Varicocele - what is the best timing and method of treatment?

Czech version

Authors: R. Kočvara
Authors‘ workplace: 1. LF UK a VFN, Praha ; Urologická klinika
Published in: Urol List 2007; 5(1): 26-29

Overview

Varicocele usually occurs in early puberty. Physical examination must determine the level of varicocele and assess the size of testicles. The finding is confirmed by verification of venose reflux and further assessment of testicle size during sonography. Only 20% of adolescents suffering from varicocele will have fertility problems - therefore its treatment is usually conservative. For early operation only those are indicated suffering from smaller testicle, functionally solitaire testicle, bilateral palpable varicocele and older adolescents with pathologic spermiograms.

In operated patients, larger sizes of testicle and better semen parameters have been described.

Lymphatics sparing operation is recommended using microsurgical techniques (open using a micsroscope or by means of laparoscopy) to prevent occurrence of hydrocele, intra-testicular oedema (testicle hypertrophy) and to improve testicle function.

Key words:
varicocele, adolescent varicocele, infertility, microsurgery, laparoscopy

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