A Comparison of Open and Laparoscopic Varicocelectomy Results in Adolescents
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Research Article
P: 248-252
June 2022

A Comparison of Open and Laparoscopic Varicocelectomy Results in Adolescents

J Ankara Univ Fac Med 2022;75(2):248-252
1. Ankara Üniversitesi Tıp Fakültesi, Çocuk Cerrahisi Anabilim Dalı, Ankara, Türkiye
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No information available
Received Date: 20.04.2021
Accepted Date: 07.01.2022
Publish Date: 30.06.2022
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ABSTRACT

Objectives:

Varicocele occurs as a result of abnormal enlargement of the pampiniform plexus. Widely accepted treatment options are open or laparoscopic surgery and other interventional procedures. In this study, it was aimed to compare the results of the patients who underwent open and laparoscopic varicocelectomy.

Materials and Methods:

Children who were operated with the diagnosis of varicocele between 2006 and 2020 were included in the study. Children were divided into three groups according to different surgical methods such as laparoscopic surgery, open surgery with loop magnification and open surgery without loop magnification. Follow-up and treatment records of the patients were reviewed retrospectively. Charts of the patients were reviewed in terms of age, preoperative complaints, physical examination findings, radiologic imaging methods, operation method and postoperative outcomes.

Results:

When the surgical techniques applied to the patients are examined; open varicocelectomy was performed in 18 patients and laparoscopic varicocelectomy was performed in 15 patients. Postoperative subclinical or clinical recurrence was detected in eight patients, hydrocele in four and hematoma in one. There was no significant difference between the outcomes of open and laparoscopic varicocelectomy techniques in terms of recurrence. Postoperative hydrocele was observed in four (26.6 %) of the patients who underwent laparoscopic varicocelectomy. Hydrocele was not observed among the patients who underwent open varicocelectomy.

Conclusion:

There is no significant difference in terms of recurrence and complications in children who underwent open and laparoscopic varicocelectomy. The use of magnification in cases who underwent open varicocelectomy may reduce the rate of recurrence. Large series of randomized controlled prospective studies are needed for further comments.

Keywords: Varicocele, Laparoscopy, Varicocelectomy

References

1
Locke JA, Noparast M, Afshar K. Treatment of varicocele in children and adolescents: A systematic review and meta-analysis of randomized controlled trials. J Pediatr Urol. 2017;13:437-445.
2
Chiba K, Ramasamy R, Lamb DJ, et al. The varicocele: diagnostic dilemmas, therapeutic challenges and future perspectives. Asian J Androl. 2016;18:276-281.
3
Skoog SJ, Roberts KP, Goldstein M, et al. The adolescent varicocele: what’s new with an old problem in young patients? Pediatrics. 1997;100:112-121.
4
Diamond DA. Adolescent varicocele. Curr Opin Urol. 2007;17:263-267.
5
Zundel S, Szavay P, Stanasel I. Management of adolescent varicocele. Semin Pediatr Surg. 2021;30:151084.
6
Cho CL, Esteves SC, Agarwal A, et al. Indications and outcomes of varicocele repair. Panminerva Med. 2019;61:152-163.
7
Hurt GS, Howards SS, Turner TT. The effects of unilateral, experimental varicocele are not mediated through the ipsilateral testis. J Androl. 1987;8:403-408.
8
Shindel AW, Yan Y, Naughton CK. Does the number and size of veins ligated at left-sided microsurgical subinguinal varicocelectomy affect semen analysis outcomes? Urology. 2007;69:1176-1180.
9
Roque M, Esteves SC. A systematic review of clinical practice guidelines and best practice statements for the diagnosis and management of varicocele in children and adolescents. Asian J Androl. 2016;18:262-268.
10
Practice Committee of the American Society for Reproductive Medicine; Society for Male Reproduction and Urology. Report on varicocele and infertility: a committee opinion. Fertil Steril. 2014;102:1556-1560.
11
Baazeem A, Belzile E, Ciampi A, et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol. 2011;60:796-808.
12
Van Batavia JP, Badalato G, Fast A, et al. Adolescent varicocele-is the 20/38 harbinger a durable predictor of testicular asymmetry? J Urol. 2013;189:1897-1901.
13
Diamond DA, Zurakowski D, Bauer SB, et al. Relationship of varicocele grade and testicular hypotrophy to semen parameters in adolescents. J Urol. 2007;178:1584-1588.
14
Zampieri N, Bianchi F, Vestri E, et al. Varicocele in paediatric age: Is the scientific community on the correct pathway? Andrologia. 2021;53:e13844.
15
Pastuszak AW, Kumar V, Shah A, et al. Diagnostic and management approaches to pediatric and adolescent varicocele: a survey of pediatric urologists. Urology. 2014;84:450-455.
16
Al-Kandari AM, Shabaan H, Ibrahim HM, et al. Comparison of outcomes of different varicocelectomy techniques: open inguinal, laparoscopic, and subinguinal microscopic varicocelectomy: a randomized clinical trial. Urology. 2007;69:417-420.
17
Goldstein M, Tanrikut C. Microsurgical management of male infertility. Nat Clin Pract Urol. 2006;3:381-391.
18
Kolon TF. Evaluation and Management of the Adolescent Varicocele. J Urol. 2015;194:1194-1201.
19
Shiraishi K, Oka S, Matsuyama H. Surgical comparison of subinguinal and high inguinal microsurgical varicocelectomy for adolescent varicocele. Int J Urol. 2016;23:338-342.
20
Cayan S, Acar D, Ulger S, et al. Adolescent varicocele repair: long-term results and comparison of surgical techniques according to optical magnification use in 100 cases at a single university hospital. J Urol. 2005;174:2003-2006.
21
Gontero P, Pretti G, Fontana F, et al. Inguinal versus subinguinal varicocele vein ligation using magnifying loupe under local anesthesia: which technique is preferable in clinical practice? Urology. 2005;66:1075-1079.
22
Orhan I, Onur R, Semerciöz A, et al. Comparison of two different microsurgical methods in the treatment of varicocele. Arch Androl. 2005;51:213-220.
23
Golebiewski A, Krolak M, Komasara L, et al. Dye-assisted lymph vessels sparing laparoscopic varicocelectomy. J Laparoendosc Adv Surg Tech A. 2007;17:360-363.
24
Schwentner C, Radmayr C, Lunacek A, et al. Laparoscopic varicocele ligation in children and adolescents using isosulphan blue: a prospective randomized trial. BJU Int. 2006;98:861-865.
25
Dubin L, Amelar RD. Varicocelectomy: 986 cases in a twelve-year study. Urology. 1977;10:446-449.
26
Szabo R, Kessler R. Hydrocele following internal spermatic vein ligation: a retrospective study and review of the literature. J Urol. 1984;132:924-925.
27
Paduch DA, Niedzielski J. Repair versus observation in adolescent varicocele: a prospective study. J Urol. 1997;158:1128-1132.
28
Ulusoy O, Karakus OZ, Ateş O, et al. Successful outcomes in adolescent varicocele treatment with high-level laparoscopic varicocelectomy. J Pediatr Surg. 2020;55:1610-1612.
29
Feber KM, Kass EJ. Varicocelectomy in adolescent boys: long-term experience with the Palomo procedure. J Urol. 2008;180(4 Suppl):1659-1690.
30
Kocvara R, Dolezal J, Hampl R, et al. Division of lymphatic vessels at varicocelectomy leads to testicular oedema and decline in testicular function according to the LH-RH analogue stimulation test. Eur Urol. 2003;43:430-435.
31
Oka S, Shiraishi K, Matsuyama H. Microsurgical Anatomy of the Spermatic Cord and Spermatic Fascia: Distribution of Lymphatics, and Sensory and Autonomic Nerves. J Urol. 2016;195:1841-1847.
32
Yaman O, Ozdiler E, Anafarta K, et al. Effect of microsurgical subinguinal varicocele ligation to treat pain. Urology. 2000;55:107-108.
33
Altunoluk B, Soylemez H, Efe E, et al. Duration of preoperative scrotal pain may predict the success of microsurgical varicocelectomy. Int Braz J Urol. 2010;36:55-59.
34
Owen RC, McCormick BJ, Figler BD, et al. A review of varicocele repair for pain. Transl Androl Urol. 2017;6(Suppl 1):20-29.
35
Han DY, Yang QY, Chen X, et al. Who will benefit from surgical repair for painful varicocele: a meta-analysis. Int Urol Nephrol. 2016;48:1071-1078.
36
Niu ZS, Hao CS, Ye H, et al. Transumbilical single-site single-port versus single-site double-port laparoscopic varicocelectomy for varicocele in adolescents. Zhonghua Nan Ke Xue. 2014;20:342-346.
37
Podkamenev VV, Stalmakhovich VN, Urkov PS, et al. Laparoscopic surgery for pediatric varicoceles: Randomized controlled trial. J Pediatr Surg. 2002;37:727-729.
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