The Increase of Arterial Hemodynamics in Patients with Varicocele and Infertility
The aim of the investigation was to develop the technique of effective and pathologically reasonable management of infertility in male patients with varicocele.
Materials and Methods. The research was based on the results of clinical observations of 865 patients with varicocele aged 18–39 years, classified into two groups depending on the presence or absence of spermatogenesis disturbances. The pattern of changes in hemodynamic indices in different periods after varicocele surgical treatment was studied in 135 patients. Ejaculate was examined in accordance with WHO laboratory manual for the examination and processing of human semen (1987). Hemodynamic condition in scrotal organs was assessed by ultrasound on “Aloka SSD-3500” and “Aloka SSD-4000” (Japan) using linear probe 7.5 MHz. The spermatogenesis condition in infertility was evaluated by morphological examination of the material obtained by testicular biopsy.
Results. The analysis of the surgical treatment results of 135 patients showed the improvement of arterial testicular blood supply in 97 patients (71.8%). The rest 38 patients (28.2%) had no changes in arterial blood supply, but in some cases (9 patients) there was insignificant increase of arterial testicular blood supply within the first month after the surgery. The developed operational procedure for varicocele included the superior testicular vein ligation, which was followed by the ligation of a. hypogastrica inferior in 93 patients. The findings suggest great efficiency of the technique. The recovery of ejaculate parameters takes far less time compared to standard varicocelectomy.
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