Functional outcomes of surgical treatment of varicocele in infertile men: Comparison of three techniques

Ouanes, Yassine; Rahoui, Moez; Chaker, Kays; Marrak, Mahdi; Bibi, M.; Dali, Kheireddine Mrad; Sellami, Ahmed; Rhouma, Sami Ben; Nouira, Yassine

doi:10.1016/j.amsu.2022.103937

“…At the same time, radiation therapy techniques were also used to seek solutions for varicocele. With the help of radiation equipment, vascular embolization or injection of sclerosing agents made the surgical incision smaller and more esthetic; however, they also led to a higher rate of surgical failure and recurrence [29][30][31][32][33][34]. In 1994, Tauber and Johnsen [8] reported 285 cases of antegrade scrotal sclerotherapy and 57 surgical failures out of 285 surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…In 2008, Galfano et al [31] performed antegrade scrotal sclerotherapy on 800 patients with varicocele, and the surgical failure rate of the operation was nearly 10%. Compared with open inguinal or laparoscopic surgery, these methods have no advantages except for the esthetics of the skin incision after operation [32,34,36]. Other relevant studies have suggested that the new type of varicocele bypass vein anastomosis surgery is more aligned with human anatomy than venous embolism and can achieve etiological treatment [37].…”

Section: Discussionmentioning

confidence: 99%

Microsurgical Varicocelectomy: Experience of Our Sub-Subinguinal Approach and Review of the Literature

Liu

¹

,

Chen

²

,

Wu

³

et al. 2023

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Objective. To discuss the experience with a novel surgical approach in the treatment of varicocele for fertility or pain in 772 patients. Methods. Retrospective analysis of 772 patients undergoing microsurgical sub-subinguinal (SSI) varicocelectomy in our hospital and the discussion of historical surgical approaches. Results. A total of 690 patients with left varicocele underwent surgical treatment for infertility (n = 519) and pain (n = 171). The sperm concentrations (mean ± standard deviation (SD)) of 519 patients measured preoperatively, 6 months postoperatively, and 12 months postoperatively were 19.24 ± 3.69 (106/ml), 27.42 ± 10.32 (106/ml), and 34.20 ± 16.29 (106/ml) ( ∗ ∗ P < 0.01 ), respectively. The sperm motilities (mean ± SD) of 519 patients measured preoperatively, 6 months postoperatively, and 12 months postoperatively were 13.78 ± 3.25, 20.98 ± 8.21, and 27.59 ± 13.71 (grade (a + b) %) ( ∗ ∗ P < 0.01 ), respectively. Pain was released surgically in 131 (76.6%) of the 171 patients. A total of 82 patients with bilateral varicocele underwent surgical treatment for infertility (n = 58) and pain (n = 24). The sperm concentrations (mean ± SD) of 58 patients measured preoperatively, 6 months postoperatively, and 12 months postoperatively were 19.21 ± 3.24 (106/ml), 27.36 ± 10.26 (106/ml), and 33.87 ± 15.20 (106/ml) ( ∗ ∗ P < 0.01 ), respectively. The sperm motilities (mean ± SD) of 58 patients measured preoperatively, 6 months postoperatively, and 12 months postoperatively were 13.54 ± 2.75, 20.75 ± 8.21, and 28.53 ± 14.83 (grade (a + b) %) ( ∗ ∗ P < 0.01 ), respectively. Pain was released surgically in 19 (79.2%) of the 24 patients. The probability of occurrence in one artery, two arteries, three arteries, and more than three arteries was 29.5%, 28.8%, 19.9%, and 1.9%, respectively. Conclusion. This surgical approach achieves a small and esthetic skin wound with fewer complications. The SSI approach is a safe and widely adopted surgical approach option for the treatment of varicocele.

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“…It has a low incidence of complications and results in a significant improvement in symptoms, semen analysis, and fertility [10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Bilateral inguinal transabdominal pre-peritoneal laparoscopic hernioplasty associated to bilateral laparoscopic varicocelectomy in the same intervention: a feasibility study

BELKOVSKY

¹

,

SARMENTO

²

,

NOVAES

³

et al. 2023

Rev. Col. Bras. Cir.

0

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Introduction: Inguinal hernia and varicocele are common conditions in male population. Laparoscopy brings the opportunity to treat them simultaneously, through the same incision. However, there are different opinions about the risks for testicular perfusion of multiple procedures in the inguinal region. In this study, we assessed the feasibility of simultaneous laparoscopic procedures by studying clinical and surgical outcomes of patients undergoing bilateral inguinal hernioplasty using the transabdominal preperitoneal (TAPP) technique with and without concomitant bilateral laparoscopic varicocelectomy (VLB). Methods: a sample of 20 patients from the University Hospital of USP-SP with indirect inguinal hernia and varicocele with indication for surgical correction was selected. Patients were randomized into two groups, 10 undergoing TAPP (Group I) and 10 undergoing simultaneous TAPP and VLB (Group II). Data regarding total operative time, complications and postoperative pain was gathered and analyzed. Results: there was no statistical difference between groups regarding total operative time and postoperative pain. Only one complication (spermatic cord hematoma) was observed in Group I and no complications were observed in Group II. Conclusions: simultaneous TAPP and VLB in was shown to be effective and safe, which provides a basis for conducting studies on larger scales.

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“…Uma das abordagens mais populares de correção de varicocele é a varicocelectomia videolaparoscópica. Trata-se de um procedimento com baixa incidência de complicações e que resulta em melhora significativa da sintomatologia, do espermograma e da fertilidade [10][11][12][13] .…”

Section: Introductionunclassified

“…Por outro lado, obesidade, sabidamente um fator predisponente para hérnia inguinal, está associada com menor prevalência de varicocele, possivelmente porque o aumento da gordura pré-peritoneal atenuaria o fenômeno de nutckracker 7 .Várias abordagens têm sido descritas para o reparo da varicocele: retroperitoneal alto, inguinal convencional, microcirúrgico inguinal ou subinguinal, laparoscópico e embolização radiográfica 8,9 .Uma das abordagens mais populares de correção de varicocele é a varicocelectomia videolaparoscópica. Trata-se de um procedimento com baixa incidência de complicações e que resulta em melhora significativa da sintomatologia, do espermograma e da fertilidade [10][11][12][13] .A correção de hérnia inguinal é o procedimento mais frequentemente realizado em cirurgia geral 14 .…”

unclassified

Hernioplastia inguinal pré-peritoneal transabdominal bilateral e varicocelectomia laparoscópica bilateral na mesma intervenção: um estudo de viabilidade

BELKOVSKY

¹

,

SARMENTO

²

,

NOVAES

³

et al. 2023

Rev. Col. Bras. Cir.

0

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RESUMO Introdução: hérnia inguinal e varicocele são doenças comuns na população masculina. O advento da laparoscopia traz a oportunidade de tratá-las simultaneamente, pelo mesmo acesso. Entretanto, existem divergências sobre os riscos para a perfusão testicular de múltiplos procedimentos na região inguinal. Neste estudo, avaliamos a viabilidade de procedimentos laparoscópicos simultâneos estudando resultados clínicos e cirúrgicos de pacientes submetidos à hernioplastia inguinal bilateral pela técnica transabdominal préperitoneal (TAPP) com e sem varicocelectomia laparoscópica bilateral (VLB) concomitante. Métodos: uma amostra de 20 pacientes do Hospital Universitário da USP-SP com hérnia inguinal indireta e varicocele com indicação de correção cirúrgica foi selecionada. Os pacientes foram randomizados em dois grupos, sendo 10 submetidos à TAPP (Grupo I) e 10 submetidos à TAPP e VLB simultâneas (Grupo II). O tempo operatório total, complicações e dor pós-operatória foram coletados e analisados. Resultados: não houve diferença estatística entre os grupos com relação ao tempo operatório total e à dor pós-operatória. Apenas uma complicação (hematoma do cordão espermático) foi observada no Grupo I e não foram observadas complicações no Grupo II. Conclusões: no mesmo procedimento, submeter pacientes à TAPP e à VLB no mesmo procedimento se mostrou eficaz e seguro, o que fornece embasamento para a realização de estudos em maiores escalas.

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Functional outcomes of surgical treatment of varicocele in infertile men: Comparison of three techniques

Cited by 3 publications

References 15 publications

Microsurgical Varicocelectomy: Experience of Our Sub-Subinguinal Approach and Review of the Literature

Microsurgical Varicocelectomy: Experience of Our Sub-Subinguinal Approach and Review of the Literature

Bilateral inguinal transabdominal pre-peritoneal laparoscopic hernioplasty associated to bilateral laparoscopic varicocelectomy in the same intervention: a feasibility study

Hernioplastia inguinal pré-peritoneal transabdominal bilateral e varicocelectomia laparoscópica bilateral na mesma intervenção: um estudo de viabilidade

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