[Surgical therapy of varicocele. Technical note on the inguinal approach].

Abstract:

BACKGROUND:There are several therapeutic proposals for idiopathic varicocele treatment, but all of them present a certain number of relapses. The technique proposed consists, through an inguinal approach, in a systematic ligation and section of all veins potentially responsible of a venous reflux. METHODS:During a period from 1990-1995 a total of 73 patients were surgically treated for idiopathic varicocele with this technique. All patients underwent preoperative spermiogram, hormonal assay and Doppler velocimetry. Through an inguinal approach, under selective spinal anaesthesia, a ligature and section of the internal spermatic vein at the internal inguinal ring is performed, followed by searching, ligature and section, of other veins responsible of venous reflux (external spermatic vein, anastomosis with sapheno-femoral veins, arteriovenous micro-anastomosis, pubic veins). The patient is discharged within twenty-four hours. RESULTS:An external dilated spermatic vein was discovered in 30.1%, pubic veins in 49.3%, anastomosis with safeno-femoral veins in 10.9% and arteriovenous micro-anastomosis in 43.8%. There were no mortality or serious postoperative morbidity; only in five cases there were complications consistent in two orchitis and three hydrocele. No relapse at follow-up (12-36 months), performed with palpation and a Doppler study, was found, while there was a spermiogram improvement in 61.6% of cases. CONCLUSIONS:This surgical approach is a safe and radical treatment without any relapse, of all types of varicocele.

journal_name

Minerva Chir

journal_title

Minerva chirurgica

authors

Armellino MF,Romano G,Imperato L,Rispoli G

keywords:

subject

Has Abstract

pub_date

1999-05-01 00:00:00

pages

367-71

issue

5

eissn

0026-4733

issn

1827-1626

journal_volume

54

pub_type

杂志文章
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