Patient's question:
I have had vulvar cysts for several years. They flare up whenever I get angry or stressed. Every time, I get IV fluids. The doctor said it's a large liquid line cyst and that surgery is needed. But after the inflammation subsides, it's fine. Are there any better non-surgical methods?Doctor's answer:
Non-surgical treatment: For mild varicocele or those accompanied by neurasthenia, scrotal support and cold compresses can be used.Guidelines:
Surgical treatment: For severe varicocele, a history of sperm count below 20 million for three consecutive times, or testicular atrophy; or when the varicose veins disappear when lying flat, high ligation of the internal spermatic vein can be performed. The surgical approaches include:
1. High ligation of the internal spermatic vein through the inguinal canal: Similar to the inguinal hernia incision, the spermatic cord is exposed, and the main trunk and branches of the internal spermatic vein are identified and ligated. This surgical approach is simple and commonly used. It can also ligate dilated external spermatic veins and gubernaculum veins. If a surgical microscope is used during the procedure, the outcome is better, with a lower recurrence rate and fewer complications.
Lifestyle care:
2. Iliac fossa approach: A left lower abdominal oblique incision is made, the peritoneum is pushed aside, and the internal spermatic vein is located and ligated behind the external iliac artery in the retroperitoneum. The advantage of this approach is that accidental injury to the internal spermatic artery at this site will not cause testicular atrophy. The disadvantage is that it cannot simultaneously treat communicating branches.