Laparoscopic varicocelectomy in children and adolescents, advantages and surgical outcomes

ABSTRACT

Varicocele occurs in approximately 16.2% of school boys aged 10-19 yrs old, an incidence that is similar to that in the adult male population. There is general acceptance for surgical treatment of varicocele in children and adolescents. However, specific indications for varicocelectomy in children and adolescents are controversial. Open surgery using different techniques has been the usual procedure. However, with the general trend towards less-invasive operating techniques, laparoscopic varicocelectomy has had an increasing acceptance in the last years and is sometimes even demanded by the parents. Seventeen children under went laparoscopic treatment of varicocele in the pediatric surgical department of Cairo University Children Hospital. The diagnosis of varicocele was based on physical examination, scrotal ultrasonography and color Doppler evaluation. The spermatic artery was separated from the venous plexus in all patients. On follow-up, symptoms of patients, clinical examination including testis size and the presence of varicocele were evaluated. Color Doppler ultrasonography studies were performed by an experienced radiologist. The children ages ranged between 9.3 and 14.5 years [median age, 13.1 yrs]. One patient had a relapse [slight reflux on Valsalva's maneuver after surgery]. One patient developed reactionary hydrocele postoperatively which resolved spontaneously. The general incidence of complications in this series was 2 out of 17 patients [11.8%]. This preliminary study confirms that laparoscopic internal spermatic veins clipping and division is a simple, safe, effective, procedure for varicocele repair