Laparoscopic Treatment of Pediatric Varicocele:

OBJECTIVETo report our experience of microsurgical subinguinal varicocelectomy in boys aged £18 years. PATIENTS AND METHODSBoys aged £18 years treated with microsurgical varicocelectomy between 1996 and 2000 at one institution were retrospectively reviewed. Indications for surgery included ipsilateral testicular atrophy, large varicocele or pain. Microsurgery was assisted by an operating microscope (¥10-25) allowing preservation of the lymphatics, and the testicular and cremasteric arteries. Patient age, varicocele grade, complications and follow-up interval were recorded. RESULTSIn all there were 97 microsurgical subinguinal varicocelectomies (23 bilateral) in 74 boys (mean age 14.7 years). Left-sided varicoceles were significantly larger (mean grade 2.9) than right-sided (mean grade 1.4) varicoceles. The mean follow-up was 9.6 months. There were four complications: two hydroceles, of which one resolved spontaneously after 4 months; one patient had persistent orchialgia that resolved after 8 months; and one developed hypertrophic scarring at the inguinal incision site. There were no infections, haematomas or intraoperative injuries to the vas deferens or testicular arteries. All boys were discharged home on the day of surgery. CONCLUSIONSMicrosurgical subinguinal varicocelectomy in boys is a safe, minimally invasive and effective means of treating varicoceles. Compared with published results of the retroperitoneal mass ligation technique, which has a 15% overall complication rate and a 7-9% hydrocele occurrence rate, the microsurgical subinguinal approach appears to offer less morbidity, with a 1% hydrocele rate. We consider that microsurgical subinguinal varicocelectomy offers the best results with lower morbidity than other techniques.

show abstract

The role of Doppler ultrasonography in determining the proper surgical approach to the management of varicocele in children and adolescents

Cimador

Pace

Peritore

et al. 2006

BJU International

View full text Add to dashboard Cite

In a study from Italy, colour‐Doppler ultrasonography was a reliable diagnostic tool in the preoperative assessment of patients with varicocele. The authors also found that it helped to distinguish those who could be treated laparoscopically from those who should be treated by microsurgical subinguinal ligature. OBJECTIVE To investigate whether colour Doppler ultrasonography (CDUS) is a reliable diagnostic tool for selecting patients with varicocele to undergo either laparoscopy or open microsurgical subinguinal ligation. PATIENTS AND METHODS In a 3‐year period, 42 boys affected by left varicocele were evaluated before surgery by inguinal and scrotal CDUS. Using this method it was possible to distinguish Coolsaet type‐1 varicocele (due to isolated renal‐internal spermatic vein reflux) and Coolsaet type‐3 varicocele (due to associated renal‐internal spermatic reflux and iliac‐deferential reflux). Boys with Coolsaet type‐1 varicocele were treated by a laparoscopic transperitoneal Palomo procedure, whereas those with Coolsaet type‐3 varicoceles were treated by lymphatic‐sparing microsurgical subinguinal ligation. RESULTS The varicocele was Coolsaet type‐3 in six patients (14%), who had microsurgical open surgery, and the remaining 36 (86%) had Coolsaet type‐1 and had laparoscopic surgery. At the follow‐up there was no venous scrotal reflux. In two patients in the laparoscopic group a hydrocele developed after surgery, which resolved spontaneously. CONCLUSIONS This study showed that CDUS was a reliable diagnostic tool for assessing boys with varicocele. It clearly distinguished Coolsaet‐type 1 varicoceles that can be treated laparoscopically, from Coolsaet type‐3 varicoceles that should be treated with microsurgical subinguinal ligature.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

Laparoscopic Treatment of Pediatric Varicocele:

Cited by 4 publications

References 18 publications

Laparoscopic Surgery of Deferential Reflux in Pediatric and Adolescent Varicocele

Laparoscopic Surgery of Deferential Reflux in Pediatric and Adolescent Varicocele

Managing varicoceles in children: results with microsurgical varicocelectomy

The role of Doppler ultrasonography in determining the proper surgical approach to the management of varicocele in children and adolescents

Contact Info

Product

Resources

About