|
|
Varicocele
>> surgical options
What
are the surgical options?
| Surgical
approach |
Cost |
Recurrence
of varicocele |
Improvement
in Semen |
Potential
for Morbidity |
| 1. Paloma's
(Retroperitoneal open approach) |
++ |
Yes |
20% to
30% |
No |
| 2. Laparoscopic
approach |
+++
Costly
|
Yes.
Very high recurrence rate. |
20% |
Serious
morbidity possible.
No proven benefit. |
| 3. Microsurgical
Trans Inguinal approach |
+++ |
No |
40% to
50% |
No |
| 4. Radiological
balloon occlusion approach |
++++ |
Maybe |
30%
to 40% |
No |
| 5. Cremasteric disruption with venous ligation |
+ |
Nil |
97%
improvement in Semen.
Pregnancy rates observed by Dr. Parag
Shah
64% pregnancy rate at one year
80% pregnancy rate at 2 years.
|
No.
Low cost, ambulatory (walk-in, walk-out from operating table)
High success rate. |
Conclusions
- The higher
the approach, the higher the incidence of recurrence and low fertility
rates.
- Laparoscopic
Approach: Costly. Has potential for serious morbidity.
|
