title: 'Preemptive hydrocelectomy' in subinguinal varicocelectomy.
abstract: OBJECTIVE
  The hydrocele rate is very low after microsurgical subinguinal varicocelectomy, but microsurgical expertise is not always available in pediatric centers. We describe a modified technique to reduce the hydrocele rate after subinguinal varicocelectomy performed without an operating microscope.
  
  
  METHODS
  A retrospective review was performed of 142 non-microsurgical subinguinal varicocelectomies performed at a single pediatric center. In 96 patients, varicocelectomy was combined with the excision and eversion of the tunica vaginalis ('pre-emptive hydrocelectomy') while in the remaining 46 cases the vaginalis was left untouched.
  
  
  RESULTS
  Pre-emptive hydrocelectomy allowed a significant reduction in the hydrocele rate in comparison to cases in whom the vaginalis was left untouched, hydrocele rate 4.3 vs. 13% (p = 0.04). In patients undergoing preemptive hydrocelectomy, hydrocele occurred in 3 of 54 (5.5%) cases in whom the vaginalis was only excised and only 1 of 42 (2.4%) in whom it was also everted. No testicular complications were observed.
  
  
  CONCLUSIONS
  In centers performing subinguinal varicocelectomy without the aid of an operating microscope, pre-emptive hydrocelectomy with eversion of the vaginalis might be offered as an adjunctive treatment with limited associated morbidity that might be able to reduce the incidence of postoperative hydrocele.
authors.affiliation: Department of Pediatric Surgery, University of Palermo, Palermo, Italy. marcocastagnetti@hotmail.com
authors.forename: Marco
authors.initials: M
authors.lastname: Castagnetti
authors.forename: Marcello
authors.initials: M
authors.lastname: Cimador
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: DiPace
authors.forename: Pieralba
authors.initials: P
authors.lastname: Catalano
authors.forename: Enrico
authors.initials: E
authors.lastname: DeGrazia
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D008297:Male; D008866:Microsurgery; D010372:Pediatrics / Q000379:methods; D012189:Retrospective Studies; D006848:Testicular Hydrocele / Q000517:prevention & control* / Q000601:surgery*; D013519:Urogenital Surgical Procedures / Q000379:methods*; D014572:Urology / Q000379:methods; D014646:Varicocele / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*