Subinguinal microsurgical varicocelectomy with intraoperative microvascular Doppler ultrasound leads to the pain-free outcome after surgery

Lv, Kun-Long; Zhang, Yadong; Liu, Sian; Gao, Yong; Zhao, Liang; Wan, Zi Yi; Zhou, Mianjing; Yu, Jingwei; Sun, Xiankai; Zhang, Yuanyuan; Deng, Chao; Tu, Xiang-An

doi:10.3233/xst-17247

Cited by 7 publications

(6 citation statements)

References 27 publications

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“…The differential in number of ligated veins was reported in all of the studied studies [5][6][7][8][9]. The difference in mean number of ligated veins between the group of subinguinal microsurgical varicocelectomy with Intraoperative Vascular Doppler Ultrasonography compared to the group of subinguinal microsurgical varicocelectomy without Intraoperative Vascular Doppler Ultrasonography was statistically significant (MD 0.94; 95 percent CI 0.62 -1.26; p < 0.00001) as shown in Figure 3.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 69%

“…Finally, the quantitative analysis of this study included 5 papers that met the inclusion criteria. In our meta-analysis, we analyzed 5 papers [5][6][7][8][9] that compared the use of IVDU against no IVDU in subinguinal microsurgical varicocelectomy procedures. Three RCTs and two observational studies made up our individual investigations.…”

Section: Selection Of Studiesmentioning

confidence: 99%

“…Because of the low heterogeneity amongst the studies (I 2 = 6%), a fixed-effects model was utilized. All of the studies that were included [5][6][7][8][9] in the analysis of the difference in the average number of preserved arteries. The mean number of preserved arteries between the groups of using Intraoperative Vascular Doppler Ultrasonography and not using Intraoperative Vascular Doppler Ultrasonography in subinguinal microsurgical varicocelectomy was statistically significant (MD 0.43; 95 percent CI 0.30 -0.57; p0,00001), according to the results of forest plot (Figure 4) analysis.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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A Systematic Review and Meta-analysis of the Efficacy of Intraoperative Vascular Doppler Ultrasonography for Vein Ligations and Artery Preservations in Microsurgical Subinguinal Varicocelectomy

Tamrin¹,

Soebadi²,

Soebadi³

et al. 2022

IJRP

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The gold standard of varicocele management is microsurgical subinguinal varicocelectomy. This procedure leads to better preservation of the testicular artery and lymphatic vessels. However, sometimes several vessels were in complex position causing the dissection to be more difficult. By using IVDU, more arteries and veins could be identified to acquire better sperm outcomes. It's uncertain if the Doppler Ultrasonography has a role in varicocele therapy. The goal of this systematic review and meta-analysis was to see how effective microsurgical subinguinal varicocelectomy with intraoperative vascular Doppler ultrasonography compared to without intraoperative vascular Doppler ultrasonography. Randomized Controlled Trials (RCTs), non-randomized trials, and comparative observational studies were searched and screened in the Embase, Medline, and Scopus databases for research examining the role of intraoperative Doppler ultrasonography. The Cochrane risk of bias (RoB) tool 2 was used to assess RCT bias, whereas the ROBINS-I tool was utilized to assess non-randomized trial bias. The New Ottawa Scale was used to evaluate observational research. The systematic search and screening yielded five suitable studies, including three RCTs, one non-randomized trial, and one observational research. Between patients receiving IVDU and those having the treatment without IVDU, there is a significant difference in the number of ligated veins (MD 0,94; 95 percent CI 0,62-1,26; p0,00001) and preserved arteries (MD 0,43; 95 percent CI 0,30-057; p0,00001). Patients receiving IVDU had better ligated veins and preserved arteries than patients having the surgery without IVDU.

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Section: Risk Of Bias Assessmentmentioning

confidence: 69%

Section: Selection Of Studiesmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

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A Systematic Review and Meta-analysis of the Efficacy of Intraoperative Vascular Doppler Ultrasonography for Vein Ligations and Artery Preservations in Microsurgical Subinguinal Varicocelectomy

Tamrin¹,

Soebadi²,

Soebadi³

et al. 2022

IJRP

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“…They suggested that the definite relationship still needs to be clarified ( 24 ). Although conflicting results are present, it is still considered that individual sperm parameter is not diagnostic for infertility, as a normal count of motility may not result in a higher chance of pregnancy ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

The Influence of Number of Ligated Veins in Varicocele Patients Undergoing Microsurgical Varicocelectomy in Postoperative Pain and Sperm Parameters Outcome

Syarief,

Rahman,

Setiawan

et al. 2023

Med Arch

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Background: The influence of the number of veins that should be ligated in varicocele surgery on postoperative pain and testicular function is not clearly understood. Objective: The aim of this study was to investigate the number of Internal Spermatic Vein (ISV) ligated in postoperative pain and sperm parameters outcome. Methods: Relevant studies were collected and systematically reviewed from Medline, Scopus, and Cochrane databases. This study followed the PRISMA guideline. The mean difference (MD), odds ratio (OR), and 95% confidence intervals (CIs) were measured in the assessment of the outcome. Revman 5.4 was used in data analysis. Results: The pooled meta-analysis demonstrated that complete pain resolution was significantly higher in patients undergoing varicocelectomy procedures with more than ten vein numbers ligated with OR 1.92, 95% CI (1.03, 3.60). Improvement of sperm parameters of change in sperm concentration was also significantly observed in patients with more than ten vein numbers ligated MD 32.79, 95% CI (23.13, 42.45). However, the number of veins ligated was not associated with the change in sperm motility MD 9.69 with 95% CI (-12.32, 31.71). Conclusion: The number of veins ligated intraoperatively determined pain relief and sperm concentration improvement. This study showed that varicocelectomy results improved with greater ISV ligation.

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“…Таким образом, пациенты в 1-й группе имели лучшие результаты в разрешении болевого синдрома (p = 0,033). Время операции, осложнения и частота рецидивов не различались [21].…”

Section: обзорная статья / Reviewunclassified

Microsurgical treatment of varicocele with intraoperative Doppler control (literature review)

Chernushenko

Ахвледиани

Рева

et al. 2023

Androl. genit. hir.

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Microsurgical subinguinal ligation of the veins of the spermatic cord (Marmara operation) is the “gold standard” treatment of varicocele. Currently, the use of an operating microscope and microsurgical instruments to perform this operation has proven its effectiveness. The question of the expediency of using intraoperative dopplerography remains a subject of discussion.The analysis of 23 articles using the MEDLINE database (PubMed) was carried out. The data on the efficacy and safety of microsurgical subinguinal correction of varicocele with and without intraoperative dopplerography are compared. The use of intraoperative dopplerography in microsurgical subinguinal correction of varicocele allows achieving the best treatment results.

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Subinguinal microsurgical varicocelectomy with intraoperative microvascular Doppler ultrasound leads to the pain-free outcome after surgery

Abstract: Subinguinal microsurgical varicocelectomy is an effective method to treat painful varicoceles. With the assistance of Doppler Ultrasound monitoring, greater numbers of vessels were identified and a better outcome of pain resolution was achieved.

Cited by 7 publications

References 27 publications

A Systematic Review and Meta-analysis of the Efficacy of Intraoperative Vascular Doppler Ultrasonography for Vein Ligations and Artery Preservations in Microsurgical Subinguinal Varicocelectomy

A Systematic Review and Meta-analysis of the Efficacy of Intraoperative Vascular Doppler Ultrasonography for Vein Ligations and Artery Preservations in Microsurgical Subinguinal Varicocelectomy

The Influence of Number of Ligated Veins in Varicocele Patients Undergoing Microsurgical Varicocelectomy in Postoperative Pain and Sperm Parameters Outcome

Microsurgical treatment of varicocele with intraoperative Doppler control (literature review)

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