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Laparoscopic varicocelectomy in the adolescent male

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Abstract

Laparoscopic varicocelectomy was introduced in the early 1990s as an alternative to the Palomo varicocelectomy. Since its introduction, the procedure has gained favor within the pediatric urology community. Laparoscopic varicocelectomy has been performed using the intraperitoneal, preperitoneal, and lumbotomy approaches with almost the same results as those obtained with the Palomo procedure. The complication rates are relatively low for this procedure except for the hydrocele rate, which has been similar to that encountered with the open Palomo approach. In this article, the results obtained with this procedure and the technique are explored. As more pediatric urologists become adept with laparoscopic techniques, we will continue to see an increase in the number of cases performed using this technique.

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References and Recommended Reading

  1. Richter F, Stock JA, LaSalle M, et al.: Management of prepubertal varicoceles: results of a questionnaire study among pediatric urologists and urologists with infertility training. Urology 2001, 58:98–102.

    Article  PubMed  CAS  Google Scholar 

  2. Lemack G, Uzzo R, Schlegel P, Goldstein M: Microsurgical repair of the adolescent varicocele. J Urol 1998, 160:179–181.

    Article  PubMed  CAS  Google Scholar 

  3. Greenfield S, Seville P, Wan J: Experience with varicoceles in children and young adults. J Urol 2002, 168:1684–1688. This study contrasts the previous study results showing that when urologists are new to a particular procedure, there is a learning curve that is present, which is clearly shown to be present in this report. Both studies have low hydrocele rates.

    Article  PubMed  Google Scholar 

  4. Silveri M, Adorisio O, Pane A, et al.: Subinguinal microsurgical ligation: its effectiveness in pediatric and adolescent varicocele. Scand J Urol Nephrol 2003, 37:53–54.

    Article  PubMed  CAS  Google Scholar 

  5. Kuenkel MR, Korth K: Rationale for antegrade sclerotherapy in varicoceles. Eur Urol 1995, 27:13–17.

    PubMed  CAS  Google Scholar 

  6. Sautter T, Sulser T, Suter S, et al.: Treatment of varicocele: a prospective randomized comparison of laparoscopy versus antegrade sclerotherapy. Eur Urol 2002, 41:398–400.

    Article  PubMed  CAS  Google Scholar 

  7. Mazzoni G, Spagnoli A, Lucchetti MC, et al.: Adolescent varicocele: tauber antegrade sclerotherapy versus Palomo repair. J Urol 2001, 166:1462–1464.

    Article  PubMed  CAS  Google Scholar 

  8. Kass EJ, Marcol B: Results of varicocele surgery in adolescents: a comparison of techniques. J Urol 1992, 148:694–696.

    PubMed  CAS  Google Scholar 

  9. Dolan D, Samadi A, Palmer L, Franco I: A randomized comparison of laparoscopic vs. open varicocelectomy in the pediatric population.Presented at 20th World Congress of Endourology and SWL. Genoa, Italy: September 2002. J Endourol 2002, 16(suppl 1):A79.

    Google Scholar 

  10. Podkamenev VV, Stalmakhovich VN, Urkov PS, et al.: Laparoscopic surgery for pediatric varicoceles: randomized controlled trial. J Pediatr Surg 2002, 37:727–729.

    Article  PubMed  CAS  Google Scholar 

  11. Abdulmaaboud MR, Shokeir AA, Farage Y, et al.: Treatment of varicocele: a comparative study of conventional open surgery, percutaneous retrograde sclerotherapy, and laparoscopy. Urology 1998, 52:294–300.

    Article  PubMed  CAS  Google Scholar 

  12. Riccabona M, Oswald J, Koen M, et al.: Optimizing the operative treatment of boys with varicocele: sequential comparison of 4 techniques. J Urol 2003, 169:666–668.

    Article  PubMed  Google Scholar 

  13. Koyle M, Furness P, Barqawi A: Laparoscopic Palomo varicocele ligation in children and adolescents. Ped Endosurg Innov Techn 2003, 6:15–19.

    Article  Google Scholar 

  14. Misseri R, Gershbein AB, Horowitz M, Glassberg KI: The adolescent varicocele. II: the incidence of hydrocele and delayed recurrent varicocele after varicocelectomy in a long-term follow-up. BJU Int 2001, 87:494–498. This paper confirms that studies with follow-up periods of less than 3 years can lead to misinformation, especially when it comes to reporting hydrocele rates.

    Article  PubMed  CAS  Google Scholar 

  15. Misseri R, Glassberg K: Laparoscopic varicocelectomy: Is there an Advantage? Presented at 20th World Congress of Endourology and SWL. Genoa, Italy: September 2002. J Endourol 2002, 16(suppl 1):A78.

    Google Scholar 

  16. Levitt S, Gill B, Katlowitz N, et al.: Routine intraoperative post-ligation venography in the pediatric varicocele. J Urol 1987, 137:716–718.

    PubMed  CAS  Google Scholar 

  17. Palmer LS, Cohen S, Reda EF, et al.: Intraoperative spermatic venography reconsidered. J Urol 1995, 154:225–227.

    Article  PubMed  CAS  Google Scholar 

  18. Gill B, Kogan SJ, Maldonado J, et al.: Significance of intraoperative venographic patterns on the postoperative recurrence and surgical incision placement of pediatric varicoceles. J Urol 1990, 144:502–505.

    PubMed  CAS  Google Scholar 

  19. Sergey K, Oleg K, Yihiel B, et al.: Laparoscopic Palomo procedure: the impact of internal spermatic artery ligation on testicular blood flow. Ped Endosurg Innov Tech 2003, 7:297–301. This paper is useful in helping us understand the flow dynamics of varicoceles. This study may explain the cause of painful varicoceles.

    Article  Google Scholar 

  20. Barqawi A, Furness P III, Koyle M: Laparoscopic Palomo varicocelectomy in the adolescent is safe after previous ipsilateral inguinal surgery. BJU Int 2002, 89:269–272. This paper helps allay fears that many surgeons have regarding the Palomo mass ligation varicocelectomy with regard to the patient who had prior inguinal surgery. It is not a definitive study and by no means is it 100% safe to say that testicular atrophy could never happen in a patient who had groin surgery. The numbers in the study are too small to have any type of real statistical significance because the likelyhood of a vascular accident during inguinal surgery is in single digits, thereby necessitating hundreds if not thousands of patients who underwent inguinal surgery to have varicocele repairs to be able to make a definitive statement.

    Article  PubMed  CAS  Google Scholar 

  21. Esposito C, Monguzzi G, Gonzalez-Sabin M, et al.: Laparoscopic treatment of pediatric varicocele: a multicenter study of the Italian society of video surgery in infancy. J Urol 2000, 163:1944–1946.

    Article  PubMed  CAS  Google Scholar 

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Franco, I. Laparoscopic varicocelectomy in the adolescent male. Curr Urol Rep 5, 132–136 (2004). https://doi.org/10.1007/s11934-004-0026-6

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