Laparoscopic Palomo varicocelectomy in the adolescent is safe after previous ipsilateral inguinal surgery

• Published in: BJU international 2002-02, Vol.89 (3), p.269-272
• Main Authors: Barqawi, A., Furness, P., Koyle, M.
• Format: Article
• Language: English
• Subjects: adolescence; Adolescent; Adult; Biological and medical sciences; Child; Collateral Circulation - physiology; Gynecology. Andrology. Obstetrics; Humans; inguinal; Inguinal Canal - surgery; laparoscopy; Laparoscopy - methods; Male; Male genital diseases; Medical sciences; Non tumoral diseases; Postoperative Care - methods; Retrospective Studies; Second-Look Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the genital tract and mammary gland; Testis - blood supply; Treatment Outcome; varicocele; Varicocele - physiopathology; Varicocele - surgery
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1046/j.1464-4096.2001.01623.x

Objective To evaluate the outcome of laparoscopic Palomo varicocelectomy (LPV) in young boys who had undergone previous ipsilateral inguinal surgery (in whom potentially the arterial supply to the testicles may be compromised) in an attempt to assess its safety for the collateral vascular supply in such cases. Patients and methods Over a 5‐year period (1995–2000) 44 patients underwent LPV, where both the spermatic artery and vein were ligated high above the internal ring. Thirteen patients had undergone previous ipsilateral inguinal surgery, which included inguinal hernia repairs in five, orchidopexy in two, communicating hydrocele repair in three and previous varicocele repair in three. All patients were followed clinically at 3 months and 1 year after surgery. Results There were no complications related to laparoscopy or varicocele ligation. No patient developed ipsilateral testicular atrophy; moreover the testis size remained stable or was associated with compensatory growth in all patients. Conclusion Previous inguinal surgery involving the ipsilateral testicle does not appear to affect the collateral blood circulation to the affected testis in boys who undergo LPV mass ligation of the internal spermatic vein and artery. LPV for varicocele is safe in boys who have undergone previous inguinal surgery, suggesting that an adequate collateral blood supply is present.