Comparison of results and complications of high ligation surgery and microsurgical high inguinal varicocelectomy in the treatment of varicocele

Çayan, Selahíttín; Kadioglu, Teoman Cem; Tefekli̇, Ahmet; Kadıoğlu, Ateş; Tellaloğlu, S

doi:10.1016/s0090-4295(99)00603-2

Cited by 167 publications

(119 citation statements)

References 19 publications

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“…However, the improvement in motility was significantly higher in the MHIV group. In a similar study there was no significant difference in pregnancy rates between two groups: pregnancy rates were 35% and 42%, respectively [5]. In the present study, semen density and motility in a total of 40% of patients revealed significant improvement after varicocelectomy.…”

Section: Discussionsupporting

confidence: 53%

“…The difference between the operation periods was not significant (p > 0.05) ( Table 1). The mean number of connected veins during the operation was 6:42 AE 1:22 (2-12), in MHIV and 9:76 AE 0:96 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) in MSIV. When compared with MHIV, statistically the number of veins connected in MSIV was significantly higher in ratios (p < 0.01).…”

Section: Resultsmentioning

confidence: 99%

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Comparison of Two Different Microsurgical Methods in the Treatment of Varicocele

Orhan

Onur

Semerciöz

et al. 2005

Archives of Andrology

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& We reviewed records from patients who underwent two different microsurgical varicocelectomy methods: 147 (high inguinal (MHIV) and 65 sub-inguinal (MSIV) microsurgery) to compare the therapeutic activity and complications. Patients who had 2 different microsurgical varicocelectomies were compared according to preoperative connected vein, number of designated arteries, postoperative semen and improvement degree in hormone parameters, increased ratio related with pregnancy and complications. The ratio of improvement of postoperative semen parameters in patients where MHIV and MSIV were performed was, 42% and 38% (p > 0.05). Pregnancy was achieved in MHIV at a ratio of 41% (34=82) and 33% (22=65) in MSIV (p > 0.05). There was no significant difference according to mean operation periods, the vein connected between the groups. The number of testicular arteries were significantly higher than the ones in MHIV (p < 0.01). However, as a postoperative complication, hydrocele was not seen in any of the patients, while relapses occurred in 1 MHIV and 2 MSIV patients. MHIV and MSIV techniques are effective methods to treat varicocele. However, the excess number of connected veins due to the anatomic feature of MSIV increases the possibility of relapses and the technical difficulty during surgical intervention.

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Section: Discussionsupporting

confidence: 53%

Section: Resultsmentioning

confidence: 99%

Comparison of Two Different Microsurgical Methods in the Treatment of Varicocele

Orhan

Onur

Semerciöz

et al. 2005

Archives of Andrology

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“…Comparing the results of microsurgical varicocelectomy from different studies, Goldstein et al [3] demonstrated a significant increase in sperm concentration, sperm motility, normal form, and pregnancy rate. Cayan et al [1] reported a 43% pregnancy rate, improvement of sperm concentration from 30 Â 10 6 to 37 Â 10 6 and improvement of sperm motility from 26 to 43%. The present technique can be easily implemented for accessing not only the internal spermatic veins, but also the external spermatic veins and dilated vasal veins at this high inguinal level.…”

Section: Discussionmentioning

confidence: 99%

High Inguinal Loupe-Assisted Varicocelectomy for Subfertile Men With Varicococeles: Technical Feasibility, Clinical Outcomes and Complications

Hsieh

Huang

Chen

et al. 2006

Archives of Andrology

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& 254 consecutive patients underwent high inguinal loupe-assisted varicocelectomy. All patients had at least a one year history of infertility with abnormal semen parameters and physical examination and=or color Doppler ultrasound proven varicocele. To facilitate the procedure, an Â3.0 loupe was used during spermatic cord dissection near or at level of internal inguinal ring. Semen analysis and physical examination were performed at 3 monthly intervals. No intra-operative complications occurred. The most common post-operative complications were transient scrotal pain and stitch reaction, occurring in 12% and 4% of men, respectively. Only one permanent and two transient hydroceles were observed. Recurrent or persistent varicocele was identified by physical examination and color Doppler in 5 varicocelectomies (1.4%), and by color Doppler only in 6 varicocelectomies (1.7%). Sperm motility increased from 30 AE 8% to 46 AE 20%, and sperm concentration. (10 6 =cc) increased from 24 AE 18 to 41 AE 28. The one-year pregnancy rate was 37%. High inguinal loupe-assisted varicocelectomy is a safe, simple, and effective treatment for varicocele.

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“…In our experience, in adult patients, microscopic high inguinal varicocelectomy is associated with a 1.3-2% recurrence rate, indicating that the involvement of gubernacular and external spermatic veins is not clinically significant. 16,21 Hopps et al identified 11.1 internal spermatic veins using the subinguinal approach compared with 8.7 veins at the inguinal level. 15 In adolescents, we observed an increased number of large veins at the subinguinal level ( Table 2).…”

Section: Discussionmentioning

confidence: 99%

Surgical comparison of subinguinal and high inguinal microsurgical varicocelectomy for adolescent varicocele

2016

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Objective: To compare the surgical outcomes of subinguinal and high inguinal approaches for microsurgical varicocelectomy. Methods: A total of 81 patients with left varicocele were randomly assigned to undergo microsurgical left varicocelectomy by the subinguinal (n = 41) or high inguinal (n = 40) approach. These two techniques were compared with regard to the operative parameters, complications and testicular growth. Anatomical parameters, including the numbers and diameters of internal spermatic arteries, veins and lymphatic vessels, were recorded. Results: The microsurgical step was significantly shorter for the high inguinal approach compared with the subinguinal approach (25.5 vs 33.3 min, respectively, P < 0.01). The numbers of preserved arteries and ligated veins were significantly greater and the artery size was significantly smaller for the subinguinal (1.6 arteries, 11.5 veins and 1.1 mm, respectively) compared with the high inguinal approach (1.2 arteries, 7.3 veins and 1.3 mm; P < 0.001, <0.0001 and <0.01, respectively). There was one patient with postoperative hydrocele, and three with persistent scrotal pain after treatment with the subinguinal approach. The postoperative catch-up growth rates at 24 months were 70% and 78% for the subinguinal and high inguinal approaches, respectively. Conclusions: The microsurgical subinguinal and high inguinal approaches seem to yield similar success rates in terms of testicular growth. However, the high inguinal approach is easier to carry out, as it requires fewer divisions of veins and is associated with a larger diameter of the spermatic artery.

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Comparison of results and complications of high ligation surgery and microsurgical high inguinal varicocelectomy in the treatment of varicocele

Cited by 167 publications

References 19 publications

Comparison of Two Different Microsurgical Methods in the Treatment of Varicocele

Comparison of Two Different Microsurgical Methods in the Treatment of Varicocele

High Inguinal Loupe-Assisted Varicocelectomy for Subfertile Men With Varicococeles: Technical Feasibility, Clinical Outcomes and Complications

Surgical comparison of subinguinal and high inguinal microsurgical varicocelectomy for adolescent varicocele

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