Surgical treatment of varicocele by a subinguinal approach combined with antegrade intraoperative sclerotherapy of venous vessels

Giovanni Maria Colpi, Luca Carmignani, Franco Nerva, Guido Piediferro, Fabrizio Castiglioni, Cristina Grugnetti, Giacomo Galasso

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Abstract

OBJECTIVE: To evaluate the efficacy, in terms of recurrences, complications and operative duration, of a new technique for treating varicocele. PATIENTS AND METHODS: Between September 1999 and December 2002 we evaluated 307 men aged 17-51 years with varicocele. In all of the men the clinical diagnosis was confirmed by ultrasonography. The men were treated by a variant of the microsurgical technique described in 1994. A 2-3 cm distal subinguinal incision was made at the level of the superficial inguinal ring and the spermatic cord was exposed. The largest vein in the spermatic cord fat was cannulated. A 7-9 cm segment of the spermatic cord was clamped for 8-10 min; at the start of the ischaemia time, 1.5-3 mL of 3% atoxysclerol was injected into the cannulated vein. After sclerotherapy, the vein was ligated at the injection site, and the blood flow to the cord was restored. RESULTS: The mean operative duration was 25 min. Follow-up at 3 and 6 months after surgery, with objective examination and scrotal ultrasonography, revealed one case of clinical recurrence/persistence. The most common complication was penile lymphangitis (nine men) that regressed spontaneously; three men had temporary orchialgia. There were no cases of secondary hydrocele or testicular atrophy. CONCLUSIONS: The modified technique appears to be relatively easy and safe, and to of low cost. Given the promising results in terms of complications and persistence, the treatment appears to be a suitable first-line approach for the surgical treatment of varicocele.

Original languageEnglish
Pages (from-to)142-145
Number of pages4
JournalBJU International
Volume97
Issue number1
DOIs
Publication statusPublished - Jan 2006

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Keywords

  • Intraoperative sclerotherapy
  • Safety
  • Subinguinal surgery
  • Varicocele

ASJC Scopus subject areas

  • Urology

Cite this

Colpi, G. M., Carmignani, L., Nerva, F., Piediferro, G., Castiglioni, F., Grugnetti, C., & Galasso, G. (2006). Surgical treatment of varicocele by a subinguinal approach combined with antegrade intraoperative sclerotherapy of venous vessels. BJU International, 97(1), 142-145. https://doi.org/10.1111/j.1464-410X.2006.05915.x