Lymphatic preservation using methylene blue dye during varicocele surgery: a single-center retrospective study.
OBJECTIVE
Hydrocele and testicular edema caused by division of lymphatic vessels during varicocelectomy could lead to decrease in testicular function. In-vivo methylene blue mapping of testicular lymphatic vessels should prevent damage to the lymphatic system.


METHODS
We retrospectively compared outcomes for 46 patients who received an intraparenchymal injection of 0.25 ml of vital dye (isosulphan blue) before a laparoscopic or an inguinal/subinguinal spermatic vein ligation with 93 controls in whom no mapping technique was adopted.


RESULTS
Methylene blue mapping of testicular lymphatics reduced the incidence of postvaricocelectomy hydrocele from 6.4% (6/93) to 2.1% (1/46); the incidence of hydrocele was 0% in all cases of successful lymphatic mapping.


CONCLUSIONS
Mapping of testicular lymphatic drainage with intraparenchymal vital dye is an easy, safe, rapid and cost-free technique. We stress the importance of sparing the lymphatic system to ensure the best andrological outcome.
D'Alessio
A
A
Department of Pediatric Surgery, A.O. Ospedale Civile di Legnano, Legnano, Italy. antonio.dalessio@ao-legnano.it
Piro
E
E
Beretta
F
F
Brugnoni
M
M
Marinoni
F
F
Abati
L
L
D000293:Adolescent; D002648:Child; D004487:Edema / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008208:Lymphatic System / Q000033:anatomy & histology* / Q000378:metabolism / Q000601:surgery; D008297:Male; D008751:Methylene Blue / Q000493:pharmacokinetics; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D006848:Testicular Hydrocele / Q000453:epidemiology / Q000517:prevention & control*; D014646:Varicocele / Q000601:surgery*
D008751:Methylene Blue