Patients with primary varicocele have no obvious symptoms, and those with children generally do not need surgery. Non-surgical methods include: wearing tight underwear and observing; Li Junqiang reported the treatment of varicocele complicated with infertility with Huoxue Bushen Decoction. Hu Zhenbiao reported the treatment of varicocele with inhalation kick.
Primary varicocele with the following conditions needs surgical treatment: ① those with severe symptoms that are ineffective after non-surgical treatment; ② Spermatogenic dysfunction of testis, accompanied by testicular atrophy, causing infertility; ③ Patients with inguinal hernia or hydrocele. Some people even advocate that if teenagers find varicocele, they should be operated as soon as possible so as not to affect their future fertility. There are always positive and negative opinions on whether varicocele ligation can improve the semen quality of infertile patients. Most non-urogenital experts are skeptical about the effect of blocking spermatic vein in treating male infertility. Many well-controlled comparative studies have confirmed that spermatic vein ligation has no effect on improving male fertility, while those reports on improving sperm quality after spermatic vein ligation are only uncontrolled clinical studies, which may be due to the variability of semen analysis. Many controlled studies have confirmed that the sperm count of infertile men may naturally increase due to the variability of semen analysis. Some authors reported the clinical comparative study of 385 patients with varicocele, and found that there was no statistical significance in semen analysis between the two groups. Crasso analyzed 68 infertile men over 30 years old with mild left varicocele. Sperm quality has not improved after varicocelectomy, and it is advocated that varicocele should not be used as a means to treat infertility for men over 30 years old. 468 patients were divided into two groups: ① high ligation of spermatic vein; ② Microsurgical treatment of high inguinal varicocele. After operation 1 year, it was found that the sperm quality in MHIV group was better than that in high ligation group, and the pregnancy rate between the two groups was not statistically significant. The postoperative recurrence rate in MHIV group was lower than that in high ligation group. Scherr reported a group of 9 1 case of bilateral varicocele, with 2 ~ 3 degrees on the left and 0/degree on the right, with 65 cases of bilateral ligation and 26 cases of unilateral ligation. The follow-up results show that the improvement of semen quality in bilateral ligation group is obviously better than that in unilateral ligation group, and it is considered that even slight varicocele will affect semen quality. Domestic scholars advocate the treatment of varicocele in infertile patients. Commonly used surgical methods are: ligation of internal spermatic vein through groin; Retroperitoneal ligation of internal spermatic vein; Internal spermatic vein-inferior epigastric vein anastomosis; Internal spermatic vein-great saphenous vein anastomosis; Internal spermatic vein-superficial circumflex iliac vein anastomosis; Embolization of internal spermatic vein; Laparoscopic high ligation of internal spermatic vein. At present, many scholars believe that retroperitoneal ligation of internal spermatic vein is more thorough and no shunt is needed. Laparoscopic high ligation of internal spermatic vein for varicocele is increasing. The reason for the failure of the operation is the leakage of venous branches. Iacon introduced a new technique of bilateral spermatic vein ligation with scrotal midline incision under local anesthesia, which is minimally invasive and can be performed in outpatient department.
Dietotherapy for varicocele (for reference only, please consult your doctor for details)
1 .kumquat root pot pork belly: kumquat root 30g, pork belly 100- 150g (washed and cut into pieces), add 4 bowls of water and cook to 1.5 bowls, season with a little salt, and eat meat with soup. It is suitable for varicocele of liver-qi stagnation type.
2. Cimicifuga sesame fennel pot pork intestines: Cimicifuga 10g, black sesame 60g, fennel 10g, one section of pork intestines (about 30cm, washed). Put the three herbs into the pig's large intestine, tie the two ends tightly, add water to cook, remove fennel, Cimicifuga, sesame, taste and drink soup to eat the pig's large intestine. People with constipation can even eat black sesame seeds. It is suitable for varicocele of qi deficiency and blood stasis type.
3. Shenqi dual-core porridge: 20 grams of Radix Astragali, 30 grams of Radix Codonopsis, 0/5 grams of litchi seed 15 grams of mango seed 15 grams, 50 grams of japonica rice, boiled porridge. It is suitable for varicocele of qi deficiency and blood stasis type.
4. Orange core motherwort black bean syrup: orange core 15g, motherwort 30g, black bean 60g, add 3 bowls of water to fry to L bowl, and add brown sugar to taste. It is suitable for varicocele of blood stasis type.
5. Stewed cuttlefish with Astragalus and Peach Blossoms: 20g of Astragalus, 0g of peach blossom/kloc-0, 6g of fennel, cuttlefish 1 strip (about 250g, washed and cut into pieces, joined with bones), boiled, and seasoned with soup to eat cuttlefish. It is suitable for varicocele of blood stasis type.
The above dietary treatment of varicocele is for your reference only. Please consult the relevant doctor for details.
(2) Prognosis
The improvement rate of semen after internal spermatic vein operation can reach 50% ~ 80%. There are many factors that affect the improvement rate of semen and pregnancy rate. The older you get, the longer the course of disease, and the greater the damage to your testicles. When the number of sperm before operation is more than 654.38+million /ml, the improvement rate of semen after operation is 85%, and the pregnancy rate is 70%. If the number of sperm before operation is less than 654.38+million per milliliter, the improvement rate of semen after operation is 35% and the pregnancy rate is 27%. The possibility of restoring fertility after azoospermia surgery is very small.