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  varicocele
The pathophysiology of varicocele-associated male infertility
      
Varicocele is the most commonly identifiable, surgically correctable lesion associated with male-factor infertility.
      
Surgical correction of a varicocele, whether unilateral or bilateral, results in improvement not only in semen parameters but also in spontaneous and assisted pregnancy rates.
      
However, despite current knowledge in the patho-physiology of varicocele-associated male infertility, the exact mechanism-or mechanisms-by which varicoceles impair fertility remains elusive.
      
This review examines scientific evidence regarding the pathophysiology of varicocele-associated male infertility.
      
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Varicocele is a significant etiological factor in male infertility. The disease is caused by incompetence or congenital absence of the valves of internal spermatic veins, resulting in venous reflux. There is considerable experimental evidence for the direct relationship between elevated testicular and/or scrotal temperature and depressed spermatogenesis. The customary surgical approach is the high ligation of internal spermatic vein but a high percentage of failure has been recorded. This paper reports...

Varicocele is a significant etiological factor in male infertility. The disease is caused by incompetence or congenital absence of the valves of internal spermatic veins, resulting in venous reflux. There is considerable experimental evidence for the direct relationship between elevated testicular and/or scrotal temperature and depressed spermatogenesis. The customary surgical approach is the high ligation of internal spermatic vein but a high percentage of failure has been recorded. This paper reports a new microsurgical techique for the treatment of this disease. The method consists of the ligature of spermatic vein with an end-to-end anastomosis of its distal end to the proximal end of the saphenous vein. The preliminary results in 10 cases have been satisfactory.

过去治疗精索静脉曲张的传统手术方法是高位结扎精索内静脉,但常导致失败。本文报告10例用显微外科技术将精索内静脉的近端结扎、切断,其远端与同侧大隐静脉作端一端吻合,使睾丸端血液壅滞蔓状静脉丛与大隐静脉建立循环,而使曲张静脉很快消失,获得良好效果。

This paper reports 41 cases undergoing spermatic-saphenous vein anastomosis for the treatment of idiopathic varicocele. The method is anastomosis of the distal cut end of spermatic vein with the proximal cut end of saphenous vein. All patients were followed for 8—15 months, 34 became free of original symptoms and signs and 7 were improved.

本文报道用精索内静脉与大隐静脉吻合术治疗精索静脉曲张症41例,经8个月至1年3个月的随访,有34例静脉曲张的症状及体征完全消失,7例有所改善,无术后效果不良者。作者介绍了手术方法、精索静脉和大隐静脉测压、放射性核素阴囊血池扫描等情况,并对精索内静脉与大隐静脉吻合术的优点及其适应证等进行了讨论。

One hundred and ten cases of varicocele patients were reported and analyzed. The highest incidence was in the age of 16-20.Among the married 40%were accompanied with sterility.At least 15% or more of the operated patients failed to be cured or the disease recurred after the operation.Through this analysis the authors considered that the result of surgery depends to a large extent on the overall understanding of the internal spermatic vein preoperatively, and it is unjust to evaluate arbitrarily any one...

One hundred and ten cases of varicocele patients were reported and analyzed. The highest incidence was in the age of 16-20.Among the married 40%were accompanied with sterility.At least 15% or more of the operated patients failed to be cured or the disease recurred after the operation.Through this analysis the authors considered that the result of surgery depends to a large extent on the overall understanding of the internal spermatic vein preoperatively, and it is unjust to evaluate arbitrarily any one operation to be good or not.Spermatic venography is a good method to ensure a satisfactory postoperative result. In addition, the relationship between varicocele and sterility is discussed herein.

本文报告60年代以来我院收治的精索静脉曲张110例。其中左侧占96.36%,右侧占2.73%,双侧占0.9%。发病高峰年龄在16~20岁之间。已婚病人40%伴有不育症。经手术治疗的病人至少有15%以上精索静脉曲张持续或复发。通过总结,作者认为治疗不能一味强调哪种术式优越,而应通过精索内静脉造影来了解情况,只有因人而异确定治疗方案才是科学的,合理的。

 
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