Varicocelectomy: 986 cases in a twelve-year study

Dubin, Lawrence; Amelar, Richard D.

doi:10.1016/0090-4295(77)90132-7

Cited by 282 publications

(125 citation statements)

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“…ligation at the internal inguinal ring [9], but more recently rates in men were reported as 3.1-13%, with higher ligation tending to cause more hydroceles [10][11][12]. The present results show about twice the frequency (28% vs 14%) of hydrocele formation after a Palomo than after a modified Ivanissevich repair.…”

Section: Discussionsupporting

confidence: 58%

“…Most studies do not indicate the interval between varicocelectomy and the discovery of a hydrocele. For example, Dubin and Amelar [10] reviewed 986 men who had undergone varicocelectomy to treat infertility. The method of varicocelectomy used was that of a 'high ligation of the internal spermatic veins at the internal inguinal ring'.…”

Section: Discussionmentioning

confidence: 99%

“…The records of 77 adolescent males (mean age 14.1 years, range [10][11][12][13][14][15][16][17][18][19][20][21][22] [8].…”

Section: Methodsmentioning

confidence: 99%

“…Fifty-six patients underwent a standard Palomo procedure (45 left and 11 bilateral) and 21 a modified Ivanissevich repair (14 left and seven bilateral). The mean (range) age of the patients at surgery was 14.1 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) years and the mean followup 25.5 (6-84) months.…”

mentioning

confidence: 99%

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The adolescent varicocele. II: the incidence of hydrocele and delayed recurrent varicocele after varicocelectomy in a long‐term follow‐up

et al. 2001

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Objective To determine, in adolescent boys after varicocelectomy, the incidence of hydroceles, when they develop and whether the development is procedure‐related.Patients and methods The records were retrospectively reviewed of 77 boys who underwent 95 varicocelectomies and had an examination at 6 months after surgery. Fifty‐six patients underwent a standard Palomo procedure (45 left and 11 bilateral) and 21 a modified Ivanissevich repair (14 left and seven bilateral). The mean (range) age of the patients at surgery was 14.1 (10–22) years and the mean follow‐up 25.5 (6–84) months.Results Of the 67 Palomo varicocelectomies 19 (24%) were complicated by hydroceles after surgery, compared with four of 28 (14%) Ivanissevich procedures (P = 0.034). Of the Ivanissevich repairs, none of the 14 unilateral repairs developed hydroceles. Three hydroceles (one bilateral and one left) developed in two of seven patients after bilateral varicocelectomy. Of the Palomo repairs, 12 of 45 unilateral repairs were complicated by hydroceles, and seven developed in five of 11 patients after bilateral varicocelectomy. Although more hydroceles developed after bilateral varicocelectomy, there was no significant difference from the unilateral group. However, patients who developed hydroceles after bilateral varicocelectomy were more likely to require hydrocelectomy (P = 0.013, Fisher's exact test), implying that hydroceles developing after bilateral repair tend to be larger. Of the hydroceles, two were detected in the first 6 months after surgery, nine at 6–12 months, three at 13–18 months, five at 19–24 months and four at > 2 years after surgery. Three patients had late varicocele recurrence, i.e. 15, 37 and 76 months after surgery; these patients had not had varicoceles on palpation after surgery at 3, 14 and 63 months, respectively.Conclusion Hydroceles are detected infrequently within 6 months of varicocelectomy, with most occurring after 6 months and even appearing after 3 years. They occur significantly more often after a Palomo repair. More hydroceles develop after bilateral repair regardless of the technique used, but not significantly so. Because hydroceles often develop, a lymphatic‐sparing procedure should be used, especially for bilateral repair. Recurrent varicoceles may appear as late as 76 months after varicocelectomy in patients where none had been detected at a mean of 27 months after surgery.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

“…The records of 77 adolescent males (mean age 14.1 years, range [10][11][12][13][14][15][16][17][18][19][20][21][22] [8].…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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The adolescent varicocele. II: the incidence of hydrocele and delayed recurrent varicocele after varicocelectomy in a long‐term follow‐up

et al. 2001

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“…Higher pregnancy rates can be achieved by left varicocelectomy in subfertile men with an absent or atrophic right testis. Sperm concentration, motility, and morphology are significantly improved by varicocelectomy [4,13].…”

mentioning

confidence: 97%