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[Essential varicocele. Which treatment?].

F Tosato1, U Passaro, L Vasapollo

  • 1Dipartimento di Scienze Chirurgiche e Tecnologiche Mediche Applicate, Università degli Studi di Roma, La Sapienza.

Minerva Chirurgica
|June 22, 2000
PubMed
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This study reviews idiopathic varicocele treatments, finding high relapse rates with standard methods. A combined surgical approach ligating both internal and external spermatic veins is proposed to improve outcomes.

Area of Science:

  • Urology
  • Vascular Surgery

Context:

  • Idiopathic varicocele presents a significant challenge in urological practice.
  • Current surgical and sclerotic treatments exhibit high recurrence and persistence rates, often exceeding 10%.

Purpose:

  • To evaluate existing surgical and sclerotic interventions for idiopathic varicocele.
  • To propose an improved surgical technique addressing limitations of current methods.

Summary:

  • A literature review highlights significant failure rates (10-20%) for retrograde sclerotic therapy and internal spermatic vein ligation.
  • Anatomical considerations suggest involvement of the external spermatic vein in approximately 20% of idiopathic varicocele cases.
  • A novel combined simultaneous ligation of both internal and external spermatic veins at the internal inguinal ring is presented as a superior alternative.

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Impact:

  • The proposed combined ligation aims to reduce recurrence and persistence rates of idiopathic varicocele.
  • This technique can be performed under local or general anesthesia with no required hospital stay.
  • Laparoscopic approaches are deemed less cost-effective and lack the flexibility of local anesthesia compared to the open combined procedure.