Microsurgical treatment of varicocele

  • A varicocele is a vascular lesion characterized by dilatation of the spermatic veins due to valvular malfunction. It affects approximately 15% of adult males and predominantly appears on the left side (90%) and the rest are bilateral (10%). Unilateral right sided varicoleles are extremely rare.

The most frequent symptoms secondary to this dilatation are:

  • The appearance of a mass similar to “bag of worms” on the top of the scrotal sac.
  • Pain or scrotal discomfort when standing (less frequent).

The diagnosis is made mainly through a good clinical examination and can be confirmed with a scrotal ultrasound. In the diagnosis of a clinical varicocele and in the case of fertility desire, a seminogram is performed to evaluate sperm quality.

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    • The main indications for the treatment of a varicocele are: pain (rarely), reduced testicular size or infertility. Currently, the main techniques used to treat varicocele are the following:

      • Sclerotherapy/embolization: percutaneous occlusion of the affected spermatic veins. Due to its high rate of relapse, it has a very limited indication.
      • Surgery: spermatic vein ligation.

       

    • Open or laparoscopic retroperitoneal varicocelectomy (high): the ligation of the main gonadal vein is performed at the abdominal level.
    • Subinguinal microsurgery varicocelectomy (low): the selective ligation of the pampiniform plexus veins is performed at the level of the inguinal cord with a microscope, with respect to the testicular artery. Currently, it is considered as the “gold standard” technique, with a lower incidence of recurrences, better results in seminal parameters and pregnancy and a lower rate of complications. It requires widespread micro-surgical experience and the use of magnifying glass or surgical microscope.

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933 933 123 

 622 811 373

contacto@andrologiabarcelona.com

Teknon Andrologia Barcelona 

C/ Vilana, 12 (Edificio Vilana, Despacho 123)
08022 Barcelona

(Centre Mèdic Teknon)