Korean J Urol.  2006 Oct;47(10):1086-1092. 10.4111/kju.2006.47.10.1086.

Surgical Repair of Varicocele: a Comparative Study of the Retroperitoneal Approach of Palomo, the Modified Palomo Technique and the Microsurgical Inguinal Approach of Ivanisseivich's Technique

• Shin JH
• Lim JS

• KMID: 2139810
• DOI: http://doi.org/10.4111/kju.2006.47.10.1086

Abstract

PURPOSE: We wanted to compare our experience and results with three different methods of treatment for varicocele.
MATERIALS AND METHODS
Between January 1995 and December 2005, 154 patients with varicocele were retrospectively assigned into three groups according to the method of treatment. Group 1 included 73 patients who were treated by the retroperitoneal approach of Palomo's technique. Group 2 consisted of 37 patients who were treated by the retroperitoneal approach and who also underwent the internal spermatic artery preserving technique, and in group 3, 44 patients were treated by the microscopic inguinal approach of Ivanissevich's technique. We analyzed the operation time, recurrence, complications, the effect of surgical treatment and the results according to the surgical techniques.
RESULTS
The mean operative time of group 3 was significantly longer among the three groups. The recurrence rate at follow-up was not significantly different among the three groups. The recurrence rate increased progressively with the increase of varicocles size from grade I to grade III for all the groups. The overall incidence of postoperative complications was significantly lower among the patients in group III. The postoperative spermiogram showed an increase in motility and sperm count for all the groups. There were no differences in the three techniques for resolution of pain, the duration of recovery and the spermiogram results.
CONCLUSIONS
There was no significant difference in the rate of relapse after the surgery between the three different treatment techniques, and the factors involved in relapse were more related to the size and severity of the varicocele. Microsurgical varicocelectomy had a disadvantage of a prolonged operation time. However, there was a low rate of postoperative complications for all three techniques.

Keyword

Varicocele; Palomo technique; Modified Palomo technique; Microsurgical varicocelectomy

MeSH Terms

Arteries
Follow-Up Studies
Humans
Incidence
Operative Time
Postoperative Complications
Recurrence
Retrospective Studies
Sperm Count
Varicocele*

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