Duplex study of blood flow through spermatic cord vesseis before and after laparoscopic varicocelectomy

ABSTRACT

This study was carried out to evaluate blood flow through spermatic cord vessels by color Doppler sonography before and after laparoscopic varicocelectomy. Between December 2000 and 2001, 34 male patients with primary varicocele were included in this study. They underwent laparoscopic varicocelectomy. A preoperative duplex study was performed in all cases to assess the presence of reflux in spermatic cord veins, arterial pulsation and size of veins; 8 patients had bilateral varicoceles, accordingly 42 spermatic cords were evaluated. These cases were divided into three groups Group I included 18 cases [mild varicoceles] with an estimated size of spermatic veins of 2.5-4 mm group II included 14 cases [moderate varicoceles] with an estimated size of spermatic veins of 4-5 mm and group III included 10 cases [large varicoceles] with an estimated size of spermatic veins of more than 5 mm. Laparoscopic varicocelectomy was done for all patients. Seven days postoperatively, another duplex was performed to determine the size of the spermatic veins. The study confirmed that laparoscopic varicocelectomy is effective in decreasing the size of cord veins in all cases, which was evaluated by Doppler sonography, as well as in preserving the artery. Laparoscopy is now a reliable and cost-effective alternative to open surgical procedures