V1589 MICROSURGICAL SUBINGUINAL VARICOCELECTOMY

Abstract

You have accessJournal of UrologyInfertility, Sexual Dysfunction and Testis1 Apr 2013V1589 MICROSURGICAL SUBINGUINAL VARICOCELECTOMY Paymon Nourparvar, Lindsey Herrel, and Wayland Hsiao Paymon NourparvarPaymon Nourparvar Atlanta, GA More articles by this author , Lindsey HerrelLindsey Herrel Atlanta, GA More articles by this author , and Wayland HsiaoWayland Hsiao Atlanta, GA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3139AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Varicoceles are found in 40% of men with primary infertility and in up to 70-81% of men with secondary infertility. Varicocelectomy improves testicular function and may halt the accelerated decline in sperm parameters and testosterone levels seen in men with varicoceles. METHODS In this video, we demonstrate our approach to the microsurgical subinguinal varicocelectomy. Hydrodissection is useful in identifying and isolating the testicular artery. We then repeatedly run the spermatic cord and ligate cremaster veins until only deferential veins remain. With testicular delivery, external spermatic and gubernacular veins are ligated. RESULTS We effectively demonstrate our approach for microsurgical subinguinal varicocelectomy with testicular delivery. All internal spermatic veins are ligated with sparing of testicular arteries and lymphatic vessels. Cremaster veins are ligated and cremaster arteries are also identified and spared. Finally, delivery of the testis allows visualization and ligation of external spermatic veins as well as gubernacular veins. With the conclusion of testicular delivery, all venous return is through the deferential veins. CONCLUSIONS Microsurgical subinguinal varicocelectomy is a successful surgical approach in managing varicoceles, both in the setting of infertility and of chronic pain associated with varicoceles. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e652 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paymon Nourparvar Atlanta, GA More articles by this author Lindsey Herrel Atlanta, GA More articles by this author Wayland Hsiao Atlanta, GA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...