Impact of internal spermatic artery preservation during laparoscopic varicocelectomy on recurrence and the catch-up growth rate in adolescents

Kim, K.S.; Lee, C.; Song, Seung Hun; Cho, S.J.; Park, S.; Moon, Kee‐Chan; Ryu, Dong Soo

doi:10.1016/j.jpurol.2013.11.003

Cited by 16 publications

(13 citation statements)

References 25 publications

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“…In the current preliminary study, ISA preservation was successful in 8 patients (34.8%). This rate of ISA preservation was lower than 100% of subinguinal varicocelectomy using a microscope or 54% of laparoscopic varicocelectomy [22,23]. The total operation time in the current study was 73.5±17.5 minutes.…”

Section: Discussionmentioning

confidence: 58%

Magnification-Assisted Subinguinal Varicocelectomy with Testicular Delivery in Children: A Preliminary Report

Cho

Kim

et al. 2014

World J Mens Health

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PurposeTo evaluate the effectiveness of magnification-assisted subinguinal varicocelectomy (MASV) with testicular delivery in children with severe varicocele.Materials and MethodsWe retrospectively analyzed the clinical data of 23 children 15 years or younger (mean age, 12.3±1.8 years) who underwent MASV with testicular delivery and ligation of all collateral veins except arteries and deferential veins between January 2010 and January 2014. All patients had grade 3 varicocele on the left side. Varicocelectomy was decided upon due to scrotal hypotrophy (n=14, 60.9%), the existence of mass (n=6, 26.1%, including 1 recurrent case), and discomfort (n=3, 13.0%). The preservation of internal spermatic artery (ISA) was successful in 8 patients (34.8%). The mean follow-up time was 10.8±6.6 months.ResultsThe surgical success rate of varicocelectomy was 100%. The overall symptom resolution rate was 91.3%. The scrotal mass and discomfort disappeared, but testicular catch-up growth did not occur in 2 among 14 patients with scrotal hypotrophy. The left testis volume increased from 6.5±4.3 mL to 10.6±7.5 mL (p=0.003). There were no significant inter-group differences in terms of the surgical success rate, symptom resolution, and catch-up growth between the ISA preservation group and the ligation group. None of the subjects demonstrated testicular atrophy or hydrocele after surgery.ConclusionsMASV with testicular delivery is an effective and safe method for children with severe varicocele.

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Section: Discussionmentioning

confidence: 58%

Magnification-Assisted Subinguinal Varicocelectomy with Testicular Delivery in Children: A Preliminary Report

Cho

Kim

et al. 2014

World J Mens Health

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“…'nın (8) yaptığı bir diğer çalışmada laparoskopik varikoselektomi sırasında internal spermatik arterin bağlandığı grupta rekürrens %5 iken bağlan-madığı grupta %22 saptanmış ve istatistiksel anlamlı bir fark ortaya konmuştur.…”

Section: Discussionunclassified

Comparison the outcomes of laparoscopic varicocele ligation and microscopic varicocelectomy in preadolescent and adolescent boys

Akgül¹,

Uçar²,

Kılıç³

et al. 2017

Tcdd

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“…15 Recurrence is defined as the presence of grade 2 or 3 VC after surgery, and the recurrence rates differ from 0.6% to 35.0% based on different surgical techniques used. 9 The use of loupe magnification or an operating microscope can contribute to the variations in the rates of VC recurrence, as the recurrence rates were observed to steadily decrease with increasing magnification, suggesting that microsurgical procedures may be correlated with a lower recurrence rate, compared with other approaches. 16 The high ligation of veins after varicocelectomy may preserve inguinal and retroperitoneal collateral venous channels of internal spermatic veins, a major cause of recurrent VC, resulting in poor postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…8 The treatment options for VC include laparoscopic varicocelectomy (LV), microscopic inguinal or subinguinal varicocelectomy (MIV or MSV), and microscopic retroperitoneal varicocelectomy (MRV). 9 Hydrocele and testicular edema are common complications after varicocelectomy and result in testicular discomfort and VC recurrence. 10 The current varicocelectomy procedures reverse impaired semen quality and decreased pregnancy rates through improving sperm concentration, motility, and morphology.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Treatment Outcomes of Different Spermatic Vein Ligation Procedures in Varicocele Treatment

Wang

Wei

et al. 2016

American Journal of Therapeutics

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In this study, 4 different spermatic vein ligation procedures for varicocele (VC) treatment were compared based on recurrence rate, postoperative complications, and semen quality. Between January 2012 and May 2013, a total of 345 male patients with VC were recruited at The First Affiliated Hospital of Soochow University. Patients were performed by different ligation procedures, and they were divided into 4 groups: laparoscopic varicocelectomy group (LV group: n = 84), microscopic inguinal varicocelectomy group (MIV group: n = 85), microscopic retroperitoneal varicocelectomy group (MRV group: n = 86), and microscopic subinguinal varicocelectomy group (MSV group: n = 90). In MSV group, the operative time was 55 ± 6.9 minutes, which was significantly longer than LV, MIV, and MRV groups (P < 0.05). Recurrence rate in LV group was at 11.9%, the highest rate observed compared with the MIV, MRV, and MSV groups (P < 0.05). Scrotal edema and testicular atrophy in MSV group were markedly decreased (P < 0.05), and scrotal pain was relieved in almost all patients in the MSV group at a significantly higher rate than LV, MIV, and MRV groups (P < 0.05). Sperm concentration, sperm count of grades a + b, and sperm motility (%) in the MSV group were sharply higher than LV, MIV, and MRV groups (all P < 0.05). Our study indicates that MSV is the most beneficial of the 4 spermatic vein ligation procedures and may be offered as the first-line treatment for VC in infertile men.

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Impact of internal spermatic artery preservation during laparoscopic varicocelectomy on recurrence and the catch-up growth rate in adolescents

Cited by 16 publications

References 25 publications

Magnification-Assisted Subinguinal Varicocelectomy with Testicular Delivery in Children: A Preliminary Report

Magnification-Assisted Subinguinal Varicocelectomy with Testicular Delivery in Children: A Preliminary Report

Comparison the outcomes of laparoscopic varicocele ligation and microscopic varicocelectomy in preadolescent and adolescent boys

Comparison of Treatment Outcomes of Different Spermatic Vein Ligation Procedures in Varicocele Treatment

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