[Videoendoscopic ligation of the internal seminal veins in bilateral varicocele]

Varicocele diagnosis should be based not only on physical methods but on ultrasound dopplerography as well (flebography or scrotal thermography) to detect a subclinical form and bilateral process. Bilateral varicocele (BV) occurs more often than is diagnosed. It results in more changes in spermogram and is a prognostic infertility factor. Bilateral pain, impairment of spermatogenesis and infertility are indications for bilateral ligation of the seminal veins in BV patients. Bilateral ligation is much more effective than unilateral. Laparoscopic and microsurgical methods are most effective and low invasive in correction of BV and present a method of choice in the treatment of such patients.