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Lee, Paick, and Kim: Microsurgical Subinguinal Varicocelectomy: Comparison of Pediatric and Adult Patients
Original Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(11): 1029-1034.

Published online: 30 November 2008

DOI: https://doi.org/10.4111/kju.2008.49.11.1029

Microsurgical Subinguinal Varicocelectomy: Comparison of Pediatric and Adult Patients

Jeong Woo Lee, Jae-Seung Paick, Soo Woong Kim

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

swkim@snu.ac.kr

Received 17 July 2008       Accepted 25 August 2008

Copyright © 2008 The Korean Urological Association

Abstract

Purpose

We compared the intraoperative microanatomy, recurrence rate and complications of the pediatric and adult patients with varicocele and who underwent microsurgical subinguinal varicocelectomy and who were followed for at least 6 months.

Materials and Methods

Twenty-seven boys (mean age: 13.2 years) and 31 men (mean age: 27.8 years) underwent left microsurgical subinguinal varicocelectomy with delivery of the testis and they were prospectively evaluated. During the surgery, the detailed intraoperative microanatomy of the spermatic cord and gubernacula was recorded for each group and then compared.

Results

External spermatic and gubernacular veins greater than 2mm were significantly more common in the adult group compared to the pediatric group (35.5% vs. 7.4%, 71.0% vs. 29.6%, respectively). Multiple internal spermatic arteries (more than two) were identified in 63.0% of the boys and in 58.1% of the men. In most cases, the internal spermatic arteries were surrounded by a dense complex of adherent veins. There were no significant differences between the pediatric and adult groups for the number of preserved lymphatics (4.6 vs. 5.3, respectively), the ligated internal spermatic veins (8.9 vs. 9.3, respectively), the preserved cremasteric arteries (1.4 vs. 1.7, respectively) and the ligated cremasteric veins (2.3 vs. 2.6, respectively). The mean operative times were 95.6 minutes for the pediatric group and 93.5 minutes for the adult group (p>0.5). During the follow-up period there were no cases of persistent or recurrent varicocele.

Conclusions

Microsurgical subinguinal varicocelectomy was an equally safe, effective means of treating varicoceles both in children and adults. The surgical microanatomy was not much different in the two groups.

Keywords: Varicocele, Pediatrics, Operative procedures

Figures and Tables

Table 1
The patients' characteristics
kju-49-1029-i001

Data are expressed as mean±SD

Table 2
Evaluation of the intraoperative varicocele anatomy
kju-49-1029-i002

Data are expressed as mean±SD. *: statistical analysis by linear by linear test, †: statistical analysis by Mann-Whitney U test

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