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Surgical Endoscopy
Published in: Surgical Endoscopy 1/2007

01-01-2007 | Original Article

Treatment of varicocele with reference to age: a retrospective comparison of three minimally invasive procedures

Authors: S. Beutner, M. May, B. Hoschke, C. Helke, M. Lein, J. Roigas, M. Johannsen

Published in: Surgical Endoscopy | Issue 1/2007

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Abstract

Background

This study investigated whether the therapeutic efficacy and morbidity of three minimally invasive techniques for varicocele correction—laparoscopic varicocelectomy (LV), antegrade sclerotherapy (AS), and retrograde embolization (RE)—differed between children and adults.

Methods

During a 10-year period, 356 procedures for varicocele correction, including 122 cases of LV, 108 cases of AS, and 126 cases of RE, were performed for 314 patients at our institution. Of these patients, 223 were 19 years of age or younger (group 1), and 133 were older than 19 years (group 2). Diagnosis and postoperative results were established clinically and with the use of Doppler ultrasonography. The failure rates and complications for each procedure were retrospectively evaluated and compared between the two age groups.

Results

The median follow-up period was 69 months (range, 6–122 months). For 25 patients (19.8%), RE was not feasible for technical reasons. In both groups, LV had a lower failure rate than AS or RE, but the difference between LV and AS was not significant in group 1 (7.7(% vs 11.9%; p > 0.5). Also in group 1, AS was associated with fewer complications than LV 1 (4.5% vs 15.4%; p < 0.05). In group 2, LV was significantly more effective in correcting varicoceles than the other two techniques (p < 0.01). In this group, the complication rates for all three procedures did not differ significantly (p > 0.05).

Conclusions

In our experience, LV was more effective than AS or RE in correcting varicoceles. For children and adolescents, AS may be more indicated because of the slightly lower complication rate and similar recurrence rates, as compared with LV, for this age group. The higher incidence of postoperative hydrocele formation after LV warrants more refined techniques such as the lymphatic-sparing approach.
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Metadata
Title
Treatment of varicocele with reference to age: a retrospective comparison of three minimally invasive procedures
Authors
S. Beutner
M. May
B. Hoschke
C. Helke
M. Lein
J. Roigas
M. Johannsen
Publication date
01-01-2007
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 1/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0684-6

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