目的:探讨一种新型阴囊镜的适用性、安全性及临床应用价值。方法:2011年6月~2013年5月,对23例慢性睾丸痛经非甾体抗炎药物保守治疗3~6个月,症状改善不明显患者在硬膜外麻醉下采用自行研制的新型阴囊镜进行阴囊镜检查,发现病灶后予取活检并使用200μm光纤,1.2~1.5J/15~20Hz(18~30 W)功率钬激光汽化病灶。所有患者排除已知引起慢性睾丸疼痛原因,术前均以视觉模拟疼痛评分(VAS)评估疼痛程度。结果:本组23例患者均顺利置入阴囊镜,镜下发现疼痛侧睾丸鞘膜腔内存在附睾/睾丸附件,且附件蒂部长为0.5~1.5cm,蒂根部扭转90~180°,部分充血、水肿;非疼痛侧睾丸及附睾表面未见睾丸及附睾附件,可见附睾表面充血。阴囊镜下用活检钳取出部分睾丸/附睾附件送病检,残端予用钬激光光纤汽化。手术时间45~90min,平均52min;术中有轻中度阴囊皮下水肿,术后1~3天水肿消退,无阴囊血肿、睾丸破裂等并发症;术后1个月门诊随访阴囊疼痛评分0~1分,平均0.3分;行B超复查双睾丸、附睾血流正常,未见异常回声,睾丸鞘膜腔内未见积液。术后病理显示纤维囊壁钙化或潴留囊肿组织。结论:新型阴囊镜临床适用简便、安全、有效、并发症少,临床可用于慢性睾丸疼痛的病因诊断并针对性治疗,是一种值得关注并进一步研究的新型微创诊疗设备。 Objective: To explore the applicability, safety and clinical value of a new type of scrotal lens. Methods: From June 2011 to May 2013, 23 patients with chronic testicular dysmenorrhea were treated conservatively for 3 to 6 months with non-steroidal anti-inflammatory drugs. The symptoms were not improved obviously in patients with epidural anesthesia. A new type of scrotaloscope After the scrotal examination, we found the lesions were biopsy and the lesions were treated with 200 μm optical fiber and holmium laser with 1.2 ~ 1.5J / 15 ~ 20Hz (18 ~ 30 W) power. All patients were excluded from the known cause of chronic testicular pain, and pain was assessed preoperatively using a visual analog pain scale (VAS). Results: Twenty-three patients in this group were successfully placed into the scrotal microscope. There were epididymal / testicular appendages in the sphincter of the pain-side testis. The length of the accessory pedicle was 0.5-1.5 cm and the torso root was reversed by 90-180 °. Some hyperemia , Edema; non-pain side of the testis and epididymis testicular and epididymis attachment was not seen on the surface of epididymis hyperemia. Scrotal microscopy with biopsy forceps removed part of the testis / epididymis sent to diseased examination, the stump to holmium laser fiber vaporization. The operation time was 45-90 minutes, with an average of 52 minutes. There was mild to moderate scrotal subcutaneous edema during operation, and the edema subsided 1 to 3 days after operation. There were no complications such as scrotal hematoma and testicular rupture. The score of scrotum pain was 1 ~ 1 point, an average of 0.3 points; line B-ultrasound double testis, normal epididymal blood flow, no abnormal echo, no fluid within the testis sheath. Postoperative pathology showed fibrous cyst wall calcification or retention of cyst tissue. Conclusion: The new type of endoscopic scrotal microscopy is simple, safe, effective and has fewer complications. It can be used clinically for diagnosis and targeted treatment of chronic testicular pain. It is a new minimally invasive diagnostic equipment worthy of attention and further study.