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Background <p>This study is to evaluate the safety and efficacy of a novel microsurgical approach (Microsurgical Spermatico-Inferior Epigastric Vein Anastomosis with Selective Venous Disconnection, MSEA-SVD) compared to conventional Microsurgical Varicocelectomy approach in patients with Nutcracker Syndrome and left-sided varicocele. This single-center, randomized controlled trial enrolled 50 patients (25 per group) diagnosed with Nutcracker Syndrome and left-sided varicocele. Group A underwent MSEA-SVD, while Group B received Microsurgical Varicocelectomy. The primary outcomes included semen quality, renal vein hemodynamics, and varicocele recurrence. Follow-up assessments were conducted at 1, 3, and 6 months postoperatively using color Doppler ultrasound and semen analysis. Statistical comparisons were performed using IBM SPSS 27.0. </p> Results <p>MSEA-SVD achieves superior outcomes in semen quality and renal vein decompression compared to Microsurgical Varicocelectomy but requires a longer surgery time and hospitalization. </p> Conclusions <p>With careful patient selection, MSEA-SVD may become a preferred approach for managing Nutcracker Syndrome-related varicocele.</p>

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Microscopic ligation combined with shunt procedure versus microsurgical varicocelectomy for nutcracker syndrome and left varicocele: a randomized controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月17日

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  • Ke Dou,
  • Xinchen Zeng,
  • Qi Yang,
  • Yutao Li,
  • Lei Wang,
  • Tao Song,
  • Juncheng Yao

摘要

Background

This study is to evaluate the safety and efficacy of a novel microsurgical approach (Microsurgical Spermatico-Inferior Epigastric Vein Anastomosis with Selective Venous Disconnection, MSEA-SVD) compared to conventional Microsurgical Varicocelectomy approach in patients with Nutcracker Syndrome and left-sided varicocele. This single-center, randomized controlled trial enrolled 50 patients (25 per group) diagnosed with Nutcracker Syndrome and left-sided varicocele. Group A underwent MSEA-SVD, while Group B received Microsurgical Varicocelectomy. The primary outcomes included semen quality, renal vein hemodynamics, and varicocele recurrence. Follow-up assessments were conducted at 1, 3, and 6 months postoperatively using color Doppler ultrasound and semen analysis. Statistical comparisons were performed using IBM SPSS 27.0.

Results

MSEA-SVD achieves superior outcomes in semen quality and renal vein decompression compared to Microsurgical Varicocelectomy but requires a longer surgery time and hospitalization.

Conclusions

With careful patient selection, MSEA-SVD may become a preferred approach for managing Nutcracker Syndrome-related varicocele.