[Efficacy and safety of microsurgical varicocelectomy combined with aescine in the treatment of varicocele].

OBJECTIVE: To discuss the efficacy and safety of microsurgical varicocelectomy combined with aescine in the treatment of varicocele.

METHODS: A total of 120 patients with varicocele received treatments and follow up in Shanghai Renji Hospital and Shanghai General Hospital between September 2013 and April 2015, 63 patients of which were infertile and 57 patients of which were painful varicocele. A total of 106 patients were unilateral varicocele and 14 patients were bilateral varicocele. Forty-one patients were treated with varicocelectomy, and 79 patients were treated with varicocelectomy combined with aescine, 300 mg, twice a day, orally. Sperm analysis, pregnancy rate, sex hormone, and complications were recorded after six months treatments.

RESULTS: There was significant difference in the sperm motility improvement in infertile patients between microsurgical group (60.0%, 12/20) and combined therapy group (83.7%, 36/43) (P < 0.05). There was no significant difference in levels of sexual hormones in infertile patients between microsurgical group and combined therapy group (luteinizing hormone (4.07 ± 1.49) vs (4.29 ± 1.32) U/L, follicule-stimulating hormone (5.64 ± 2.70) vs (5.11 ± 1.25) U/L, and testosterone (16.09 ± 2.25) vs (15.98 ± 3.79) µg/L). The pregnancy rate of infertile patients in microsurgical group and combined therapy group were 15.0% (3/20) and 18.6% (8/43), respectively, with no statistic difference between these two groups (P > 0.05). The total improvement rates for the pain resolution in microsurgical group and combined therapy group were 76.2% (16/21) and 94.4% (34/36), respectively, with statistic difference between these two groups (P < 0.05). In the microsurgical group, there were two cases of scrotal edema and one case of reoccurrence after treatment, while no complications were appeared in the combined therapy group.

CONCLUSIONS: Microsurgical varicocelectomy combined with aescine could improve sperm quality, relieve pain, and prevent complications occurrence to some extent compared with microsurgical varicocelectomy. Microsurgical varicocelectomy combined with aescine could be applied in clinical varicocele treatment.