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[Idiopathic varicocele in children. Epidemiological study and surgical approach]
F S Camoglio1, R M Cervellione, G Dipaola
1Dipartimento di Scienze Chirurgiche e Gastroenterologiche, Cattedra di Chirurgia Pediatrica, Università degli Studi, Verona, Italy.
Insights
Early surgery for idiopathic varicocele, especially microsurgical venous bypass, effectively treats male infertility. This approach shows high success rates and low recurrence, preserving fertility in young males.
Area of Science:
- Urology
- Andrology
- Reproductive Medicine
Context:
- Idiopathic varicocele is a common cause of male infertility.
- Early detection and treatment are crucial for preventing infertility.
- A study investigated the incidence and outcomes of varicocele treatment in peripubertal males.
Purpose:
- To report the findings of an epidemiological study on idiopathic varicocele.
- To evaluate the clinical and functional outcomes of surgical varicocele correction.
- To compare the efficacy of microsurgical venous bypass versus laparoscopic ligation.
Summary:
- An epidemiological study found a high incidence (48.5%) of idiopathic varicocele in peripubertal males.
- Surgical correction, particularly microsurgical venous bypass, yielded satisfactory clinical and functional results.
- Microsurgical venous bypass demonstrated a low relapse rate of 2.6% at 18 months post-surgery.
Impact:
- Supports an early surgical approach for managing idiopathic varicocele.
- Highlights microsurgical venous bypass as a superior technique for varicocele correction.
- Aims to improve fertility outcomes in males affected by varicocele.
Background:
Idiopathic varicocele is one of the most frequent conditions capable of reducing male fertility. Early detection and adequate therapy make it possible to prevent the infertility related to this disease.
Methods:
The results of a clinical and instrumental (Doppler) epidemiological study conducted in 766 subjects of peripuberal age are reported. The clinical and functional results in those subjects undergoing surgery for varicocele. The technical options adopted for varicocele correction were either microsurgical venous bypass between the internal spermatic vein and the inferior epigastric vein or laparoscopic ligation of the internal spermatic vein in a retroperitoneal site.
Results:
The epidemiological investigation conducted by the authors showed a high incidence (48.5% including the subclinical forms) of idiopathic varicocele in the male population. The clinical and instrumental (Doppler) follow-up carried out at 3, 6 and 18 months postoperatively showed satisfactory results, particularly in patients submitted to microsurgical venous bypass, with a relapse rate of only 2.6%.
Conclusions:
On the basis of the results obtained, the authors advocate an early surgical approach to varicocele. Among the corrective techniques available, microsurgical treatment is, in the authors' opinion, capable of yielding the best clinical and functional results.