Abstract

The aim of this study was to report our long-term diagnostic and surgical outcomeduring the last 18 years, in paediatric and adolescent management ofvaricocoele. The present retrospective study enrols 374 patients observed at ourinstitution between 1994 and 2011. Patients were divided into three groups:Group A includes 142 youngsters and adolescents treated with open surgery forleft varicocoele, in which a pre-operative CDUS was not performed; Group Bincludes 65 patients treated with open surgery in which a pre-operative CDUSevaluation was carried out, to assess varicocoele haemodynamic pattern andtesticular volume. Group C includes 167 patients treated by laparoscopy andwith pre-operative CDUS assessment. For all groups post-operative follow-upconsisted of CDUS evaluation performed 1, 3, 6, 12 months after surgical treatment,than every year. Persistence ⁄ recurrence of varicocoele, testicular volumeand presence of hydrocele were evaluated. Recurrence rate was significativelyhigher in group A (11.2%) than B (no recurrence, p = 0.003) or C (no recurrence,p = 0.000). Post-operative hydrocele was not significantly observed overallin group A in 9.8% of cases (13% if tunica vaginalis was left untouched,4.2% if everted or resected p = 0.005), in group B in 3% and in group C in7.1% of cases (p = NS). In conclusion, open and laparoscopic surgery offerssimilar results. In our opinion, the key-point in paediatric and adolescent varicocoeleis not the surgical approach to use, but the exact diagnosis. CarefulCDUS evaluation is, in our opinion, a valid, safe, cost-effective and immediatetool to accurately detect all refluxing venous system and for achieving acomprehensive evaluation of the vascular anatomy of varicocoele in paediatricand adolescent age. Laparoscopic Palomo or open subinguinal microsurgicalvaricocelectomy offer similar results in terms of recurrence; meanwhile the useof a lymphatic sparing surgery with or without blue-dye is recommended toreduce post-operative hydroceles.international journal of andrology ISSN 0105-6263ª 2012
Lingua originaleEnglish
pagine (da-a)1-6
Numero di pagine6
RivistaInternational Journal of Andrology
Volume1
Stato di pubblicazionePublished - 2012

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Reproductive Medicine
  • Urology

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