青春期精索静脉曲张

青春后期精索静脉曲张 (varicocele ,VC)发病率为 12 .4 %～ 17.8% ,平均 14 .7% ,与成年男性相似。青春期VC可导致睾丸发育障碍 ,而手术治疗可使其逆转 ,但在睾丸发育障碍出现之前不主张预防性手术。手术治疗青春期VC的建议指征 :①睾丸发育障碍 ,左右侧容积差别大于 2ml;②伴有精液分析异常的重度VC ;③有疼痛、下坠、肿胀等症状的VC ;④双侧VC。VC术后复发率为 9%～ 16 % ;但经腹膜后同时高位结扎精索内动脉和静脉 ,复发率可降至 2 %。

Adolescent Varicocele

The incidence of varicocele in older adolescence varies from 12.4% to 17.8% with an average of 14.7%, similar to the incidence in adult males. Varicocele is associated with testicular growth arrest in adolescents. Varicocelectomy can reverse the testicular growth arrest. But without the testicular growth arrest, prophylactic surgery for every adolescent with varicocele is not advised. Surgery treatment should be offered to: 1. adolescents with testicular growth arrest more than 2 ml of difference between left and right testicle, 2. adolescents with abnormal semen analysis with high-grade varicocele, 3. adolescents with symptoms: pain, heaviness, swelling, 4. adolescents with bilateral varicoceles. Recurrence of the varicocele after surgery treatment can occur in 9% to 16% of adolescents. But rate of recurrence can be kept below 2% in adolescents treated by high retroperitoneal ligation with testicular artery ligation.