Abstract
Varicoceles are relatively rare in boys and adolescent males. The literature is conflicted on the necessity of treatment of the entity, and is further divergent on the best approach if intervention is pursued. We, the authors of this chapter, believe that treatment is indicated in boys shown to have consistently divergent testicular growth over a year of observation. This chapter first details the evaluation and work-up for pediatric varicoceles, and then describes the aspects and considerations of the laparoscopic method. We find this approach to be most suitable given its relative ease to perform with minimal operative time and its outcomes and complication rates comparable to other techniques.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Akbay E, Çayan S, Doruk E, et al. The prevalence of varicocele and varicocele-related testicular atrophy in Turkish children and adolescents. BJU Int. 2000;86:490–3.
Kumanov P, Robeva RN, Tomova A. Adolescent varicocele: who is at risk? Pediatrics. 2008;121:e53–7.
Skoog SJ, Roberts KP, Goldstein M, et al. The adolescent varicocele: what’s new with an old problem in young patients? Pediatrics. 1997;100(1):112–21.
Li F, Chiba K, Yamaguchi K, et al. Effect of varicocelectomy on testicular volume in children and adolescents: a meta-analysis. Urology. 2012;79:1340–5.
Kass EJ, Belman AB. Reversal of testicular growth failure by varicocele ligation. J Urol. 1987;137:475–6.
Pastuszak AW, Kumar V, Shah A, et al. Diagnostic and management approaches to pediatric and adolescent varicocele: a survey of pediatric urologists. Urology. 2014;84:450–6.
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;13:437–45.
Chu DI, Zderic SA, Shukla AR, et al. The natural history of semen parameters in untreated asymptomatic adolescent varicocele patients: a retrospective cohort study. J Pediatr Urol. 2017;13:77.e1–5.
Okuyama A, Nakamura M, Namiki M, et al. Surgical repair of varicocele at puberty: preventive treatment for fertility improvement. J Urol. 1988;139:562–4.
Lipshultz LI, Corriere JN. Progressive testicular atrophy in the varicocele patient. J Urol. 1977;117:175–6.
Palomo A. Radical cure of varicocele by a new technique: preliminary report. J Urol. 1949;61:604–7.
Aaberg RA, Vancaillie TG, Schuessler WW. Laparoscopic varicocele ligation: a new technique. Fertil Steril. 1991;56:776–7.
Podkamenev VV, Stalmakhovich VN, Urkov PS, et al. Laparoscopic surgery for pediatric varicoceles: randomized controlled trial. J Pediatr Surg. 2002;37:727–9.
Parrilli A, Roberti A, Escolino M, et al. Surgical approaches for varicocele in pediatric patient. Transl Pediatr. 2016;5:227–32.
Sakamoto H, Saito K, Oohta M, et al. Testicular volume measurement: comparison of ultrasonography, orchidometry, and water displacement. Urology. 2007;69:152–7.
Diamond DA, Zurakowski D, Bauer SB, et al. Relationship of varicocele grade and testicular hypotrophy to semen parameters in adolescents. J Urol. 2007;178:1584–8.
Kolon TF, Clement MR, Cartwright L, et al. Transient asynchronous testicular growth in adolescent males with a varicocele. J Urol. 2008;180:1111–5.
Spinelli C, Di Giacomo M, Lo Piccolo R, et al. The role of testicular volume in adolescents with varicocele: the better way and time of surgical treatment. J Urol. 2010;184:1722–6.
Diamond DA, Gargollo PC, Caldamone AA. Current management principles for adolescent varicocele. Fertil Steril. 2011;96:1294–8.
Mehta A, Sigman M. The adult urologist’s perspective on management of varicoceles in the pediatric population. Dialogues Pediatr Urol. 2008;30:2–4.
Nork JJ, Berger JH, Crain DS, et al. Youth varicocele and varicocele treatment: a meta-analysis of semen outcomes. Fertil Steril. 2014;102:381–387.e6.
Fine RG, Gitlin J, Reda EF, et al. Barriers to use of semen analysis in the adolescent with a varicocele: survey of patient, parental, and practitioner attitudes. J Pediatr Urol. 2016;12:41.e1–6.
Moursy EES, ElDahshoury MZ, Hussein MM, et al. Dilemma of adolescent varicocele: long-term outcome in patients managed surgically and in patients managed expectantly. J Pediatr Urol. 2013;9:1018–22.
Borruto FA, Impellizzeri P, Antonuccio P, et al. Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis. J Pediatr Surg. 2010;45:2464–9.
Jarow JP, Assimos DG, Pittaway DE. Effectiveness of laparoscopic varicocelectomy. Urology. 1993;42:544–7.
Esposito C, Monguzzi G, Gonzalez-Sabin MA, et al. Results and complications of laparoscopic surgery for pediatric varicocele. J Pediatr Surg. 2001;36:767–9.
McManus MC, Barqawi A, Meacham RB, et al. Laparoscopic varicocele ligation: are there advantages compared with the microscopic subinguinal approach? Urology. 2004;64:357–60.
Cuda SP, Musser JE, Belnap CM, et al. Incidence and clinical significance of arterial injury in varicocele repair: arterial injury in varicocele repair. BJU Int. 2011;107:1635–7.
Atassi O, Kass EJ, Steinert BW. Testicular growth after successful varicocele correction in adolescents: comparison of artery sparing techniques with the Palomo procedure. J Urol. 1995;153:482–3.
Oswald J, Körner I, Riccabona M. The use of isosulphan blue to identify lymphatic vessels in high retroperitoneal ligation of adolescent varicocele – avoiding postoperative hydrocele. BJU Int. 2001;87:502–4.
Capolicchio J-P, El-Sherbiny M, Brzezinski A, et al. Dye-assisted lymphatic-sparing laparoscopic varicocelectomy in children. J Pediatr Urol. 2013;9:33–7.
D’Alessio A, Piro E, Beretta F, et al. Lymphatic preservation using methylene blue dye during varicocele surgery: a single-center retrospective study. J Pediatr Urol. 2008;4:138–40.
Ishibashi H, Mori H, Yada K, et al. Indigo carmine dye-assisted lymphatic-sparing laparoscopic Palomo varicocelectomy in children. J Med Investig. 2014;61:151–5.
Esposito C, Iaquinto M, Escolino M, et al. Technical standardization of laparoscopic lymphatic sparing varicocelectomy in children using isosulfan blue. J Pediatr Surg. 2014;49:660–3.
Author information
Authors and Affiliations
Corresponding authors
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Carpenter, C.P., Giel, D.W. (2020). Laparoscopic Varicocelectomy. In: Gargollo, P.C. (eds) Minimally Invasive and Robotic-Assisted Surgery in Pediatric Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-57219-8_20
Download citation
DOI: https://doi.org/10.1007/978-3-030-57219-8_20
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-57218-1
Online ISBN: 978-3-030-57219-8
eBook Packages: MedicineMedicine (R0)