Review of current varicocelectomy techniques and their outcomes

Diegidio, Paul; Jhaveri, Jay; Ghannam, Suzanne; Pinkhasov, Ruben; Shabsigh, Ridwan; Fisch, Harry

doi:10.1111/j.1464-410x.2010.09959.x

Cited by 128 publications

(107 citation statements)

References 39 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results showed the Complications, cost and also operative time, laparoscopy is not superior to other methods of varicocelectomy. It is similar to other studies (22). We recommend laparoscopic approach for obese patients, recurrent (or persistent) varicocele, history of inguinal surgery and patients who had other diseases (renal cyst, inguinal hernia, non palpable testis, etc).…”

Section: Complicationssupporting

confidence: 72%

Laparoscopic Varicocelectomy

Shamsa¹

2011

Advanced Laparoscopy

View full text Add to dashboard Cite

Section: Complicationssupporting

confidence: 72%

Laparoscopic Varicocelectomy

Shamsa¹

2011

Advanced Laparoscopy

View full text Add to dashboard Cite

“…If this is done, the high inguinal approach has a success rate comparable with the subinguinal access. 4 The cremasteric-external pudendal anastomosis is readily accessible only with the subinguinal approach. Furthermore, we remind readers that the internal spermatic and deferential veins are located deep in the spermatic cord together with the vas deferens, all surrounded by the internal spermatic fascia; a membranous layer separates gonadal vessels from the vas deferens.…”

Section: Conflict Of Interestmentioning

confidence: 99%

“…3,4 Data regarding microsurgical subinguinal and inguinal adolescent varicocelectomy are limited. [5][6][7][8][9][10][11][12][13] However, the associated testicular growth is good, and the complication rates for varicocele (persistent/recurrent) and scrotal hydrocele are low (0.8% and 1.1%, respectively).…”

Section: Introductionmentioning

confidence: 99%

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

2016

View full text Add to dashboard Cite

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.

show abstract

“…Numerous surgical and non-surgical techniques [40] have been proposed and used in the treatment of clinically significant varicocele, but there is no consensus on what might be termed as the ''gold standard'' leading to the best clinical outcome, the lowest complication rate and the best cost/benefit ratio.…”

Section: Therapymentioning

confidence: 99%

Children and adults varicocele: diagnostic issues and therapeutical strategies

et al. 2014

View full text Add to dashboard Cite

Varicocele is defined as abnormally dilated scrotal veins. It is present in 15 % of normal males and in 40 % of males with infertility. This disorder is a challenge for the physicians involved in the diagnosis and treatment, as the pathophysiology of varicocele is not yet completely understood. For this reason, accurate diagnostic criteria and clear indications for treatment in asymptomatic adolescents or adults with clinical or subclinical varicocele are still not defined. Ultrasonography (US) is considered the best method for calculating the volume of the testicles, measuring vein diameter and monitoring the growth of the testis in adolescent patients. Color-Doppler US is the method of choice for detecting spermatic vein reflux and for classifying the grade of varicocele. Various classification systems have been published with recommendations on how to perform US imaging of the scrotum. Currently, color-Doppler US and spectral analysis are the most effective, non-invasive diagnostic procedures as they allow detection of subclinical varicocele associated with infertility. Various techniques are used in the treatment of varicocele including open surgery, laparoscopic procedures and interventional radiology. However, there is no consensus among physicians on which technique is the most effective in terms of outcome and complication rates. This review shows that color-Doppler US is currently the most widely employed diagnostic method for detection and classification of varicocele caused by venous reflux, as it is reliable and easily performed. The review also highlights the role of varicocelectomy in the management of adult male infertility.Riassunto Il varicocele è una dilatazione abnorme delle vene scrotali. Esso si riscontra nel 15 % degli uomini normali e nel 40 % dei soggetti che presentano infertilità. Rappresenta ancora oggi un problema clinico per gli specialisti che sono coinvolti nella diagnosi e nel trattamento di questa affezione, in quanto i meccanismi fisiopatologici che stanno alla base di questa patologia non sono stati ancora chiariti in maniera completa. Per questi motivi non esistono ancora indicazioni condivise tra i medici sulle possibilità diagnostiche e sulle scelte terapeutiche da applicare negli adolescenti asintomatici o negli adulti con varicocele clinico o subclinico. L'esame ultrasonografico dello scroto viene considerato attualmente come la metodica migliore per calcolare il volume dei testicoli, per misurare il diametro dei vasi venosi e per seguire l'accrescimento testicolare negli adolescenti. Il Color-Doppler è il metodo più semplice e preciso per studiare e documentare l'inversione del flusso nelle vene spermatiche e serve per una precisa classificazione del varicocele. Sono state proposte numerose classificazioni cliniche ed ecografiche del varicocele e sono state pubblicare raccomandazioni su come condurre l'esame ecografico dello scroto per l'identificazione del varicocele. Attualmente il color-Doppler associato all'analisi spettrale è la procedura diagnostica più 18...

show abstract

Review of current varicocelectomy techniques and their outcomes

Abstract: • Microsurgical subinguinal or microsurgical inguinal techniques offer best outcomes • Varicocelectomy is a cost effective treatment modality for infertility • Further research is needed to explore new developments in varicocelectomy.

Cited by 128 publications

References 39 publications

Laparoscopic Varicocelectomy

Laparoscopic Varicocelectomy

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

Children and adults varicocele: diagnostic issues and therapeutical strategies

Contact Info

Product

Resources

About