What kind of treatment is better for varicocele?

1. Non-surgical treatment of mild varicocele

For those with mild symptoms and no complications, non-surgical treatment should be taken first, including scrotal sling, local cold compress and avoiding excessive sexual intercourse to reduce venous plexus congestion. Explain those who have neurasthenia symptoms in order to reduce mental burden and give appropriate sedatives when necessary.

2. Interventional therapy

It means that the catheter is inserted into the left internal spermatic vein through the inferior vena cava and the left renal vein, and then 5% sodium morrhuate or gelatin sponge and steel ring are injected to treat varicocele by embolization of this vein.

. The disadvantage is that patients with venous malformation or collateral circulation are not suitable for embolization and need special equipment. This method is rarely used now. 3. Open surgical treatment

It is an effective treatment commonly used in clinic. The surgical indications are: ① those who have obvious clinical symptoms or whose symptoms cannot be relieved after conservative treatment; ② Varicocele with infertility or abnormal semen should be treated by surgery regardless of the severity of symptoms; ② When children and adolescents have varicocele, they should be operated as soon as possible to prevent testicular spermatogenic dysfunction and testicular atrophy.

There are two main surgical methods:

(1) High ligation of internal spermatic vein through inguinal canal is the same as hernia repair. Expose the spermatic cord, find out the trunk and branches of the internal spermatic vein, and then ligate it. 」

(2) Make an oblique incision in the left lower abdomen through iliac fossa, push open the peritoneum, and find the internal spermatic vein behind the peritoneum and before the external iliac artery for ligation.

4. Minimally invasive surgical treatment

Laparoscopic treatment of varicocele has been carried out at home and abroad. This method is simpler, more effective and less complicated than open surgery. Microsurgery can protect the spermatic artery from being stabbed by mistake, and bilateral simultaneous surgery does not require secondary incision.