Results of varicocele surgery in adolescents: a comparison of techniques

We report our experience using 3 different operative techniques for varicocele ligation in adolescents. Between August 1985 and April 1991 we performed 102 varicocelectomies on 91 adolescents. Varicocele persistence rate was 16% with a modified Ivanissevich inguinal approach and 11% using a selective high retroperitoneal technique with preservation of the internal spermatic artery. Intraoperative post-ligation spermatic venography did not significantly improve the results with the artery sparing techniques. Palomo mass high retroperitoneal ligation of the internal spermatic vessels produced significantly better results compared to the artery sparing techniques. Testicular atrophy did not occur in any patient regardless of the surgical technique used. These data suggest that the Palomo technique results in a significant decrease in the operative failure rate compared to the artery sparing procedures and it should be the preferred technique for varicocele ligation in the adolescent.