varicocele treatment. We retrospectively analyzed 27 men with varicocele between October 2019 and July 2020. All patients underwent microsurgical spermatic (distal end)-superficial or inferior epigastric vein anastomosis. The prognosis was reviewed retrospectively with an additional survey conducted 3 months after surgery. The mean ± standard deviation of the age was 26.1 ± 7.3 years in patients with microsurgical spermatic (distal end)-superficial or inferior epigastric vein anastomosis. The maximum diameter of the varicocele vein, perineal pain score, sperm density, and forward movement of sperm improved over 3 months after surgery. Microsurgical spermatic (distal end)-superficial or inferior epigastric vein anastomosis is a safe and efficient surgical treatment for varicoceles.

Keywords: microsurgery; pain; varicocele; vein anastomosis

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