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Microsurgical Subinguinal Varicocelectomy in Children and Adolescents


Authors: R. Kočvara 1,2;  J. Sedláček 1;  J. Doležal 3;  Z. Staněk 3;  Z. Dítě 1,2;  J. Dvořáček 1,2
Authors‘ workplace: Urologická klinika 1. LF UK a VFN, Praha 1;  Subkatedra dětské urologie IPVZ, Praha 2;  Urologické oddělení Nemocnice České Budějovice 3
Published in: Čas. Lék. čes. 2007; 146: 763-766
Category: Original Article

Overview

Background.
Microsurgical varicocele repair has become the gold standard in adults and only a few reports are available in children and adolescents. We present our experience with this method and concentrate on the technical performance, complications and development of testicular size. 

Methods and Results.
47 patients aged 11 to 18 years (x-15.4) underwent microsurgical subinguinal repair for varicocele grade II.–III. Operation was indicated because of hypoplastic testicle (expressed by the atrophy index > 25 %), pain, large varicocele or parents preference. The patients were examined clinically, by ultrasound including the Doppler study; hormonal examination was added using the gonadoreline stimulation test. Microscope has been used to identify the internal spermatic artery, to dissect the artery from the complex of small surrounding veins and to identify the lymphatic vessels. We found 3 recurrences in 46 patients (6 %) operated for primary varicocele. The atrophy index decreased from x - 19.7 to 12.7 %, without any association with pubertal stage. Atrophy of the testis was not found in any patient. Hydrocele was detected in one patient (2.1 %), and left testicular hypertrophy also in one patient (2.1 %). 

Conclucions.
Microsurgical subinguinal varicocelectomy is a safe and efficacious method in children and adolescents; using the microscopic dissection, the internal spermatic artery and accompanying lymphatic vessels are safely spared. 

Key words:
varicocele, children and adolescents, microsurgical varicocelectomy, subinguinal varicocelectomy.


Labels
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental Hygienist

Article was published in

Journal of Czech Physicians

Issue 10

2007 Issue 10

Most read in this issue
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