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  11. Retrospective Analysis Of Laparoscopic Varicocelectomy In Pediatric Patients: Impact Of Lymphatic-sparing Techniques And Methylene Blue On Outcomes-a Series Of Cases

Retrospective Analysis of Laparoscopic Varicocelectomy in Pediatric Patients: Impact of Lymphatic-Sparing Techniques and Methylene Blue on Outcomes-A Series of Cases

Arzu Canmemis1, Meltem Caglar2, Cigdem Ulukaya Durakbasa3

  • 1Division of Pediatric Urology, Department of Pediatric Surgery, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, 34722 Istanbul, Türkiye.

Journal of Clinical Medicine
|June 13, 2025

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View abstract on PubMed

Summary
This summary is machine-generated.

Lymphatic-sparing laparoscopic varicocelectomy preserves testicular volume in pediatric patients. However, using methylene blue dye with this technique may increase the risk of testicular calcification, warranting caution.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Surgical Innovation

Background:

  • Varicocelectomy is a common procedure for pediatric varicoceles.
  • Laparoscopic varicocelectomy (LV) offers minimally invasive benefits.
  • Comparing lymphatic-sparing (LS) and non-lymphatic-sparing (NLS) techniques is crucial for optimizing outcomes.

Purpose of the Study:

  • To compare outcomes of LS versus NLS laparoscopic varicocelectomy in pediatric patients.
  • To evaluate complications, focusing on the impact of methylene blue dye.
  • To assess the effect on testicular volume and recurrence rates.

Main Methods:

  • Retrospective review of 21 pediatric patients with Grade 3 left-sided varicocele undergoing LV (2010-2023).
  • Patients categorized into LS and NLS groups.
Keywords:
complicationslymphatic sparingmethylene bluetesticular calcification

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  • Pre- and postoperative testicular volumes measured by ultrasonography; complications recorded.

    • Main Results:

    • LS technique was used in 33.3% of patients; methylene blue identified lymphatics in the LS group.
    • No significant difference in hydrocele or recurrence rates between groups.
    • Testicular calcification occurred significantly more in the LS group (p=0.002), while no testicular atrophy was observed.

    Conclusions:

    • LS laparoscopic varicocelectomy effectively preserves testicular volume.
    • Intratesticular methylene blue use in LS LV is linked to increased testicular calcification.
    • Further long-term studies on vital dyes in pediatric varicocelectomy are recommended.
    varicocele