Related Experiment Video
Updated: Jun 8, 2026
Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
Reactive hydrocele after laparoscopic Palomo varicocele ligation in pediatrics
Roberto Méndez-Gallart1, Adolfo Bautista Casasnovas, Elina Estévez Martínez
1Pediatric Surgery Department, Hospital Clinico Universitario de Santiago, Santiago de Compostela, La Coruña, Spain. roberto.mendez.gallart@sergas.es
Objectives:
To evaluate the incidence of hydrocele following laparoscopic Palomo varicocele ligation in pediatric and adolescents in our institution.
Methods:
Between 1997 and 2009, 180 boys diagnosed as having varicocele who underwent Palomo laparoscopic ligation were evaluated retrospectively. Outcome variables recorded for analysis were age at presentation, symptoms, varicocele grade (Dubin-Amelar classification), testicular atrophy, length of hospital stay, perioperative complications, recurrence and hydrocele formation after surgery. Mean follow up was 5.8 years (6 months- 9 years).
Results:
Age at diagnosis ranged between 9 and 19 years. Mean age at operation was 14.1 ± 1.8 years. There were 177 left-side varicoceles (98%) and four cases were bilateral. Testicular atrophy was noted in 45. Mean operative time was 38 min. The last 63 surgeries were performed on a two-trocar basis with Ligasure vascular sealing device and operative time decreased significantly to 22 min. Median hospital stay was 31h. Twenty-three patients developed hydrocele (13%); 11 of these underwent Winkelman-Lord's hydrocelectomy at least 1 year after Palomo (9% of total). Of the remaining 12, two resolved spontaneously and 10 were stable at mean 4-year follow up.
Conclusions:
Laparoscopic Palomo procedure is a safe successful method to correct varicoceles in pediatric and adolescent males. Reactive hydrocele formation following laparoscopic varicocelectomy is a worrisome problem particularly in cases with longer follow-up.
