Antegrade subinguinal sclerotization with temporary clamping of the spermatic cord: a new surgical technique for varicocele
Articolo
Data di Pubblicazione:
2011
Citazione:
Antegrade subinguinal sclerotization with temporary clamping of the spermatic cord: a new surgical technique for varicocele / M. Mancini, L. Carmignani, A. Agarwal, F. Ciociola, F. Pasqualotto, M.F. Castiglioni, G. Piediferro, G.M. Colpi. - In: UROLOGY. - ISSN 0090-4295. - 77:1(2011 Jan), pp. 223-226. [10.1016/j.urology.2010.02.028]
Abstract:
Objectives :
The purpose of our study was to evaluate the duration, effectiveness, and complications associated with a new operating technique for varicocele, using a subinguinal surgical approach and antegrade sclerotization of the spermatic veins.
Methods :
A total of 756 varicocele patients who came under our care for infertility underwent surgical treatment with our technique. The diagnosis was based on clinical examination and confirmed by color-Doppler ultrasound of the spermatic cord. Only patients with continuous basal reflux inside the left spermatic vein detected in orthostatism underwent operation. The Colpi technique was used, which consists of a subinguinal incision with suspension of the spermatic cord; cord clamping for 8-10 minutes using two elastic bands; and injection of 1.5-3 mL of sclerosing agent during induced ischemia without any intraoperative radiological control.
Results :
The average operating time was 25 minutes (range: 18-45 minutes). At the 3-month postoperative follow-up, there were 15 cases of persistent reflux (1.9%), 6 cases of hydrocele requiring surgical correction (0.7%), and 50 cases of fibrotic sequelae of penile lymphangiitis (6.6%).
Conclusions :
The new technique was more effective than the previous ones, with the exception of the microsurgical technique, which, however, takes 2-3 times longer to perform.
The only significant complication was superficial single-vessel lymphangiitis of the penis, which resolved within 3 months with no apparent consequences. In conclusion, this new operating technique for varicocele is simpler to perform and may be effective compared with other techniques.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Spermatic Cord; Adolescent; Adult; Constriction; Humans; Inguinal Canal; Male; Middle Aged; Sclerotherapy; Time Factors; Urologic Surgical Procedures, Male; Varicocele; Young Adult
Elenco autori:
M. Mancini, L. Carmignani, A. Agarwal, F. Ciociola, F. Pasqualotto, M. Castiglioni, G. Piediferro, G.M. Colpi
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