Research On Pathology Of Internal Spermatic Vein Of Varicocele And Approach To It's Relative Pathogenesis

Objective To investigate routine regularity of pathology changes and the relationship between morphologic character and pathogenesis of varicocele, to explore and get the message whatever there were venous valves in internal spermatic vein,then judge the valvular insufficiency theory is right pathogenesis or not of varicocele,all this message could achieved though control study between normal and different degree internal spermatic veins. By using of Elivison immunohistochemical staining method to reveal nerve fibers near around and in vessel wall of different group internal spermatic veins to found the distribution regularity and the relationship between its character and pathogenesis of varicocele.Method Normal internal spermatic veins choose from patients with left hydrocele and varicocele were eliminated by Doppler ultrasonography and common palpation practice combined Valsalva maneuver before operation therapy.When these patients received mer-inguina operation to removal or turnover hydrocele of tunica vaginalis we shear a section of left internal spermatic vein about 2 cm long in each one.Then these vein samples were fixed in 10% formalin. During one year empirical work there were 8 normal internal spermatic veins collected, The patients ranged in age from 18 to 32 years old,mean age 24.7 years.There were 30 varicocele internal spermatic vein specimens collected among hospitalized patients in Urology department in the same procedure, The patients ranged in age from 12 to 40 years old,mean age 23.6 years.In the total, I~0 varicocele internal spermatic vein specimens were 5 segments,II~0 varicocele internal spermatic vein specimens were 9 segments,III~0 varicocele internal spermatic vein specimens were 16 segments.Normal internal spermatic veins and different varicocele veins were divide into four groups. Four group vein samples were all performed conventional pathological microtomy and Hematoxylin and eosine(HE) stain.Through light microscope pathologic appearance were analysised,at the same time,we searched all pathological section to find venous valve in spermatic veins.Distribution of S-100 protein was analyzed in different groups by means of immunohistochemical Elivison staining method in next step. Statistical method were used to aid analysis.Finaly,we make a comparison to draw a conclusion about pathological change and S-100 protein distribution regularity between normal spermatic vein and three group of varicocele veins.Result Through observing cross and longitudinal section of spermatic veins under light microscope,we found that lumens of varicocele vein expanded evidently compared with normal internal spermatic vein, vessel wall atrophied in all layers.The atrophy degree manifested positive correlation with varicocele level by means of Spearman,s test (P <0.05),that is to say much variciform degree more atrophic. Meanwhile,no venous valve or similar structure have been found in internal spermatic vein lumens among all cross pathological sections and longitudinal pathological sections. The number of nerve fibers were decreased in vessel walls of I~0,II 0and III~0 varicocele , especially ,in II 0,III~0 varicocele groups,which revealed by staining S-100 protein in immunohistochemical approach.The positive spots of S-100 protein were counted in one whole transection of each internal spermatic vein under high power field,there were significant statistical difference among the three groups of varicocele and normal group by using one-way analysi(sP <0.05).It is indicated that amount of nerve fibers near around spermatic veins or in vessel walls obviously decreased even more with the varicocele aggravated.Conclusion Atrophy trend of vessel wall was obviously in all layers with the degree progress of varicocele compared with normal spermatic vein. No venous valve or similar structure have been found in internal spermatic vein lumens among all cross and longitudinal pathological section. The theories about venous valve depletion or insufficiency of function are not necessarily correct.Nerval developmental anomaly about internal spermatic vein may be a considerable pathogenesis of varicocele.