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Distant 10 years results of laparoscopic operative treatment in patients with varicocele

  • Zbigniew Jabłonowski
  • Adam Grzegorczyk
  • Robert Kȩdzierski
  • Eugeniusz Miȩkoś
  • Marek Sosnowski
Research Article
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Abstract

Varicocele has been regarded a curable cause of infertility for dozens of years. The impact of varicocele treatment in terms of increase in pregnancy rates is a debated issue. We evaluate data from a 10-year cohort of results from laparoscopic operative treatment of varicocele patients according to pregnancy rate, complication rate, and satisfaction with varicocele repair. Ninety seven patients were treated by means of laparoscopy between 1993 and 1996. Ten years after operation questionnaires were sent to all patients. Answers were obtained from 49/97 pts. (50,5%). Details connected with marital status, pregnancy rate, addictions and scrotal pain discomfort were collected. Statistical analysis was performed using chi-square independence test and Spearman’s rank correlation coefficient. After 10 years, 75.5% who answered the questionnaire were fully satisfied with the results of treatment, 12.3% pts of patients were partially satisfied; 63.3% of patients fathered 1 to 3 children. Married patients and those who fathered children were found to be the most satisfied with the operation. We also found the statistically significant negative dependency between smoking addiction and number of children. There were no major complications intra- or postoperatively. No harmful consequences of testicular artery ligation were found. In conclusion, long-time 10 years follow-up enables better estimation of the results of laparoscopic treatment in patients with varicocele. Pregnancy rate may depend not only on varicocele repair but on smoking addiction as well. There is still no evidence of harmful consequences due to testicular artery ligation after varicocele repair

Keywords

Varicocele Laparoscopy Pregnancy rate Complications Distant results 

References

  1. [1]
    Czaplicki M., Wpływ leczenia operacyjnego żylaków powrózka nasiennego na stan nasienia, Praca habilitacyjna, AM Warszawa, 1994 [Polish]Google Scholar
  2. [2]
    Turner T.T., Varicocele: still an enigma, J. Urol., 1983, 129, 695–699PubMedGoogle Scholar
  3. [3]
    Tulloch W.S., Varicocele in subfertility: results of treatment, Br. Med. J., 1955, 2, 356–358PubMedGoogle Scholar
  4. [4]
    Zucchi A., Mearini L., Mearini E., Costantini E., Bini V., Porena M., Treatment of varicocele: randomized prospective study on open surgery versus Tauber antegrade sclerotherapy, J. Androl., 2005, 26, 328–332PubMedCrossRefGoogle Scholar
  5. [5]
    Schlegel P.N., Is assisted reproduction the optimal treatment for varicocele-associated male fertility? A cost-effectiveness analysis,. Urology, 1997, 49, 83–90Google Scholar
  6. [6]
    Evers J.L.H., Collins J.A., Vandekerckhove P., Surgery of embolisation for varicocele in subfertile men, Cochrane Database Syst. Rev., 2001, 1,:CD000479Google Scholar
  7. [7]
    Evers J.L.H., Collins J.A., Assessment of efficacy of varicocele repair for male subfertility: a systematic review, Lancet, 2003, 361, 1849–1852PubMedCrossRefGoogle Scholar
  8. [8]
    Jabłonowski Z., Miękoś E., Różański W., Estimation of testis volume in patients with varicocele treated by laparoscopic operation, Arch. Med. Sci., 2005, 1, 163–166Google Scholar
  9. [9]
    Ficarra V., Cerruto M.A., Liguori G., Mazzoni G., Minucci S., Tracia A., et al., Treatment of varicocele in subfertile men: the Cochrane Review - a contrary opinion, Eur. Urol., 2006, 49, 258–263PubMedCrossRefGoogle Scholar
  10. [10]
    Cockett A.T.K., Takihara H., Consentino M.J., The varicocele, Fertil. Steril., 1984, 41, 5–11PubMedGoogle Scholar
  11. [11]
    Pinto K.J., Kroovand R.L., Jarow J.P., Varicocele related testicular atrophy and its predictive effect upon fertility, J. Urol., 1994, 152, 788–790PubMedGoogle Scholar
  12. [12]
    Cockett A.T.K., Urry R.L., Dougherty K.A., The varicocele and semen characteristics, J. Urol., 1979, 121, 435–436PubMedGoogle Scholar
  13. [13]
    Baker H.W., Burger H.G., De Kretser D.M., Hudson B., Rennie G.C., Straffon W.G., Testicular vein ligation and fertility in men with varicoceles, Br. Med. J., 1985, 291, 1678–1680CrossRefGoogle Scholar
  14. [14]
    Karatepe O., Altiok M., Battal M., Adas G., Gülcicek O.B., Acet E., et al., Agenesis of the gallbladder as a rare misdiagnosis, Cent. Eur. J. Med. 2009; (in press)Google Scholar
  15. [15]
    Erman-Vlahović M., Habek D., Vlahović I., Vuković Bobić M., Pseudoacute abdomen in female caused by haematometrocolpos and haematosalpinx because hymen imperforatus: diagnosis and therapy of imperforate hymen. Cent. Eur. J. Med., 2007, 2, 351–355.CrossRefGoogle Scholar
  16. [16]
    Madgar I., Lunenfeld B., Weissenberg R., Controlled trial of high spermatic vein ligation for varicocele in infertile men, J. Urol., 1991, 45, 115AGoogle Scholar
  17. [17]
    Zampieri N., Cervellione R.M., Varicocele in adolescents: a 6-year longitudinal and followup observational study, J. Urol., 2008, 180, 1653–6PubMedCrossRefGoogle Scholar
  18. [18]
    Palomo A., Radical cure of varicocele by a new technique: preliminary report. J. Urol., 1949, 61, 604–607PubMedGoogle Scholar
  19. [19]
    Jabłonowski Z., Rysz J., Paradowski M., Miękoś E., Różański W., Jabłński S., et al., The estimation of erythropoietin levels in the blood serum and cystic fluid in patients with solitary renal cysts, Arch. Med. Sci., 2006, 2, 122–124Google Scholar
  20. [20]
    Atassi O., Kass E.J., Steinert B.W., Testicular growth after successful varicocele correction in adolescents: comparison of artery sparing techniques with the Palomo procedure, J. Urol., 1995, 153, 482–483PubMedCrossRefGoogle Scholar
  21. [21]
    Matsuda T., Horii Y., Yoshida O., Should the testicular artery be preserved at varicocelectomy?, J. Urol., 1993, 149, 1357–1360PubMedGoogle Scholar
  22. [22]
    Jabłonowski Z., Otulski H., Miękoś E., Brocki M., Lesiewicz H., Kutwin L., Laparoscopic treatment of varicocele, J. Endourol., 1995, 9(suppl.1), 85Google Scholar
  23. [23]
    Kass E.J., Marcol B., Results of varicocele surgery in adolescents: a comparison of techniques, J. Urol., 1992, 148, 694–696PubMedGoogle Scholar

Copyright information

© © Versita Warsaw and Springer-Verlag Berlin Heidelberg 2008

Authors and Affiliations

  • Zbigniew Jabłonowski
    • 1
  • Adam Grzegorczyk
    • 1
  • Robert Kȩdzierski
    • 1
  • Eugeniusz Miȩkoś
    • 1
  • Marek Sosnowski
    • 1
  1. 1.Department of UrologyMedical UniversityŁódźPoland

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