Effectiveness And Safety Of Microsurgical Varicocelectomy For Treating Nutcracker Phenomenon Associated Varicocele

Purpose:The aim of our study was to access the clinical effectiveness and safety of microsurgical varicocelectomy in the treatment of male nutcracker phenomenon associated left varicocele.Materials and Methods:We retrospectively analyzed 66 patients with left varicocele in our institution between August 2015 and February 2017.Patients were categorized into two groups.In group A,35 patients with nutcracker phenomenon associated left varicocele were included.Furthermore,25 patients underwent microsurgical varicocelectomy were classified as group Al,and the rest 10 patients underwent microsurgical spermatic-inferior epigastric vein anastomosis were classified as group A2.Group B included 31 patients with left varicocele alone underwent microsurgical varicocelectomy.Results:The preoperative serum hormone levels,results of scrotal ultrasound and semen analysis between group A and group B were observed no significant difference except in age,BMI,T level and peak velocity ratio.There was no significant difference in preoperative value between group A1 and group A2.However,group A1 spent less surgical time compared with group A2(p<0.001).Significant decreases in post-operative left internal spermatic vein diameter and the reflux time were presented among group A1,A2 and group B,respectively.In addition,all these three groups achieved a significantly better result of semen parameters at 6 months postoperatively than those before surgery.But,the postoperative parameters like the results of scrotal ultrasound and semen analysis showed no statistical difference among group A1,A2 and group B.Conclusions:This study indicated that microsurgical varicocelectomy is an efficient and safe surgical modality for treating patients with asymptomatic nutcracker phenomenon associated varicocele.