765 COMPARATIVE IMPACT OF SEMINAL VESICAL INVASION VERSUS LYMPH NODE METASTASES ON SURVIVAL FOR PATIENTS FOLLOWING RADICAL PROSTATECTOMY

Abstract

reproductive system were excluded. Mean age was 37 y and mean follow-up postoperatively 19,6 months. In 5 patients (14%) the varicocele was bilateral and they were subjected to bilateral varicelectomy. In the rest of the patients (n 30, 86%) the laparoscopic procedure was unilateral–29 on the left side (83%) and 1 on the right side (3%). The grade of varicocele was 3 in 17 patients (48.5%), 2 in another 17 (48.5%) and 1 in 1 patient (3%). The mean pre-op visual analogue score (VAS), was 2.39 in the scale of 0-5, and in all patients fertility was not an issue. All patients were followed up at 3 months and bi-annually thereafter. RESULTS: After the operation 32 patients (91%) had significant improvement in (VAS), two had partial improvement (6%), and one had no change (3%). In our cohort we haven’t observed post-op worsening of the symptoms. Mean VAS score post-op at 3 months was 0.4. During the follow-up period we observed 4 recurrences (12%) with 2 re-do procedures, performed by inguinal approach. In 3 of these recurrences (75%) the improvement in pain symptoms was significant, and in 1 (3%) it remained unchanged even after the re-do procedure. We have observed two cases of wound infection (6%). Post operatively three cases (9%) of de novo developed hydroceles were observed. CONCLUSIONS: Laparoscopic varicocelectomy is a highly successful option for surgical treatment of varicocele in our cohort, with significant improvement of symptoms in approximately 90% of the patients and minimal complications. We feel that this high success rate can be attributed to the careful selection of patients and by excluding those with sharp radiating scrotal pain. Another factor that possibly contributes to these results is the fact that our cohort doesn’t include small subclinical varicoceles, although this was not explicit excluding criteria.