El drenaje de las venas varicosas (vein milking) durante la varicocelectomía microscópica subinguinal: efectos sobre el dolor, el resultado estético y el espermiograma

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-04-01 DOI:10.1016/j.acuro.2025.501706

B. Kati , E. Ordek , I. Demir , E. Sabri Pelit

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引用次数: 0

Abstract

Introduction

Varicocele, defined as abnormal convoluted enlargement of the pampiniform plexus veins, is the most common cause of correctable male infertility. This study aimed to investigate the effect of blood drainage in varicose veins on spermiogram parameters, postoperative pain, cosmetic appearance, and patient satisfaction in patients undergoing subinguinal microscopic varicocelectomy.

Methods

Patients diagnosed with clinical varicocele and admitted to our urology outpatient clinic between January 2020 and January 2024 were evaluated. Those with a venous vessel diameter ≥ 2.5 mm underwent subinguinal microscopic varicocelectomy. In 75 patients, a small incision was made in the thickest varicose vein, and the veins were ligated after venous blood was drained by hand patting. In another 75 patients, vessels were cut and ligated by the classical method without venous blood drainage. Exclusion criteria included patients younger than 18, those with secondary varicocelectomy history, undescended testis, testicular trauma or tumors, and prior infertility treatment. Preoperative and postoperative spermiogram values, pain scores, cosmetic appearance, and patient satisfaction were recorded and compared.

Results

The pain rate was significantly lower (p < 0.05) in the blood-milking varicocelectomy group during postoperative controls (7-10 days) compared to the classical method group. The blood-milking group also showed significantly higher (p < 0.05) sperm count and motility at the 3rd postoperative month. Cosmetic satisfaction was significantly higher (p < 0.05) in the blood-milking group.

Conclusions

Blood drainage during subinguinal microscopic varicocelectomy significantly reduces postoperative pain and enhances sperm values, cosmetic outcomes, and patient satisfaction. These findings reveal that vein-milking techniques during varicocelectomy can optimize postoperative outcomes.

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腹股沟下显微静脉曲张切除术期间静脉挤奶：对疼痛、美容效果和精子图的影响

精索静脉曲张，定义为pampiniform丛静脉的异常卷曲扩大，是可矫正男性不育的最常见原因。本研究旨在探讨静脉曲张引流对腹股沟下显微精索静脉曲张切除术患者精子造影参数、术后疼痛、外观及患者满意度的影响。方法对2020年1月至2024年1月在我院泌尿外科门诊诊断为临床精索静脉曲张的患者进行评估。静脉血管直径≥2.5 mm者行腹股沟下显微精索静脉曲张切除术。75例患者在最粗的静脉曲张处做小切口，手拍引流静脉血后结扎静脉。另外75例患者采用经典方法切开结扎血管，不进行静脉血引流。排除标准包括年龄小于18岁、有继发性精索静脉曲张切除术史、睾丸未下降、睾丸外伤或肿瘤、既往不育症治疗的患者。记录并比较术前和术后精子造影值、疼痛评分、外观和患者满意度。结果疼痛率明显低于对照组(p <；术后对照组（7 ~ 10 d）与经典方法组比较，精索静脉曲张采血组差异有统计学意义（0.05）。挤奶组也有显著升高(p <；0.05)术后第3个月精子计数和活力。美容满意度显著提高(p <；0.05)。结论腹股沟下显微镜下精索静脉曲张切除术行放血可明显减轻术后疼痛，提高精子价值、美容效果和患者满意度。这些发现表明静脉挤乳技术在精索静脉曲张切除术可以优化术后效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.