Abstract
Background: Varicocele is an abnormal dilation and tortuosity of the internal spermatic veins within the pampiniform plexus veins draining the testicle. The principle of varicocele treatment is to block the reflux in the internal spermatic vein while preserving the internal spermatic artery, lymphatics and vas deferens. Treatment can be performed through percutaneous venous embolization or surgical correction, either open or laparoscopic approach. The purpose of the study was to review our experience in the management of laparoscopic varicocele repair and to assess the outcomes after operation. Methods: We retrospectively reviewed files of patients who underwent laparoscopic varicocelectomy from January 2010 to December 2009 in three health center of Yaoundé (Cameroon). Clinical and diagnosis features of varicocele, indication for surgery, operative procedure and outcomes, as well as long-term follow-up of were analyzed. Results: A total of 74 file of patients were collected. The average age of patients was 36.93 years old. Among them, 43 (58.11%) had varicocele grade 1, 21 (28.38%) grade 2, and 2 (2.70%) grade 3. Fifty-four (72.97%) cases had bilateral varicocele, 17 (22.97%) and 3 (4.05%) patients had left and right varicocele respectively. 42(56.7%) patients complained for fertility problem. Scrotal pain was found in 26 (35.13%) cases. The pneumoperitoneum was achieved in all cases through a supra-umbilical open coelioscopy with the insertion of a 10 mm-optic port. Two 5 mm working ports were used in all cases. Dilated veins were clipped without section simple in 56 cases (75.68%). the mean operative time was 31.9 min ± 8.6 min. With a mean follow-up period of 27 months, we recorded 4.05% of recurrence and hydrocele in 1 case (1.35%), symptoms’ regression in 87% of cases and pregnancy in 65.9% of cases of infertility. Conclusion: Laparoscopic varicocelectomy is feasible and safe in our setting, with good results. We emphasize this approach in even in low setting like our own.
Highlights
Varicocele is an abnormal dilation and tortuosity of the internal spermatic veins within the pampiniform plexus veins draining the testicle
We retrospectively reviewed files of patients who underwent laparoscopic varicocelectomy from January 2010 to December 2009 in three health center of Yaoundé (Cameroon)
We present our experience and outcomes of laparoscopic varicocelectomy in three health structures in Yaoundé, Cameroon
Summary
Varicocele is an abnormal dilation and tortuosity of the internal spermatic veins within the pampiniform plexus veins draining the testicle It can result in testicular discomfort, atrophy, infertility, and possibly hypogonadism [1]. The laparoscopic varicocele, introduced by Sanchez-de-Badajoz et al in 1990 utilises a transperitoneal intra-abdominal approach, which offers several advantages including increased efficiency for bilateral surgery and relatively short operating times [3]. This approach is an intra-abdominal procedure and carries a small added risk for complications, e.g. visceral injury from trocar placement [3]. With a mean follow-up period of 27 months, we recorded 4.05% of recur-
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