RESUMO
The article deals with the findings obtained in a roentgenological examination of the left renal vein and left internal spermatic vein in a total of one hundred and eighty-three 16-to-46-year-old patients presenting with varicocele. Analysing the roentgenograms revealed that four patients had portacaval anastomoses in the basin of the left internal spermatic vein (ISV), with the blood flow being directed from the system of the portal vein into the system of the venae cavae. Retrograde contrasting of the inferior mesenteric veins showed a sharp deceleration of the contrast medium to the portal vein with an apparent obstacle to the blood flow in the projection of the intersection of the inferior mesenteric vein, lower contour of the pancreas and the aorta. In two cases, the "mesentericospermatic" venous shunt into the system of the left ISV was the only visible cause of varicocele.
Assuntos
Derivação Portocava Cirúrgica , Varicocele/cirurgia , Adolescente , Adulto , Meios de Contraste , Humanos , Infertilidade Masculina/etiologia , Masculino , Pessoa de Meia-Idade , Flebografia , Testículo/irrigação sanguínea , Varicocele/complicações , Varicocele/diagnóstico por imagem , Varicocele/fisiopatologia , VeiasRESUMO
Study group consisted of 115 patients with varicocele undergone laparoscopic clipping of left seminal vein, control group--121 patients after Ivanisevich's operation. Chemiluminescence of seminal fluid with detection of oxygen active forms were studied at all the patients before surgery, in 14 and 72 days after it. Volume of ejaculate, concentration, mobility and morphology of spermatozoa were also examined. It is demonstrated that level of oxygen active forms may be regarded as criteria of efficacy of surgical treatment. Laparoscopic clipping of left seminal vein demonstrates better results (less postoperative complications and recurrences) compared with Ivanisevich's operation.
Assuntos
Fertilidade/fisiologia , Laparoscopia/métodos , Espécies Reativas de Oxigênio/sangue , Sêmen/metabolismo , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Varicocele/cirurgia , Veias/cirurgia , Adulto , Seguimentos , Humanos , Ligadura/métodos , Masculino , Glândulas Seminais/irrigação sanguínea , Resultado do Tratamento , Varicocele/metabolismo , Varicocele/fisiopatologiaAssuntos
Artérias/cirurgia , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/cirurgia , Endarterectomia/métodos , Isquemia/diagnóstico , Trombectomia/métodos , Estado Terminal , Humanos , Isquemia/fisiopatologia , Extremidade Inferior/irrigação sanguínea , Extremidade Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Ultrassonografia DopplerRESUMO
The topographic radiological anatomy of the left internal spermatic vein was studied in 95 patients with varicocele, of them 76 had secondary impaired spermatogenesis. Recurrent varicocele after Ivanissevich's operation was observed in 23 patients. The left internal spermatic vein has been found to empty as one trunk into the renal vein in 97.8% of cases. The renal capsular vein always falls into the proximal segment of the left internal spermatic vein. Intersystemic overflows, if present, also empty into the latter. A unified procedure for double-level occlusion of the left internal spermatic vein is described. The proposed procedure was used to operate on 46 patients. Long-term results were studied in periods of 3 months to 2 years. Recurrent varicocele was not revealed.