Can varicocele be cured?

Varicose cord is a disease phenomenon. This disease is more common in young and middle-aged men. Varicose cord has a relatively large impact on the human body. This disease may also lead to male infertility. Varicose cord can be treated, so don't delay the treatment. Patients with this disease should also pay attention to rest.

Causes

This disease is a vascular disease characterized by varying degrees of dilation and tortuosity of the intravaricanal venous plexus. According to the cause, VC can be divided into primary and secondary VC. Primary VC may be caused by increased intravascular pressure, the long left spermatic vein that flows into the left renal vein at a right angle, the compression of the left renal vein by the superior mesenteric artery and aorta, affecting the return of the left internal spermatic vein, which is the "nutcracker" phenomenon (NCS), weak connective tissue around the internal spermatic vein, dysfunction and incomplete closure of the venous valves, abnormal structure of the spermatic vein wall tissue, anatomical variation of the spermatic vein, incomplete development of the levator testis muscle and other anatomical factors or developmental abnormalities. The causes of secondary VC may include: intra-abdominal or retroperitoneal tumors, hydronephrosis, ectopic blood vessels compressing the ascending spermatic vein, etc.

examine

Using staining methods and strictly following WHO standards for sperm morphology analysis can help evaluate the degree of fertility impairment in infertile patients, and is also conducive to standardizing operations and unifying analysis standards. Therefore, for patients whose routine semen examination shows low sperm density, low motility and vitality, and high deformity rate, it is recommended to undergo color Doppler flow imaging (CDFI) examination. CDFI can intuitively and accurately observe the degree of expansion of varicocele and blood flow status, and is currently a non-invasive and accurate diagnostic approach. You can also choose infrared scrotal thermometry or varicocele.

The clinical diagnostic criteria for CDFI are:

1. Clinical VC

At least three spermatic veins are detected in the spermatic venous plexus under quiet breathing, and the inner diameter of one of them is greater than 2.0 mm, or the inner diameter of the vein increases significantly when the abdominal pressure is increased, or the venous blood refluxes significantly after the Valsalva test;

2. Subclinical VC

The internal diameter of the spermatic vein is ≥1.8mm, there is no blood reflux during quiet breathing, reflux occurs during the Valsalva test, and the reflux phase is ≥800ms.

treat

Surgery is the main treatment method and can achieve ideal therapeutic effects. Some people also take (or combine) drug treatment.

First, secondary factors such as renal tumors, hydronephrosis, retroperitoneal tumors, and ectopic blood vessels should be ruled out.

Primary VC accompanied by infertility or semen abnormalities are all indications for treatment regardless of the severity of the symptoms. Current surgical treatments include high ligation of the internal spermatic vein through the inguinal canal, laparoscopic surgery, high ligation of the internal spermatic vein through the retroperitoneum, and varicocelectomy. Compared with inguinal canal surgery and laparoscopic surgery, retroperitoneal high ligation of the varicocele has the advantages of less surgical trauma, less risk of damaging other blood vessels, less risk of missing the varicocele, shorter operation time, lower surgical costs, less postoperative complications, and lower recurrence rate. It is the preferred treatment for unilateral varicocele.

The improvement of semen parameters and pregnancy rate in patients treated with surgery combined with medication were significantly better than those treated with surgery alone.