Abstract
The adolescent varicocele remains a controversial issue in pediatric urology. In our institution, the indications for intervention are primarily the findings of a varicocele with ipsilateral testicular hypotrophy and less commonly for symptoms. Therapeutically, the patient and his family are counselled in depth regarding the conflicting data surrounding varicoceles and their management and then offered the options of surveillance (knowing that fertility potential cannot be reliably measured in this age group), radiologic embolization, or open surgical correction using a high Palomo technique or a microscopic subinguinal method. The majority of this author’s patients, however, choose the laparoscopic approach to the Palomo high ligation of the spermatic vessels. The primary reasons why patients and families make this choice are due to its high success, minimal morbidity, virtually no scars, and, most importantly, because it allows rapid return to full activity. Success rates are excellent (>99 %) and recurrence rates are very low. De novo ipsilateral hydrocele formation is a potential complication that may require further intervention and must be disclosed during preoperative counselling but, in long-term follow-up, has only been necessary in 2–3 % of adolescents undergoing this technique. Testicular atrophy or loss has not occurred in our hands.
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Gleason, J.M., Koyle, M.A. (2014). Laparoscopic Varicocelectomy. In: Godbole, P., Koyle, M., Wilcox, D. (eds) Pediatric Endourology Techniques. Springer, London. https://doi.org/10.1007/978-1-4471-5394-8_19
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DOI: https://doi.org/10.1007/978-1-4471-5394-8_19
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