Abstract
Introduction. Varicocele is detected in 15% of healthy men, in 35% – with primary and in 80% – with secondary infertility. At the moment, microsurgical varicocelectomy by sub-inguinal access is one of the most effective ways to treat varicocele in adult patients. Currently, there is no comprehensive data on the optimal treatment of varicocele recurrence. According to Russian clinical guidelines, testicular vein thrombosis is an extremely rare cause of varicocele development in the practice of a urologist. Material and methods. From November 2018 to February 2023, 118 patients were operated on for varicose veins of the scrotum organs. For all patients with the underlying disease, surgical aid was performed in the amount of micro-surgical subinguinal dissection of the testicular veins from the affected side (sides), or Marmara surgery. Results. The average duration of the operation was 46±11.3 minutes. In all the subjects, the period of hospitalization did not exceed one day. Complications in the postoperative period (according to the Cavien-Dindo scale) were not detected in any of the patients. The severity of the pain syndrome was determined by the VAS scale, and amounted to 0.78 ± 0.6 points. The average dose of non–narcotic analgesics (ketorolac, single dose – 30 mg) was 7.38 ± 3.63 mg. Recurrence of varicocele after microsurgical subinguinal dissection of testicular veins was recorded in 1.7% of patients. Conclusions. Marmara surgery is an effective method of surgical treatment of varicocele in spontaneous thrombosis. Recurrence of varicocele after microsurgical sublingual dissection of the testicular veins was recorded in 1.7% of patients. Spontaneous thrombosis of the branch of the testicular vein is a rare etiological factor of varicocele. The Marmara operation is an effective method of surgical treatment of varicocele with spontaneous thrombosis of the testicular vein.
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