It is important to choose the right method for the treatment of varicocele

Clinically, varicocele is the most common type of men's disease, and patients also need to find the right method for treatment. The following article will introduce the methods for treating varicocele.

1. Non-surgical treatment

For mild varicocele with mild symptoms and no complications, non-surgical treatment is first adopted, including scrotal support, local cold compress, and avoiding excessive sexual intercourse to reduce venous congestion. For patients with neurasthenia symptoms, explanations are given to reduce the mental burden, and appropriate sedatives are given when necessary.

2. Interventional therapy

It refers to inserting a catheter into the left internal spermatic vein through the inferior vena cava and the left renal vein, and then injecting 5% sodium cod liver oil or gelatin sponge and steel coil to treat varicocele by embolizing this vein. The disadvantage is that the vein is not suitable for embolization if it is deformed or has collateral circulation, and special equipment is required. This method is rarely used now.

3. Open surgical treatment

It is an effective treatment method commonly used in clinical practice. The indications for surgery are: ① Patients with obvious clinical symptoms or symptoms that cannot be relieved after conservative treatment; ② Patients with varicocele accompanied by infertility or semen abnormalities should undergo surgery regardless of the severity of the symptoms; ③ When children and adolescents develop varicocele, surgical treatment should be performed as soon as possible to prevent testicular spermatogenesis dysfunction and testicular atrophy in adulthood.

There are two main surgical approaches:

(1) Transinguinal canal Transinguinal canal high ligation of the internal spermatic vein uses the same incision as hernia repair surgery, exposing the spermatic cord, finding the main trunk of the internal spermatic vein and its branches, and ligating them. This surgical approach is simple and commonly used, and can ligate the dilated external spermatic vein and gubernaculum testis vein at the same time. If a surgical microscope is used during the operation, the effect will be better, the recurrence rate is low, and there are fewer complications, but it is easy to have problems such as incomplete ligation or accidental injury to the testicular artery.

(2) Through the iliac fossa, make an oblique incision in the left lower abdomen, push aside the peritoneum, find the internal spermatic vein behind the peritoneum and in front of the external iliac artery, and ligate it. The advantage is that it does not affect the structure of the inguinal canal, and the main trunk of the spermatic vein can be ligated, so the ligation is complete; if the internal spermatic artery is accidentally injured at this point, it will not cause testicular atrophy.