Related Experiment Video
Updated: Jul 3, 2026
Microscopic Varicocelectomy under Local Anesthesia as the Treatment of Varicocele
Published on: October 25, 2024
Lymphatic preservation using methylene blue dye during varicocele surgery: a single-center retrospective study
A D'Alessio1, E Piro, F Beretta
1Department of Pediatric Surgery, A.O. Ospedale Civile di Legnano, Legnano, Italy. antonio.dalessio@ao-legnano.it
Objective:
Hydrocele and testicular edema caused by division of lymphatic vessels during varicocelectomy could lead to decrease in testicular function. In-vivo methylene blue mapping of testicular lymphatic vessels should prevent damage to the lymphatic system.
Materials And Methods:
We retrospectively compared outcomes for 46 patients who received an intraparenchymal injection of 0.25 ml of vital dye (isosulphan blue) before a laparoscopic or an inguinal/subinguinal spermatic vein ligation with 93 controls in whom no mapping technique was adopted.
Results:
Methylene blue mapping of testicular lymphatics reduced the incidence of postvaricocelectomy hydrocele from 6.4% (6/93) to 2.1% (1/46); the incidence of hydrocele was 0% in all cases of successful lymphatic mapping.
Conclusion:
Mapping of testicular lymphatic drainage with intraparenchymal vital dye is an easy, safe, rapid and cost-free technique. We stress the importance of sparing the lymphatic system to ensure the best andrological outcome.
