Article 130: Surgical Instructions, Traditional Chinese Medicine Diagnosis, and Daily Precautions for Varicocele

◇A Guide to Caring for Your Husband's Health as a Good Wife◇

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Treatment and recuperation of common diseases

Postoperative care instructions for varicocele surgery

1. Varicocele is an abnormal dilation of the pampiniform plexus veins in the testis.

2. Commonly seen in the left-side veins of adults, it may indicate infertility.

3. Symptoms include pain, tenderness, and discomfort in the groin area, which can be corrected by surgical ligation of the spermatic vein in the groin or by endoscopic ligation.

4. Local pain and slight bleeding from the wound are normal after surgery.

5. Apply ice packs to relieve swelling within hours of surgery.

6. If there is heavy bleeding from the wound, rapid swelling or purple discoloration of the scrotum, or persistent high fever, seek medical attention immediately.

7. Avoid lifting heavy objects or strenuous exercise for two weeks after surgery.

8. You can be discharged from the hospital immediately after the surgery and follow up with your doctor at the outpatient clinic as instructed.

How does Traditional Chinese Medicine differentiate syndromes and treat diseases?

1. Liver Qi Stagnation Type: Symptoms include visible blue veins in the scrotum or thickened spermatic cord, local distension, sometimes accompanied by traction pain, which worsens with anger, chest and rib distension and discomfort, irritability, red tongue with white coating, and wiry pulse.

Treatment principle: regulate qi and soothe the liver, invigorate blood and unblock collaterals.

Prescription: Bupleurum 10g, Tangerine Peel 12g, Ligusticum chuanxiong 10g, Bitter Orange Peel 12g, Red Peony Root 12g, Achyranthes Root 12g, Tangerine Seed 15g, Peach Kernel 10g, Safflower 10g, Angelica Root 12g, Licorice Root 3g.

2. Damp-heat stagnation type: Symptoms include visible blue veins in the scrotum, or palpable thickening of the spermatic cord, slight redness and swelling in the scrotum, occasional heaviness and discomfort, radiating pain, accompanied by scanty yellow urine, incomplete bowel movements, red tongue with yellow and greasy coating, and a soft and rapid pulse.

Treatment principle: Clear heat and dry dampness, promote qi circulation and blood flow.

Prescription: Gentian root 10g, Bupleurum root 10g, Gardenia fruit 10g, Scutellaria root 12g, Rehmannia root 24g, Plantago seed (wrapped) 15g, Alisma rhizome 12g, Angelica root 12g, Ligusticum root 6g, Red peony root 15g, Achyranthes root 12g, Peach kernel 10g, Safflower 10g, Licorice root 5g.

3. Qi deficiency and blood stasis type: Symptoms include visible blue veins in the scrotum or palpable thickening of the spermatic cord, local distension and discomfort radiating to the lower abdomen, which worsens after exertion and is slightly relieved by rest, fatigue, loss of appetite, pale tongue with white coating, and weak pulse.

Treatment principle: Replenish Qi and promote blood circulation.

Prescription: Astragalus membranaceus 20g, Codonopsis pilosula 15g, Poria cocos 12g, Angelica sinensis 12g, Ligusticum chuanxiong 6g, Prunus persica 10g, Carthamus tinctorius 10g, Paeonia lactiflora 12g, Lumbricus 10g, Achyranthes bidentata 12g, Bupleurum chinense 10g, Glycyrrhiza uralensis (processed) 5g.

4. Kidney deficiency and blood stasis type: Symptoms include slight swelling of the scrotum, even with visible blue veins, distending pain, fatigue, cold limbs, premature ejaculation, weak erection, pale tongue with white coating, and weak pulse.

Treatment principle: Tonify the kidneys and invigorate blood circulation.

Prescription: Astragalus membranaceus 20g, Epimedium brevicornu 12g, Achyranthes bidentata 12g, Angelica sinensis 12g, Paeonia lactiflora 12g, Prunus persica 10g, Pheretima aspergillum 10g, Luffa cylindrica 15g.

Traditional Chinese medicine prescriptions for treating varicocele

1. Astragalus membranaceus 30g, Spatholobus suberectus 30g, Foeniculum vulgare 10g, Salvia miltiorrhiza 30g, Carthamus tinctorius 10g, Notopterygium incisum 10g. Decocted in water, the decoction is used to fumigate and wash the affected area for 30 minutes each time, twice a day. One dose can be used for 2-3 days.

2. Astragalus membranaceus 50-100g, Lycium barbarum 20g, Angelica sinensis 20g, Paeonia lactiflora 10g, Plantago asiatica (wrapped) 10g, Liquidambar formosana 10g, Ligusticum chuanxiong 10g, Carthamus tinctorius 8g, Prunus persica 6g, Pheretima aspergillum 5g. Decocted in water and taken orally, one dose per day. Used for primary varicocele complicated with abnormal semen.

3. Peach kernel 10g, safflower 5g, dried rehmannia root 12g, red peony root 10g, angelica root 10g, chuanxiong rhizome 6g, achyranthes root 10g, raw cattail pollen 10g, trogopterus dung 10g, corydalis rhizome 10g. Decocted in water and taken orally, one dose per day.

4. Angelica sinensis 10g, Cinnamomum cassia (added later) 3g, Paeonia lactiflora 6g, Salvia miltiorrhiza 10g, Scrophularia ningpoensis 6g, Platycodon grandiflorus 3g, Lindera strychnifolia 6g, Asarum heterotropoides 1.5g, Tetrapanax papyriferus 3g, Carthamus tinctorius 5g, Foeniculum vulgare 6g, Jujube 3 pieces. Decocted in water and taken orally, one dose per day.

5. Astragalus membranaceus 30g, fennel 10g, chuanxiong rhizome 5g, danshen root 5g, notopterygium root 10g. One dose daily, decocted in water for external washing.

6. Angelica sinensis 15g, safflower 15g, salvia miltiorrhiza 15g. Decocted in water, and when warm, apply as a warm compress to the affected area with a towel.

Should young, unmarried men who are diagnosed with varicocele receive treatment?

Some young, unmarried men are found to have varicocele during routine physical examinations. Since these men often experience no discomfort and are unsure if it will cause infertility, the treatment plan depends on the results of semen analysis. If the semen analysis is normal or slightly worse than normal, regular follow-up examinations can be conducted to monitor changes in the spermatic veins. If the semen analysis shows abnormalities, or even testicular atrophy, surgical treatment should be performed immediately.

What should we pay attention to in daily life?

1. Pay attention to the balance between work and rest, and avoid strenuous activities, heavy physical labor, and prolonged standing.

2. Arrange sexual activity reasonably to avoid and reduce sexual arousal during periods without orgasm, thereby reducing prolonged genital congestion.

3. For severe varicose veins with obvious local symptoms, or accompanied by neurasthenia symptoms, use a scrotal support to prevent scrotal sagging and apply cold compresses to the area to relieve pain.

4. Due to decreased local resistance, it is essential to keep the area clean and dry.

5. Prevent constipation, keep bowel movements regular, and avoid prolonged increases in abdominal pressure that can hinder blood return.

6. For unmarried men with severe varicocele, surgical treatment is recommended because medication takes a long time and semen analysis is inconvenient. For men with varicocele and infertility, surgical treatment may be considered if medication is ineffective after more than one year.