Patient's question:
Why are there other cotton-like sac-like objects floating between my two testicles?Doctor's answer:
This condition is considered to be varicocele caused by hormones. Asymptomatic mild varicocele does not require treatment.Non-surgical treatment: For mild varicocele or those accompanied by neurasthenia, methods such as scrotal support and cold compresses can be used.
Surgical treatment: For severe varicocele, a history of sperm count below 20 million per cubic centimeter for three consecutive times, or testicular atrophy; if 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 incision for hernia, the spermatic cord is exposed, and the main trunk and branches of the internal spermatic vein are identified and ligated. This approach is simple and commonly used. It can also ligate dilated external spermatic veins and cremasteric veins. If a surgical microscope is used during the procedure, the outcome is better, with a lower recurrence rate and fewer complications.
2. Iliac fossa approach: A left lower abdominal oblique incision is made, and the peritoneum is pushed aside. The internal spermatic vein is located behind the peritoneum and in front of the external iliac artery and is ligated. The advantage of this approach is that if the internal spermatic artery is accidentally injured here, it will not cause testicular atrophy. The disadvantage is that it cannot simultaneously address communicating branches.
3. Recently, someone inserted a catheter through the inferior vena cava and left renal vein into the left internal spermatic vein, then injected 5% sodium squalene oil or gelatin sponge with steel coils to embolize the vein, treating varicocele. The disadvantage is that this method is not suitable for veins with (abnormalities) or collateral circulation, and it requires special equipment.