Results of Microsurgical Inguinal or Subinguinal Varicocelectomy in Children and Adolescents

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  • 小児精索静脈瘤に対する顕微鏡下精索静脈低位結紮術の治療成績の検討
  • ショウニセイサクジョウミャクリュウ ニ タイスル ケンビキョウ カセイサクジョウミャク テイイ ケッサツジュツ ノ チリョウ セイセキ ノ ケントウ

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Abstract

<p>Purpose: We have established microsurgical varicocelectomy techniques with which the testicular artery and lymphatic vessels are identified with a micro-Doppler probe and indigo carmine solution, respectively. In this study, we evaluated the results of microsurgical varicocelectomy in children and adolescents at our institution.</p><p>Methods: We performed a retrospective chart review of all patients who underwent microsurgical varicocelectomy for varicoceles during a period of 7 years and 5 months at our institution. We excluded patients who underwent bilateral varicocelectomy, simultaneous surgery for other diseases, and previous groin surgery as well as patients with <3 months of postoperative follow-up and mechanical failure.</p><p>Results: We evaluated 36 children and adolescents with left varicoceles who underwent microsurgical varicocelectomy. The patients’ median age was 12 years (range, 10–16 years), and the varicocele classification was Grade 2 in 6 patients and Grade 3 in 30 patients. The approach was subinguinal in 16 patients and inguinal in 20 patients. The average operation time was 132.5 minutes (range, 83–209 minutes). Only one patient (2.8%) developed a recurrent varicocele and underwent reoperation. None of the patients developed postoperative testicular atrophy or a hydrocele on the affected side. Twelve of the 20 patients (60%) with testicular atrophy on the affected side exhibited catch-up growth.</p><p>Conclusions: Microsurgical inguinal or subinguinal varicocelectomy is less invasive than other surgical procedures and is a familiar approach for pediatric surgeons and pediatric urologists. Because of its high safety and curability, we recommend microsurgical varicocelectomy on the affected side for children and adolescents with symptoms or testicular atrophy.</p>

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