Varicocele surgery: 10 years of experience in two pediatric surgical centers.

Abstract

AIM:

The study was designed to compare recurrence rates and complications after laparoscopic versus open varicocele surgery in children.

SUBJECTS AND METHODS:

A retrospective case-note review of all varicocele surgery over a 10-year period (April 1999-March 2009) in two pediatric surgical centers was performed. Multivariate analysis using logistic regression was performed using SPSS Statistics version 18 (SPSS Inc., Chicago, IL).

RESULTS:

Thirty-seven patients had varicocele surgery during the study period. The median age at surgery was 14 years (range, 11-16 years). Most children had left-sided Grade 2 varicocele. Twenty-five (68%) primary procedures were laparoscopic (17 artery-sparing), and 12 (32%) procedures were open (9 artery-sparing). Six (16%) children had recurrence, and 6 (16%) had postoperative hydrocele. Recurrence rates after laparoscopic (16%) and open (17%) surgery were similar. Increasing age significantly decreased recurrence (odds ratio, 0.373; 95% confidence interval 0.161-0.862; P = .021). Although laparoscopy was associated with higher rates of postoperative hydrocele (odds ratio, 2.817; 95% confidence interval, 0.035-3.595; P = .380) and artery-sparing ligation was associated with higher rates of recurrence (odds ratio, 2.667; 95% confidence interval, 0.022-4.235; P = .787), these associations were not statistically significant.

CONCLUSIONS:

The best results of varicocele surgery in terms of recurrence and postoperative hydrocele were achieved by open mass ligation; however, larger prospective studies are warranted.

• Authors: Anindya Niyogi, Shalini Singh, Azrina Zaman, Ayesha Khan, Cezar Nicoara, Munther Haddad, Nicholas Madden, Simon A Clarke, Azad Mathur, Thomas Tsang, Milind Kulkarni, Ashish Minocha, Diane DeCaluwé
• Journal: Journal of laparoendoscopic & advanced surgical techniques. Part A (J Laparoendosc Adv Surg Tech A) Vol. 22 Issue 5 Pg. 521-5 (Jun 2012) ISSN: 1557-9034 [Electronic] United States
• PMID: 22568541 (Publication Type: Comparative Study, Journal Article, Multicenter Study)

Topics

• Adolescent
• Ambulatory Surgical Procedures
• Child
• Humans
• Laparoscopy (adverse effects, methods, statistics & numerical data)
• Male
• Recurrence
• Retrospective Studies
• Testicular Hydrocele (etiology)
• Varicocele (surgery)