K S Kim1, C Lee1, S H Song1, S J Cho2, S Park5, K H Moon1, D S Ryu4, S Park5. 1. Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap2-dong, Songpa-gu, 138-736 Seoul, South Korea. 2. Department of Anesthesiology and Pain Medicine, Cheju National University College of Medicine, Cheju National University Hospital, 690-716, #154, 3-Do 2-Dong, Jeju City, South Korea. 3. School of Mechanical Engineering, Pusan National University, 30 Jangjeon-dong, Gumjeong-gu, 609-735 Busan, South Korea. 4. Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50, Hapsung-dong, Masan hoewon-gu, 630-723 Changwon, South Korea. 5. Department of Urology, University of Ulsan College of Medicine, Ulsan University Hospital, 290-3 Jeonha-dong Dong-gu, 682-714 Ulsan, South Korea. Electronic address: scpark@amc.seoul.kr.
Abstract
OBJECTIVE: To investigate the effectiveness of laparoscopic varicocelectomy (LV) in adolescents with varicocele and analyze the impact of internal spermatic artery (ISA) preservation on surgical outcomes. MATERIALS AND METHODS: Data on 92 adolescents with left varicocele who underwent LV between December 1998 and January 2011 were retrospectively analyzed. The mean age of the patients was 13.2 ± 2.1 years. Age, grade of disease, number of ligation veins, recurrence rates, and catch-up growth were analyzed in patients who underwent ISA preservation and ligation. The median duration of the follow-up was 21 months. RESULTS: ISA preservation was performed on 50 patients (54%). There were no significant inter-group differences in terms of age, varicocele grade, number of ligation veins, and catch-up growth (93% vs. 90%). The patients who received artery preservation demonstrated a higher recurrence rate (22%) than those who received artery ligation (5%; p = 0.032). Among 13 patients who had persistent or recurrent varicocele, nine were treated with embolization and one was treated with magnification-assisted subinguinal varicocelectomy. None of these 10 patients demonstrated recurrence or testicular atrophy. CONCLUSIONS: LV with ISA ligation can reduce the recurrence rate and results in the same catch-up growth rate in comparison with LV with ISA preservation.
OBJECTIVE: To investigate the effectiveness of laparoscopic varicocelectomy (LV) in adolescents with varicocele and analyze the impact of internal spermatic artery (ISA) preservation on surgical outcomes. MATERIALS AND METHODS: Data on 92 adolescents with left varicocele who underwent LV between December 1998 and January 2011 were retrospectively analyzed. The mean age of the patients was 13.2 ± 2.1 years. Age, grade of disease, number of ligation veins, recurrence rates, and catch-up growth were analyzed in patients who underwent ISA preservation and ligation. The median duration of the follow-up was 21 months. RESULTS: ISA preservation was performed on 50 patients (54%). There were no significant inter-group differences in terms of age, varicocele grade, number of ligation veins, and catch-up growth (93% vs. 90%). The patients who received artery preservation demonstrated a higher recurrence rate (22%) than those who received artery ligation (5%; p = 0.032). Among 13 patients who had persistent or recurrent varicocele, nine were treated with embolization and one was treated with magnification-assisted subinguinal varicocelectomy. None of these 10 patients demonstrated recurrence or testicular atrophy. CONCLUSIONS: LV with ISA ligation can reduce the recurrence rate and results in the same catch-up growth rate in comparison with LV with ISA preservation.