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目的:对比分析显微精索静脉结扎术对阴囊疼痛不适及不育情况的改善率。方法:2011年3月~2012年12月采用显微精索静脉结扎术治疗2~3度精索静脉曲张患者88例,其中左侧精索静脉曲张66例,双侧精索静脉曲张22例。49例(55.7%)主诉为患侧阴囊疼痛不适,39例(44.3%)主诉为不育。阴囊疼痛不适患者使用视觉模拟评分法评估手术效果,不育患者评估精液质量及配偶自然妊娠情况。结果:术后1年随访,33例患者(67.3%)疼痛完全缓解,18例患者(46.2%)配偶已自然妊娠。疼痛完全缓解率与配偶自然妊娠率的差异有统计学意义(P<0.05)。结论:显微精索静脉结扎术是治疗精索静脉曲张所致阴囊疼痛不适及男性不育的有效方法,其中阴囊疼痛不适患者手术效果较不育患者更佳。
OBJECTIVE: To compare and analyze the improvement rate of scrotal pain discomfort and infertility caused by microsurgical varicocelectomy. Methods: From March 2011 to December 2012, 88 patients with 2 ~ 3 degree varicocele were treated with microsurgical varicocelectomy, including 66 cases of varicocele on the left and 22 cases of bilateral varicocele . 49 cases (55.7%) complained of ipsilateral scrotal pain discomfort, 39 cases (44.3%) complained of infertility. Scrotal pain and discomfort were assessed using visual analogue scoring to assess surgical outcomes and infertility patients to assess semen quality and spouses’ natural pregnancy status. RESULTS: Pain was completely relieved in 33 patients (67.3%) at 1 year after surgery, and 18 patients (46.2%) had spontaneous pregnancy. There was a significant difference between the complete pain relief rate and the natural pregnancy rate (P <0.05). CONCLUSIONS: Microsurgical varicocelectomy is an effective method for the treatment of varicocele-induced scrotal pain and male infertility. Among them, scrotal pain and discomfort are more effective than infertility patients.