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

Links [Surgical therapy of varicocele. Technical note on the inguinal approach] [Article in Italian] Armellino MF, Romano G, Imperato L, Rispoli G

Minerva Chir. 1999 May;54(5):367-71. Links [Surgical therapy of varicocele. Technical note on the inguinal approach] [Article in Italian] Armellino MF, Romano G, Imperato L, Rispoli G. Divisione di Chirurgia, Ospedale S. Leonardo, Castellammare di Stabia. 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. PMID: 10443120 [PubMed - indexed for MEDLINE] Related Links Microsurgical spermatico-epigastric venous anastomosis in the treatment of varicocele in children: assessment of long-term patency. [Eur J Pediatr Surg. 2003] PMID: 13680495 Laparoscopic simultaneous ligation of internal and external spermatic veins for varicocele. [J Urol. 1995] PMID: 7861514 Intraoperative varicocele anatomy: a microscopic study of the inguinal versus subinguinal approach. [J Urol. 2003] PMID: 14634418 Sub-inguinal interruption of dilated veins in adolescent varicocele: should it be considered a gold standard technique? [Minerva Pediatr. 2003] PMID: 14676731 Clinical follow-up after subinguinal varicocele ligation to treat pain. [Arch Ital Urol Androl. 2002] PMID: 12161934 See all Related Articles... Display Summary Brief Abstract AbstractPlus Citation MEDLINE XML UI List LinkOut ASN.1 Related Articles Cited Articles Cited in Books CancerChrom Links Domain Links 3D Domain Links GEO DataSet Links Gene Links Gene (GeneRIF) Links Genome Links Project Links GENSAT Links GEO Profile Links HomoloGene Links Nucleotide Links Nucleotide (RefSeq) Links OMIA Links OMIM (calculated) Links OMIM (cited) Links BioAssay Links Compound Links Compound via MeSH Substance Links Substance via MeSH PMC Links Cited in PMC PopSet Links Probe Links Protein Links Protein (RefSeq) Links SNP Links Structure Links Taxonomy via GenBank UniGene Links UniSTS Links Show 5 10 20 50 100 200 500 Sort by Pub Date First Author Last Author Journal Send to Text File Printer Clipboard E-mail Order .

Divisione di Chirurgia, Ospedale S. Leonardo, Castellammare di Stabia.


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.




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