关键词: 精索静脉曲张；显微镜；腹腔镜；精液分析 ,  

Abstract: 〗［Abstract］ Objective To analyze the effect of low-approach microsurgical varicocelectomy and high-approach laparoscopic varicocelectomy and the influence on hemodynamics and semen quality.
Methods One hundred and four varicocele patients were randomly divided into control group and observation group, 52 cases in each group. The control group was treated with high-approach laparoscopic varicocelectomy, the observation group was treated with low-approach microsurgical varicocelectomy. The time of operation, the time of hospitalization after operation, the incidence of complications and the rate of recurrence of two groups were compared. The hemodynamic parameters of the testicular arteries and semen quality before and 6 months after the operation between two groups were compared.
Results The operation time of observation group was significantly longer than control group, the time of hospitalization after operation was significantly lower than control group（P＜0.05）. The resistance index(RI), pulse index(PI), and peak systo lic velocity(PSV) of both groups were decreased and that of observation group were significantly lower than control group 6 months after operation(P＜0.05). The number of sperm, sperm concentration and sperm motility of the two groups were significantly increased 6 months after operation(P＜0.05), and that of the observation group was significantly higher than the control group(P＜0.05). The incidence of complications and the rate of recurrence of observation group were significantly lower than control group.
Conclusion Low-approach microsurgical varicocelectomy can effectively treat varicocele, reduce the incidence of complications and recurrence, reduce the resistance of the testicular blood flow, improve the hemodynamics and improve the quality of the semen. It is safe and worthy of clinical promotion.

Key words: varicocele； microscopy, laparoscopic； semen analysis