Focus on paediatric and adolescent varicocoele: a single institution experience.
Summary of "Focus on paediatric and adolescent varicocoele: a single institution experience."
The aim of this study was to report our long-term diagnostic and surgical outcome during the last 18â€ƒyears, in paediatric and adolescent management of varicocoele. The present retrospective study enrols 374 patients observed at our institution between 1994 and 2011. Patients were divided into three groups: Group A includes 142 youngsters and adolescents treated with open surgery for left varicocoele, in which a pre-operative CDUS was not performed; Group B includes 65 patients treated with open surgery in which a pre-operative CDUS evaluation was carried out, to assess varicocoele haemodynamic pattern and testicular volume. Group C includes 167 patients treated by laparoscopy and with pre-operative CDUS assessment. For all groups post-operative follow-up consisted of CDUS evaluation performed 1, 3, 6, 12â€ƒmonths after surgical treatment, than every year. Persistence/recurrence of varicocoele, testicular volume and presence of hydrocele were evaluated. Recurrence rate was significatively higher in group A (11.2%) than B (no recurrence, pâ€ƒ=â€ƒ0.003) or C (no recurrence, pâ€ƒ=â€ƒ0.000). Post-operative hydrocele was not significantly observed overall in group A in 9.8% of cases (13% if tunica vaginalis was left untouched, 4.2% if everted or resected pâ€ƒ=â€ƒ0.005), in group B in 3% and in group C in 7.1% of cases (pâ€ƒ=â€ƒNS). In conclusion, open and laparoscopic surgery offers similar results. In our opinion, the key-point in paediatric and adolescent varicocoele is not the surgical approach to use, but the exact diagnosis. Careful CDUS evaluation is, in our opinion, a valid, safe, cost-effective and immediate tool to accurately detect all refluxing venous system and for achieving a comprehensive evaluation of the vascular anatomy of varicocoele in paediatric and adolescent age. Laparoscopic Palomo or open subinguinal microsurgical varicocelectomy offer similar results in terms of recurrence; meanwhile the use of a lymphatic sparing surgery with or without blue-dye is recommended to reduce post-operative hydroceles.
Department for Mother & Child Care, Pediatric Urology, UniversitÃ di Palermo, Palermo, Italy.
This article was published in the following journal.
Name: International journal of andrology
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22709244
- DOI: http://dx.doi.org/10.1111/j.1365-2605.2012.01283.x
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