Varicocelectomy under local anesthesia

ABSTRACT

To assess the safety, efficacy and morbidity of subinguinal varicocelectomy performed under local anesthesia. Between May 2003 and May 2006, 47 patients underwent subinguinal varicocelectomy [30 bilateral and 17 unilateral]. All varicocelectomies were performed under local infiltrating anesthesia and intravenous sedation when needed. A transverse subinguinal approach was chosen and internal spermatic artery and lymphatics within the cord were spared with the aid of optical magnifying loop and irrigation with diluted warm papaverine. All varicocelectomies were performed on an outpatient basis. The average operative time was 37 +/- 13 minutes for unilateral cases and 58 +/- 13 minutes for bilateral cases. All patients were discharged 3 to 5 hours following surgery. No intraoperative complications occurred. Only 17 cases [36%] needed intravenous sedation during operation. At a mean follow up of 12 months, 2 patients [4.2%] developed mild to moderate hydrocele and 2 patients had recurrence of varicocele. No cases of testicular atrophy were observed. Semen parameters [sperm count, morphology and motility] significantly improved in all patients. Subinguinal varicocelectomy under local anesthesia is an attractive approach that allows varicocele ligation in a minimally invasive, effective way, and associated with rapid recovery, minimal morbidity and cost effective