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Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
Evaluation and management of the persistent/recurrent varicocele
Kenneth I Glassberg1, Gina M Badalato, Stephen A Poon
1Division of Pediatric Urology, Department of Urology, Morgan Stanley, Children’s Hospital and New York-Presbyterian Columbia University, College of Physicians and Surgeons, New York, NY, USA.
Urology
|January 25, 2011
Summary
Redo varicocelectomy in adolescents is successful, offering similar catch-up growth potential as initial surgery. However, risks include testicular volume loss and hydrocele development.
Area of Science:
- Urology
- Pediatric Surgery
Background:
- Varicocelectomy is a common procedure for adolescent varicoceles.
- Redo varicocelectomy is performed for persistent or recurrent varicoceles.
- Outcomes of redo varicocelectomy in adolescents require further evaluation.
Purpose of the Study:
- To review outcomes in adolescent patients following redo varicocelectomy surgery.
- To assess testicular asymmetry, testicular volume, retrograde venous flow, and hydrocele incidence post-redo varicocelectomy.
Main Methods:
- A retrospective review of a single surgeon's composite varicocele registry.
- Identification of patients who underwent redo varicocelectomy.
- Evaluation of clinical and intraoperative variables.
Main Results:
- Nineteen adolescent boys underwent redo varicocelectomy (16 open, 1 laparoscopic, 2 embolization) with a mean follow-up of 23.4 months.
- Seventeen surgical redoes resulted in no palpable varicocele; one case had testicular volume compromise, and three developed hydroceles.
- Eight of nine boys with significant preoperative asymmetry showed catch-up testicular growth post-redo.
- Post-redo retrograde venous flow was absent or minimal in 16 out of 19 patients.
Conclusions:
- Redo varicocelectomy is a successful procedure in adolescents, comparable to initial repair for catch-up testicular growth.
- Potential complications include testicular volume compromise and a significant risk of hydrocele formation.
- The role of distal collateral veins in varicocele recurrence may be less significant than previously believed.
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