Is adolescent varicocelectomy safe after previous inguinal surgery?

Solomon L. Woldu, Jason P. Van Batavia, Stephen A. Poon, Peter M. Raimondi, Kenneth I. Glassberg

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Purpose: Varicocelectomy after previous inguinal surgery poses a potential risk of testicular volume loss. To assess the extent to which varicocelectomy can be done without the complication of ipsilateral testis atrophy we present outcomes in adolescent patients with a history of inguinal surgery who underwent ipsilateral varicocelectomy. Materials and Methods: We retrospectively reviewed patient data from a single urologist practice. Testicular volume was recorded preferentially by ultrasound or, when unavailable, by ring orchidometry. Testicular asymmetry was calculated using the formula, [(right testis volume - left testis volume)/right testis volume] × 100. Symmetry was defined as less than 10% asymmetry. Catch-up growth was defined as resolution of asymmetry. Results: We identified 22 adolescent patients who fit study criteria. The patients underwent a total of 25 varicocelectomies since 3 underwent bilateral repair after previous bilateral inguinal surgery. Initial inguinal surgery included inguinal herniorrhaphy, hydrocelectomy and orchiopexy. Varicocelectomy was done laparoscopically in 17 cases and via open technique in 8 with variations in preservation/sacrifice of the lymphatics and artery. Median ± SD followup was 24.2 ± 18.2 months. After varicocelectomy mean testicular asymmetry decreased from 27.6% to 10.5%. There was no incidence of testicular atrophy postoperatively. The incidence of catch-up growth was 43% with no difference between the artery sparing and the nonartery sparing technique. Conclusions: Varicocelectomy with a history of previous inguinal surgery is safe and provides a significant incidence of testicular catch-up growth. Artery sparing vs sacrificing technique did not make a difference in terms of catch-up growth.

Original languageEnglish (US)
Pages (from-to)1716-1721
Number of pages6
JournalJournal of Urology
Volume184
Issue number4 SUPPL.
DOIs
StatePublished - Oct 2010
Externally publishedYes

Keywords

  • hernia
  • orchiopexy
  • testicular hydrocele
  • testis
  • varicocele

ASJC Scopus subject areas

  • Urology

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    Woldu, S. L., Van Batavia, J. P., Poon, S. A., Raimondi, P. M., & Glassberg, K. I. (2010). Is adolescent varicocelectomy safe after previous inguinal surgery? Journal of Urology, 184(4 SUPPL.), 1716-1721. https://doi.org/10.1016/j.juro.2010.03.123