Clinical Study on Intraoperative Venography of Varicocele

Kim, Je Jong; Koh, Sung Kun

Abstract

The varicocele may cause a male infertility and mild subjective symptoms such as heavy sensation, dragging pain over the ipsilateral scrotum. One of the therapeutic method of the varicocele is a high ligation of internal spermatic vein of affected side. We have performed the venography of internal spermatic vein during operation in 10 cases to detect the collateral circulation from January 1980 to June 1981. The following results were obtained. 1. The venograms of internal spermatic vein showed left to right anastomosis prepubically in 1 case. anastomosis of left internal spermatic vein with ductus deferens vein in 2 cases and no anastomosis in 7 cases. 2. After high ligation of internal spermatic vein, the clinical symptoms and size of varicocele decreased within 3 days in 4 cases and within 7 days in another 4 cases postoperatively, however no decrease noted in 2 cases until 3 months to 12 months postoperatively, This 2 cases showed anastomosis with ductus deferens vein. 3. Preoperative semen analysis revealed oligospermia 5 cases, asthenospermia in 2 cases and low percentage of normal form of sperm in 4 cases. Postoperative semen analysis showed increase of sperm count in 4 cases of which had been oligospermia, slight improvement noted in 1 case of asthenospermia and in 3 cases of low normospermia. 4. 2 cases In which the spermatic vein was anastomosed with left ducts deferens vein seemed to b associated with obstruction of left common iliac vein.