Microscopic spermatic vein ligation for nutcracker phenomenon complicated with left varicocele
GAO Qing-qiang
XU Zhi-peng
CHEN Hai
SONG Tao
DAI Yu-tian
CHEN Yun
Abstract：Objective:To investigate the clinical effect of microscopic spermatic vein ligation in the treatment of nutcracker phenomenon (NCP) complicated with left varicocele (VC).Methods:This retrospective study included 31 cases of NCP complicated with left VC treated in our hospital by subinguinal microscopic ligation of the left spermatic vein (group A,n =11),open retroperitoneal high ligation of the left spermatic vein (group B,n =11),or conservative therapy (group C,n =9).The patients were followed up for 6-24 (15.3 ± 5.4) months.We compared the semen parameters,spermatic vein diameter,left testis volume,and recurrence rate among the three groups of patients before and after treatment.Results:Compared with the baseline,the semen quality parameters were significantly improved in both groups A and B at 6 months after treatment (P ＜ 0.05) but reduced in group C (P ＜ 0.05);the spermatic vein diameter at rest and that at Valsalva maneuver were markedly decreased in groups A ([2.53 ± 0.27] vs [1.84 ± 0.22] and [3.53 ± 0.19] vs [2.16 ± 0.25] mm,P ＜0.05) andB ([2.62 ± 0.33] vs [2.15 ± 0.43] and [3.36 ± 0.25] vs [2.44 ± 0.27] mm,P ＜0.05) but increased in groupC ([2.56 ± 0.28] vs [2.94 ± 0.24] and [3.33 ± 0.21] vs [3.77 ± 0.26] mm,P ＜ 0.05).No statistically significant differences were found in the left testis volume at 6 months after treatment in groupA([9.85 ± 1.86] vs [10.27 ± 1.18] ml,P ＞0.05),B ([9.77 ± 2.03] vs [9.96 ± 1.72] ml,P ＞ 0.05),orC ([9.83 ± 1.59] vs [10.48 ± 2.05] ml,P ＞0.05),nor in the recurrence rate between groups A and B (P ＞ 0.05).Conclusion:Hematuria,proteinuria and other mild symptoms of nutcracker phenomenon complicated with left VC can be treated palliatively by microscopic ligation of the spermatic vein,which can relieve the clinical symptoms,improve the semen quality,and protect the testicular function of the patient.
Keywords：nutcracker phenomenonvaricocelemicroscopyspermatic vein ligation
Publication Date：2017-08-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 692-696 )