The improvement effect and influencing factors of microsurgical varicocelectomy on scrotal pain

CHEN Kan; YAN Chun-hui; LIU Bo; SHI Jian; LI Fang

doi:10.11659/jjssx.06E024049

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The improvement effect and influencing factors of microsurgical varicocelectomy on scrotal pain

Clinical Research | 更新时间：2025-07-31

- The improvement effect and influencing factors of microsurgical varicocelectomy on scrotal pain
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 8, Pages: 693-697(2025)
- 作者机构：
  
  1.中部战区总医院泌尿外科，湖北武汉 430067
  2.深圳萨米医疗中心/深圳市第四人民医院泌尿外科，广东深圳 518000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.06E024049
  CLC： R697
- Received：13 June 2024，
  
  Published：25 August 2025
- 稿件说明：
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陈侃,严春晖,刘波等.显微镜下精索静脉曲张结扎术对阴囊疼痛的改善及影响因素[J].局解手术学杂志,2025,34(08):693-697.

CHEN Kan,YAN Chun-hui,LIU Bo,et al.The improvement effect and influencing factors of microsurgical varicocelectomy on scrotal pain[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(08):693-697.
陈侃,严春晖,刘波等.显微镜下精索静脉曲张结扎术对阴囊疼痛的改善及影响因素[J].局解手术学杂志,2025,34(08):693-697. DOI： 10.11659/jjssx.06E024049.

CHEN Kan,YAN Chun-hui,LIU Bo,et al.The improvement effect and influencing factors of microsurgical varicocelectomy on scrotal pain[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(08):693-697. DOI： 10.11659/jjssx.06E024049.

摘要

目的

探讨显微镜下精索静脉曲张结扎术中静脉结扎对阴囊疼痛的改善作用以及影响术后疼痛改善的相关因素。

方法

回顾性分析2021年11月至2023年6月中部战区总医院收治的110例行显微镜下经腹股沟精索静脉曲张结扎术患者的临床资料。在手术前后使用数字评定量表（NRS）对疼痛程度进行评分。评估患者疼痛缓解率、术后并发症发生情况和患者总体满意度。分析患者手术前后精液及激素水平情况。采用单因素和多因素线性回归分析临床变量与术后7 d NRS评分的关系。

结果

术中结扎的平均静脉数为（6.60±3.76）条；患者术后满意度（4.23±1.08）分；术后7例患者出现并发症；术后3个月随访，总体疼痛缓解率为92.73%（102/110）。与术前相比，术后7 d患者的NRS评分显著降低，术后3个月患者精子总运动性、催乳素和睾酮水平增加，血清促卵泡激素（FSH）和黄体生成素（LH）水平降低，差异均有统计学意义（

0.05）。经单因素和多因素线性回归分析，精索静脉曲张Dubin-Amelar分级（

=0.045）、手术时间（

=0.049）和结扎静脉数（

=0.024）与术后7 d NRS评分变化显著相关。对术中结扎静脉数量为1~4条、5~10条和

10条的患者进行亚组分析，术后3个月3组患者疼痛缓解率分别为77.78%（28/36）、100%（58/58）、100%（16/16），3组比较差异有统计学意义（

=17.732，

0.001）。

结论

显微镜下精索静脉曲张结扎术能够有效缓解阴囊疼痛，并提高精液质量；且术后疼痛缓解与精索静脉曲张Dubin-Amelar分级、结扎足够的精索静脉数量以及术者的手术经验有关。

Abstract

Objective

To investigate the improvement effect of microsurgical varicocelectomy with vein ligation on scrotal pain and the related factors affecting the improvement of postoperative pain.

Methods

A retrospective analysis was conducted on the clinical data of 110 patients who underwent microsurgical inguinal varicocelectomy in Central Theater Command General Hospital from November 2021 to June 2023.The degree of pain before and after the operation was evaluated by Numerical Rating Scale （NRS）.The pain relief rate，the occurrence of postoperative complications and the overall satisfaction of patients were evaluated. The semen and hormone levels of the patients before and after the operation were analyzed. Univariate and multivariate linear regression analyses were performed to investigate the relationship between clinical variables and postoperative 7-day NRS score.

Results

The average number of ligated veins during the operation was （6.60±3.76）；postoperative satisfaction of patients was （4.23±1.08） points； complications occurred in 7 patients after the operation；after 3 months of follow-up，the overall pain relief rate was 92.73% （102/110）. Compared with those before the operation， the NRS score of the patients significantly decreased 7 days after the operation， and the levels of total sperm motility， prolactin and testosterone increased 3 months after the operation， while the levels of serum follicle-stimulating hormone （FSH） and luteinizing hormone （LH） decreased，the differences were statistically significant （

0.05）. The univariate and multivariate linear regression analyses showed that the Dubin-Amelar classification of varicocele （

=0.045），operation time （

=0.049）， and number of ligated veins （

=0.024） were significantly correlated with the change o

f postoperative 7-day NRS score. Patients with 1 to 4，5 to 10，and

10 intraoperative ligation veins were analyzed，and pain relief rates 3 months after the operation were 77.78%（28/36），100%（58/58），and 100%（16/16），respectively，with statistically significant difference （

=17.732，

0.001）.

Conclusion

Microsurgical varicocelectomy can effectively relieve scrotal pain and improve semen quality. Moreover， the relief of postoperative pain is related to the Dubin-Amelar classification of varicocele， the sufficient number of ligated spermatic veins， and the surgical experience of the surgeon.

关键词

Keywords

references

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