Fast Five Quiz: Test Your Knowledge of Varicoceles

Bradley Schwartz, DO

Disclosures

March 06, 2018

Injury to the testicular artery has been reported in 0.9% of microsurgical varicocele repairs. This incidence may be higher when optical magnification is not used for varicocele repair. Because the testis typically has additional arterial supplies from the vasal and cremasteric arteries, testicular atrophy is uncommon after division of the testicular artery. Smaller atrophic testes may be at greater risk for accidental testicular artery injury because of the smaller size of the artery in these cases.

Hydrocele formation is the most common complication of varicocelectomy and most likely results from lymphatic obstruction. An effort to spare lymphatics intraoperatively with the laparoscopic approach has been shown to result in lower hydrocele rates. Inguinal, retroperitoneal, and laparoscopic ligations carry a postoperative hydrocele risk of less than 10%; embolization is very infrequently associated with hydrocele formation.

In a large multicenter analysis of complications and recurrence after treatment of varicocele in young (<19 years) men, Lurvey and colleagues found that the retreatment rate was significantly higher with percutaneous embolization than with either open or laparoscopic varicocelectomy and that open and laparoscopic varicocelectomy did not differ significantly from each other with regard to retreatment rate and hydrocele formation.

For more on complications associated with surgical treatment of varicocele, read here.

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