Comparison the outcomes of laparoscopic varicocele ligation and microscopic varicocelectomy in preadolescent and adolescent boys

Akgül, Ahsen Karagözlü; Uçar, Murat; Kılıç, Nizamettin; Balkan, Emin

doi:10.5222/jtaps.2017.113

Cited by 1 publication

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“…[8] Daha önce tek merkez ve daha az sayıda hasta ile laparoskopik ve mikroskobik varikoselektomi tekniklerinin sonuçlarını karşılaştırdığımız çalışmada teknikler arasında istatistiksel anlamlı bir fark saptamamış ve her iki tekniğin de etkili ve güvenli bir şekilde tercih edilebileceği sonucunu paylaşmıştık. [9] 2014 yılında Pastuszak ve ark. ise Amerika'da 131 pediatrik ürolog ile yaptığı bir anket çalışmasında, varikosel tedavisinde tercih edilen cerrahi yaklaşımların sırasıyla; laparoskopik (%38), subinguinal mikrocerrahi (%28), inguinal (%14) ve açık Palomo (%13) olduğunu bildirmişlerdir.…”

Section: Discussionunclassified

Adölesan varikosel tedavisinde uygulanan üç farklı cerrahi yöntem sonuçlarının karşılaştırılması

Uçar¹,

Akgül²,

Caylan³

et al. 2019

Androl Bul

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Varikosel, pampiniform pleksus ve internal spermatik venlerin anormal bir dilatasyonu olup, seminifer tübüllerdeki sıcaklığın artmasına, toksik adrenal ve renal metabolitlerin renal ven yoluyla geri akışına, sperm kalitesinin düşmesine ve testis büyümesinin durmasına neden olur. [1] Erkek infertilitesinin en sık düzeltilebilir nedenidir. Adölesan varikosel insidansı erişkinlere benzer şekilde %15-16'dır. [2] Tedavi endikasyonları arasında varikoselin semptomatik ABSTRACT OBJECTIVES: In the treatment of adolescent varicocele, there isn't any consensus and the ideal technique is not yet defined. Open surgery (microscopy-assisted or not) or laparoscopic techniques are surgical methods used in treatment. We planned to compare the results of microscopic, laparoscopic and open varicocelectomy techniques. MATERIAL and METHODS: Patients who underwent varicocele therapy between 2003-2018 were evaluated retrospectively in 3 groups. Patients who underwent laparoscopic varicocele ligation were included in Group 1, patients who underwent microscopic varicocelectomy were included in Group 2 and patients who underwent subinguinal varicocelectomy were included in Group 3. Three groups were compared in terms for operation and postoperative follow-up data. RESULTS: The study included 113 patients, 30 patients in Group 1, 43 patients in Group 2, 40 patients in Group 3. The mean age was 13.2 years. There was no significant difference between groups in terms of side and varicocele degree. The median operation times for group1.2 and 3 were 55 (35-70), 50 (40-80) and 55 min. (40-70) (p>0.05). The hydrocele development after surgery was detected in 3, 1 and 2 patients, respectively (p>0.05). Varicocele recurrence was not seen in the LVL group, but it was seen in 3 patients in the MV group and in 7 patients in the SV group (p>0.05). Postoperative testicular volume loss was detected in 3 patients in Group 1, 1 patient in Group 2 and in Group 3 no patient was detected. There was no statistical significant different between groups although there were clinical differences between the groups in terms of results or complications. CONCLUSION: In the treatment of adolescent varicoceles, it was found that all 3 techniques can be used successfully but in microscopic or under magnification (via loop) techniques, complication rates seem to be much less and clinical successful rates seem to be much higher.

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Section: Discussionunclassified