The Management of Varicocele by Microdissection of the Spermatic Cord via a Low Inguinal Approach (Goldstein procedure =Modified Marmar Procedure)

Choi, Dong Sik; Ahn, Moo Sik

Abstract

Several different techniques have been utilized for the correction of a varicocele. Urologists have operated by high ligation of the internal spermatic veins via an inguinal or retroperitoneal approach. Radiologists have embolized or sclerosed these veins by percutaneous venography. Recently, microsurgeons have diverted the internal spermatic veins. Although classical procedures for the varicocele have been used successfully to eliminate retrograde blood flow, improved techniques seen desirable because a growing list of unwanted effects have been cited in associations with these procedures. In this report, we describe a new technique(Goldstein microsurgical technique) for the management of varicoceles which combines microdissection of the cord, ligation of all the tributaries of internal spermatic vein. complete control of collateral and small cross collateral veins except the vasal vein via a low inguinal approach.