Optimizing the Operative Treatment of Boys with Varicocele: Sequential Comparison of 4 Techniques

Abstract

Comparison of all 4 groups revealed significant differences in varicocele recurrence (p = 0.038) and hydrocele formation (p = 0.023). Pairwise group comparison showed that the modified Palomo technique resulted in a significant decrease in the incidence of postoperative hydrocele formation compared with the standard Palomo method (p = 0.015). This procedure can be recommended as the optimal surgical technique for varicocele treatment in males of this young age.

Open versus minilaparoscopic herniorrhaphy for children: a prospective comparative trial with midterm follow-up evaluation

“…Second, according to the experience derived from mass high ligation of varicoceles, the multiple collateral circulations of the testis make dissection at the internal ring level extremely safe, even in patients with previous inguinal surgery [9,10]. This may explain why the incidence of testicular atrophy is so rare in this laparoscopic era.…”

Is the laparoscopic Palomo procedure for pediatric varicocele safe and effective?

“…ISA sparing techniques have a low incidence of postoperative hydrocele but a high recurrence rate [13,22]. Although Ivanissevich and Palomo procedures can be complicated by postoperative hydrocele, these techniques are effective as indicated by their very low recurrence rates [7,12,25] (Figs. 1 and 2).…”

“…1 and 2). Testicular atrophy is an extremely rare complication in all surgical procedures [7,13,22,25].…”

“…Both mass ligation of the spermatic vessels and selective ligation of the enlarged veins with ISA preservation are feasible via a laparoscopic approach [9,17,20,29,33]. Whatever treatment or approach is chosen, postoperative complications are fairly common and include hydrocele, recurrence, persistence, and testicular atrophy [7,8,13,22,25].…”

Macroscopic and microsurgical varicocelectomy: what’s the intraoperative difference?

“…Because of the presence of vasal and cremasteric arteries, whether the testicular arteries should be preserved in the surgical repair of varicocele is still controversial. Several authors argued that ligation of the testicular artery during varicocele repair did not induce testicular atrophy [11,12].…”