الاثنين، 23 مارس 2009

. Techniques of Varicocelectomy


The most common complications from varicocelectomy are hydrocele, varicocele recurrence, and testicular artery injury. Use of the operating microscope allows for reliable identification of spermatic cord lymphatics, internal spermatic veins and venous collaterals, and the testicular artery or arteries so that the incidence of these complications can be reduced significantly. Delivery of the testis through a small subinguinal incision provides direct visual access to all possible avenues of testicular drainage. In addition, men with larger varicoceles have poorer preoperative semen quality, but repair of large varicoceles results in greater improvement (128% increase in motile sperm) than repair of small varicoceles (27% increase.) Microsurgical varicocelectomy provides a safe and effective approach to varicocele repair with preservation of testicular function, improvements in semen quality, and improvements in pregnancy rates in a significant number of men.
Refers ence

1. Goldstein M., Gilbert BR, Dicker AP, Dwosh J, Gnecco C: Microsurgical inguinal varicocelectomy with delivery of the testis: An artery and lymphatic sparing technique. J. Urol 148:1808-1811, 19922. Mattews, GJ., Matthews, ED., Goldstein, M: Induction of spermatogenesis and achievement of pregnancy after microsurgical varicocelectomy in men with azoospermia and severe oligoasthenospermia

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