Portal de Periódicos da CAPES

Review of current varicocelectomy techniques and their outcomes

2011; Wiley; Volume: 108; Issue: 7 Linguagem: Inglês

10.1111/j.1464-410x.2010.09959.x

1464-410X

Paul Diegidio, Jay Jhaveri, Suzanne M. Ghannam, Ruben Pinkhasov, Ridwan Shabsigh, Harry Fisch,

Testicular diseases and treatments

What’s known on the subject? and What does the study add? The relationship between varicocele and infertility is well established, and several surgical and radiological techniques for varicocelectomy are currently used in practice. The postoperative benefits of the surgery is also well established. The AUA has set forth guidelines on the evaluation and indications for treatment of varicocele; however, to date, there is no consensus as to which surgical technique should be considered the gold standard. This paper evaluates the current methods in practice and evaluates them based on specific and stringent criteria. All surgical and radiological methods that are frequently used were included. We suggest that by using either of the two microsurgical techniques, inguinal or subinguinal, that there would be better outcomes across all parameters postoperatively with better long term outcomes. We also investigated several new techniques and made recommendations for further research. OBJECTIVES To review all the various techniques and their results and efficiencies to provide practicing urologists with some guidance for choice of technique To discuss improvements of varicocelectomy techniques in the last 15 years and their impact on results of surgery. PATIENTS AND METHODS A PubMed English literature review of literature from 1995 to present. RESULTS Pregnancy rates were highest with microsurgical subinguinal technique Varicocele recurrence rates were lowest with microsurgical subinguinal technique Hydrocele formation rates were lowest with microsurgical inguinal technique Surgical complications were highest in the laparoscopic technique Varicocelectomy by itself or in conjunction with IVF is cost effective CONCLUSIONS Microsurgical subinguinal or microsurgical inguinal techniques offer best outcomes Varicocelectomy is a cost effective treatment modality for infertility Further research is needed to explore new developments in varicocelectomy