Dergiler / Üroloji Bülteni / 1999 / Cilt: 10 - Sayı: 2
İki değişik varikoselektomi yönteminin karşılaştırılması
- Dergi
- Üroloji Bülteni
- Sayfa
- 88–92
- DOI
- —
Özet
Varikosqlli infertil erkek hastalarda yuksek ligasyon ve mikrocerrahi ile yuksek inguinal varikoselektominin sperm parametre sonuglan, gebelik ve nuks oranlan, ve operasyon komplikasyonlan " yonunden karsila§tin]m.asi. Hastalar ve Yontem: Aynnti11 anamnez, fizik muayene ve Doppler ultrasonografi ile degerlendirilerek varikosel belirlenen ve varikoselektomi yapilan 100 hasta gali§maya almdi. Sol varikosel belirlenen 68 hastanm 36'stna yuksek ligasyon, 32'sine mikrocerrahi ile yuksek inguinal varikoselektomi, bilateral varikosel saptanan 32 hastanm 14'une yuksek ligasyon, 18'ine mikrocerrahi ile yuksek inguinal varikoselektomi yapildi. iki farkli teknik gruplardaki tedavi sonuglan ve komplikasyonlar agisindan karsjlas,tmldi. Bulgular: Postoperatif bir yil sonraki sperm sayisindaki artis oranlan arasinda tek tarafli ve iki tarafli, yuksek ligasyon ve mikrocerrahi ile yuksek ingt|nal varikoselektomi uygulanan gruplar arasinda istatistiksel olarak anlamli fark saptanmadi. Motilitede duzelme oranlan ise mikrocerrahi ile yuksek inguinal varikoselektomi uygulanan gruplarda anlamli olarak daha yuksekti. Gebelik oranlan arasinda, anlamli fark saptanmamakla birlikte, mikrocerrahi ile yuksek inguinal varikoselektomi uygulanan hastalardaki postoperatif rekurrens oranlan yuksek ligasyon yapilan hastalardan daha dusiiktu. Postoperatif hidrosel komplikasyonu agisindan iki tarafli yuksek ligasyon ve mikrocerrahi ile yuksek inguinal varikoselektomi yapilan gruplar arasinda fark saptanmazken, tek tarafli mikrocerrahi yuksek inguinal varikoselektomi uygulanan grupta bu komplikasyon anlamli olarak daha az bulundu. Sonug: Mikrocerrahi ile yuksek inguinal varikoselektomi, semen parametrelerinde duzelme, dus.uk nuks ve komplikasyon oranlan ile varikosel tedavisinde etkin biryontemdir.
Abstract
Comparison Of Two Different Varicocelectomy Techniques-Objective: To compare the high ligation and microsurgical high inguinal varicocelectomy techniques in the treatment of infertile patients with varicocele, in terms of sperm parameters, pregnancy and recurrence rates and postoperative complications. Patients and Methods: A total of 100 patients were included into the study. The patients underwent varicocelectomy after the diagnosis has been made by detailed history, physical examination and Doppler ultrasonography. Of 68 patients with left varicoceles, high ligation was performed in 36 and microsurgical high inguinal varicocelectomy was performed in 32 cases. Out of 32 patients with bilateral disease 14 underwent high ligation and 18 cases underwent microsurgical high inguinal varicocelectomy. The two operative techniques were compared with regard to treatment outcome and complications.Results: Increase in sperm numbers at the end of the first year after treatment was comparable in both groups either with unilateral or bilateral lesions. The improvement in sperm motility however, was significantly better in the microsurgical high inguinal varicocelectomy group. Although there were no significant differences between the pregnancy rates, patients in the microsurgical high inguinal varicocelectomy group experienced a lower rate of recurrence when compared to those in the high ligation group. While the postoperative hydrocele formation rates were similar with both techniques in bilateral cases, this complication remained significantly lower with the microsurgical method in unilateral cases. Conclusion: Microsurgical high inguinal varicocelectomy is an effective surgery for the treatment of varicocele that not only causes improvement in semen parameters but also has low rates of recurrence and complication.