[Current trends in the treatment of varicocele]

A varicocele first develops in early adolescence and it can negatively affect testicular growth, histology and function. The use of early varicocelectomy to prevent severe testicular damage and sub-infertility in adulthood seems to be incontrovertible. However there is a difference of opinion as to the proper surgical procedure of varicocele ablation. To date, the inguinal and high retroperitoneal approaches are the most commonly accepted methods. However significant postoperative morbidity is common, with a recurrence rate ranging from 1 to 25% and return to normal activity often is prolonged. This considerations have prompted many to search for alternative techniques. The Authors performed laparoscopic clipping and division of the internal spermatic vein or the internal spermatic vessels in 55 adolescents to treat varicocele. Indications for the operation were third degree varicocele and second degree with testicular hypotrophy. At a mean 6 months follow-up, they did not observe either relapses or complications; no hydrocele was noted and testicular size did not decrease in any patient. In the Authors' experience and opinion, laparoscopic varicocelectomy is a simple, safe, effective and minimally invasive surgical procedure and it can be proposed as a viable alternative to open traditional surgical methods.