Treatment of bilateral varicocele and other scrotal comorbidities using a single scrotal access: our experience on 34 patients.

F Iacono,E Illiano,A Ruffo,G Di Lauro,S Sansalone,G Romeo,D Prezioso,L Romis

doi:10.1155/2014/403603

Abstract

Introduction. Varicocele is the main cause of infertility in male and the most correctable cause of it too. In this study, we present our experience on 34 patients affected by bilateral varicocele and other scrotal comorbidities treated underwent surgery with a scrotal access. Materials and Methods. 34 patients were enrolled with clinical palpable and infraclinical (ultrasonic doppler scanning) bilateral varicocele and other comorbidities like right hydrocele, left hydrocele, bilateral hydrocele, and epididymal cyst. They all underwent scrotal bilateral varicocelectomy under local anesthesia. Results and Discussion. At 6 months, no other complications were reported. No case of testicular atrophy was observed. None had recurrence of varicocele. All scrotal comorbidities were treated as well. Conclusion. Scrotal access with local anesthesia is a safe and useful technique to treat patients with bilateral varicocele and other scrotal comorbidities.

Highlights

Varicocele is the main cause of infertility in male and the most correctable cause of it too
We present our experience on 34 patients affected by bilateral varicocele and other scrotal comorbidities treated underwent surgery with a scrotal access
Materials and Methods. 34 patients were enrolled with clinical palpable and infraclinical bilateral varicocele and other comorbidities like right hydrocele, left hydrocele, bilateral hydrocele, and epididymal cyst

Summary

Introduction

Varicocele is a common abnormality with the following andrological implications: failure of ipsilateral testicular growth and development, symptoms of pain and discomfort, male infertility. Varicoceles are recognized as the most common surgically correctable cause of male infertility, but the exact mechanism of varicocele-induced impairment of spermatogenesis remains a matter of debate. The exact association between reduced male fertility and varicocele is unknown, but a metaanalysis showed that semen improvement is usually observed after surgical correction [4]. Varicocele is associated with increased sperm DNA damage, and this sperm pathology may be secondary to varicocele-mediated oxidative stress. Varicocelectomy can reverse this sperm DNA damage, as shown in several studies [5]. No specific recommendations exist as to the optimal surgical technique for varicocelectomy, the use of magnification to preserve lymphatics and testicular arteries is recommended. By the way we think that scrotal access is useful in the management of bilateral varicocelectomy in order to avoid two surgical incisions [10] and it can be a valid technique when there are other scrotal comorbidities to be treated

Materials and Methods

Results and Discussion

Conclusions